Four simple ways to fight fatty liver disease and slash your risk of early death

COVID-19 may be the only health crisis grabbing major headlines these days. But everyday illnesses—and chronic diseases—are still just as threatening as ever to our overall health and longevity, as I discuss on page 3.

Of course, I don’t need to remind you that our plates were already full well before the novel coronavirus showed up on the scene—both literally and figuratively.

In fact, the twin epidemics of diabetes and obesity have been crushing the public health for decades now. And in recent years, fatty liver has emerged to complete this lethal trifecta—which now threatens to strike Americans of all ages, slowly and steadily.

Fatty liver refers to a dangerous build-up of triglycerides in this organ. And aside from alcoholism, the leading cause of this condition is the excessive consumption of sugar (hence the term “non-alcoholic” fatty liver disease, or NAFLD).

This isn’t the first time I’ve addressed fatty liver here. And unfortunately, given the flood of ugly statistics out there, it probably won’t be the last.

Recent figures estimate that about one third of adults in Western countries—and a staggering 10 percent of children, even as young as two years old—now suffer from this silent condition.

Those numbers are frightening for various reasons… including a higher risk of diabetes and dementia. And now, new research shows that even a mild case of fatty liver can raise your odds of death dramatically.

NAFLD doubles your risk of death

A major study recently appeared in the journal Gut. And it revealed marked increases in death risk among patients with NAFLD.

Researchers compared more than 10,000 Swedish subjects with confirmed NAFLD diagnoses to matched controls from the general population. And they found that NAFLD was associated with higher mortality across the board—even in its earliest stages.

Cancer and cirrhosis accounted for most of this increase. (Meanwhile, heart-related deaths were relatively modest.) Nevertheless, NAFLD patients were nearly twice as likely to die of any cause—with actual risk varying according to the severity of their condition.1

But the real takeaway here is that even the mildest form of NAFLD—simply known as steatosis—posed a lethal threat. And it only got worse from there.

Before this gets too “doom and gloom” though, there IS some good news. In fact, when it comes to fatty liver disease, your fate is almost entirely in your own hands. And changing it for the better can be easier than you’d expect.

As usual, it starts with diet—and kicking sugar to the curb once and for all, specifically. But when it comes to fighting fatty liver, recent studies suggest that what you do eat may prove every bit as critical as what you don’t eat.

Fight fatty liver with broccoli

This won’t be the first (or last) time I tell you to eat your vegetables. But here’s a reminder of what strong medicine food can be: Researchers at Texas A&M recently found that a natural compound called indole—one of the main phytonutrients in cruciferous veggies—may help to fight NAFLD.2

This study looked at 137 Chinese subjects and found that participants with higher body mass indexes (BMIs) also tended to have lower levels of indole in their blood. Ultimately, obese subjects’ indole concentrations were significantly lower than lean subjects. But that’s not all.

Subjects with lower levels of indole also showed higher levels of fat deposits in their livers. And if these scientists’ lab experiments are any indication, that’s no coincidence.

Researchers used animal models to mimic fatty liver disease in mice, then treated them with indole. And results showed that this phytonutrient was able to decrease both liver fat accumulation and inflammation.

Further experiments on individual cells showed a similar pattern. Not only did indole slash fat in liver cells, but it also acted on intestinal cells responsible for sending out signals that silence inflammation.

In other words, cruciferous vegetables like broccoli—and cauliflower, kale, Brussels sprouts, etc.—deliver some pretty impressive health benefits. Especially alongside a hearty portion of your favorite protein…

High protein cuts liver fat in half

I’ve mentioned the benefits of high-protein, low-carb eating against fatty liver before. But one recent study, appearing in the journal Liver International, shed new light on some of the mechanisms at work.

Researchers assigned 19 obese people with NAFLD to follow either a reduced calorie, high-protein diet or a reduced calorie, low-protein diet for three weeks. They collected liver samples for analysis afterward. And the results speak for themselves…

Both groups of dieters lost just over ten pounds. But subjects who followed a high-protein diet cut their liver fat by roughly 40 percent—while the low-fat dieters didn’t benefit from any changes in liver fat at all.3

And this was no coincidence, either. Because an analysis of liver samples also showed that certain genes responsible for liver fat storage were less active in the high-protein dieters.

Of course, speaking of diets—you know I don’t subscribe to the old “calories in, calories out” myth. Which is why I don’t recommend harsh calorie restriction in your efforts to lose weight. (In the end, quality will always trump quantity.)

But I do recommend intermittent fasting (IF) for various reasons, and especially in the fight against fatty liver…

Fast your way out of fatty liver

Back in 2016, German scientists found that short periods of restricted calorie intake changed the genetic activity of liver cells. More specifically, it activates a gene linked to the production of a protein called GADD45β.

GADD45β is responsible for repairing damaged DNA. (Which might be one explanation for why fasting is emerging as an all-natural anti-aging solution.) But as it turns out, this molecule also has a hand in regulating your liver’s fatty acid absorption.

In laboratory studies, mice without the gene were more prone to fatty liver disease. But when the scientists restored this protein, it normalized the liver’s fat levels and corrected sugar metabolism.

Similarly, low GADD45β levels in humans correlate to higher levels of both blood sugar and liver fat. But these researchers concluded that fasting stresses liver cells just enough to trigger the release of GADD45β—generating higher levels as hunger increases.4

Now, there are any number of ways to adopt IF into your daily routine. For example, you can limit your daily meals to specific eating windows—say, between noon and 6 p.m., like I do. Or you can use the 5:2 approach, where any two days in a single week are your fasting days.

Or, you could fast every other day, using an approach called alternate day fasting (ADF). But that doesn’t necessarily mean going without food altogether. Many people who do ADF simply eat fewer than 500 calories on their fasting days. On non-fasting days, you may eat without caloric restrictions. (Of course, that doesn’t mean you should eat whatever you want. Again, quality matters—so continue following a healthy, balanced diet full of fresh, whole foods.)

Bottom line is, all of these approaches deliver benefits that you won’t get from continuous calorie restriction. So find a method that works for you… and put it to work for your liver.

A common-sense combination

Of course, we can’t make it through this discussion without at least one mention of exercise. As always, I recommend moving as much as possible—and aiming for at least 20 minutes per day.

But I’m going to take this recommendation one step further, and suggest that you brew up a pot of green tea to enjoy after you finish your workout.

Why? Because recent research also shows that this fat-burning combination can cut the severity of NAFLD by a staggering 75 percent… in mice, at least.

When scientists at Penn State supplemented mice with green tea extract and regular exercise for sixteen weeks, those mice only had 25 percent of the fat in their livers that matched controls had.5 (Mice given green tea extract or exercise alone, meanwhile, had half as much liver fat as controls—still impressive protection, by any standard.)

Further analysis showed that these simple strategies actually changed the way the mice processed food and nutrients. And it seemed to impact fat digestion in particular—allowing more fat to pass through the body rather than being stored in the liver.

Again, this research is in mice, not humans. So feel free to take it with a grain of salt. But let me say this: It’s not exactly a stretch to suggest that if every American swapped their sugary sodas for green tea and started exercising every day, that our fatty liver problem might evaporate entirely.

If you ask me, that’s plain common sense that might just help you avoid being a statistic in America’s next major health epidemic.

SIDEBAR: Six supplements for powerful liver support

Diet is and always will be your best defense against fatty liver. But supplements can really make a difference, too. Here are six of my favorites:

1.) Glucevia. This is a standardized extract of Fraxinus excelsior—the European ash tree. I’ve written about this supplement a lot in the past, but it really is a crucial part of this fight, as it helps your body eliminate stored fat in the liver. A good dose is 1,000 mg per day.

2.) Lactobacillus fermentum ME-3. This is the only supplement proven to promote the production of glutathione, which is the main detoxifying agent in your liver, and one of the body’s most important antioxidants. I recommend 60 mg per day.

3.) Milk thistle. This is an “oldie but goodie” in the liver-support category. And to this day, it still remains a favorite. I recommend taking 500 mg of silymarin (that’s the active component of milk thistle) twice per day.

4.) N-acetyl cysteine. This amino acid is a precursor to glutathione. In fact, your body needs N-acetyl cysteine as a building block in order to form that all-important antioxidant. I recommend 1,200 mg per day.

5.) Benfotiamine. This is a special form of the B vitamin thiamine. It’s essential to buffer your body from the damaging effects and toxic reactions resulting from excess sugar in your body. I recommend 150 mg per day.

6.) Mulberry. This powerful antioxidant does double duty for blood sugar support. It doesn’t act directly on the liver like some of the nutrients on this list. But since liver damage is largely fueled by sugar, you need both antioxidants and blood sugar balancers in your arsenal to effectively fight this battle. I recommend 200 mg per day.


  1. SimonTG, et al. “Mortality in biopsy-confirmed nonalcoholic fatty liver disease: results from a nationwide cohort.” Gut. 2020 Oct 9;gutjnl-2020-322786. 
  2. Ma L, et al. “Indole Alleviates Diet-Induced Hepatic Steatosis and Inflammation in a Manner Involving Myeloid Cell 6-Phosphofructo-2-Kinase/Fructose-2,6-Biphosphatase 3.”Hepatology. 2020 Jan 17;10.1002/hep.31115. 
  3. Xu C, et al. “High‐protein diet more effectively reduces hepatic fat than low‐protein diet despite lower autophagy and FGF21 levels.”Liver Int. 2020 Jul 11.  
  4. FuhrmeisterJ, et al. “Fasting-induced liver GADD45β restrains hepatic fatty acid uptake and improves metabolic health.” EMBO Mol Med. 2016 Jun 1;8(6):654-69. 
  5. Khoo WY, et al. “Mitigation of nonalcoholic fatty liver disease in high-fat-fed mice by the combination of decaffeinated green tea extract and voluntary exercise.”Nutr Biochem. 2020 Feb;76:108262.