Not All Pasta Is Bad for Fatty Liver Disease: Here’s What Matters Most

Note: This article is based on my personal experience and research. I am not a doctor or a dietitian, and this content is for informational purposes only. Always consult with your healthcare provider before making any changes to your diet or lifestyle.

If you’re here, you are probably in my situation: you love pasta. But if you’re trying to reverse a fatty liver, you probably know that you should stay away from eating it. And, for the most part, you’d be correct!

A cup of cooked white pasta packs 43 grams of carbohydrates and barely over a gram of fat.

For someone actively working to heal their fatty liver disease (MASLD aka NAFLD), these numbers are a direct metabolic threat, just as it is the case with bread and fatty liver.

Add to that the fact that almost nobody eats plain pasta, but with added toppings and sauces, and the situation is far from great.

However, there is a bit of hope – that’s what I learned years after being diagnosed. I am helping you learn this faster: you can keep pasta on your plate if you fundamentally change how you prepare, what type you consume and how you serve it.

How to eat pasta the right way with a fatty liver

I have to be honest and admit that, early on, after my MASLD diagnosis (called “fatty liver disease” back then) I stopped eating all pasta – and did so for around six months.

But later on, I started adding it to my rotation, making sure I eat a specific type and very small amounts, and I was also careful with the other ingredients used when eating it. Moderation is key when it comes to dieting for reversing your fatty liver!

Always choose whole grain pasta

First of all, I must say that in this case, the best approach remains eliminating pasta completely, just as it is the case with all other refined flour products.

But if you can’t stop, or you don’t want to, having some pasta every now and then can be done as long as you only eat whole wheat or whole grain options.

These provide significantly higher dietary fiber content compared to their white counterparts. This added fiber slows digestion, preventing the rapid blood sugar spikes that directly contribute to liver fat accumulation (and they also keep you fuller for longer).

Cooking It The Right Way (and Resistant Starch)

This is the trick I learned years after being diagnosed, and the thing that will probably help you a lot if you love eating pasta.

The cooking technique influences the way your body processes carbohydrates from your spaghetti, penne, etc. If you boil your pasta until it becomes soft and mushy, you drive up its glycemic index.

Stopping the cooking process while the noodles are still firm to the bite, known in Italian cooking as al dente, requires a bit more digestive effort and results in a slower, steadier release of glucose into your bloodstream, which is better.

Finally, cooling the dish down and reheating it takes this metabolic advantage a step further. If you have time to prepare, chilling your pasta in the refrigerator overnight and reheating it the next day transforms its carbohydrates into resistant starch.

Your body digests resistant starch similarly to fiber, blunting the insulin response even further.

Control Your Portion Sizes!

All portion sizes – not just pasta – should be kept under control when dealing with a fatty liver.

Aim for a serving size of at most one cup of cooked pasta, and make sure to always pair it with healthy vegetables and, if you really want to, lean protein (more on this below).

You can still have meat as, fortunately for the meat lovers out there, you don’t have to become vegan to reverse your fatty liver.

Selecting Liver-Friendly Toppings and Sauces

I’m sorry to say it, but your traditional mac and cheese or meatball toppings and other heavy cream, high-fat sauces are completely out of the question, as are probably most toppings and combos you used to have.

The saturated fats and hidden sugars in the classic “comfort food” type of cooking are dangerous and should be eliminated from your daily diet, no matter what dish you’re pairing them with.

So… what to eat your whole grain pasta with?

I was a huge fan of mac and cheese, as well as Bolognese, but I managed to learn relatively fast to appreciate the healthy pasta sauces out there and now I can say I wouldn’t have it any other way.

I became a huge fan of a simple mix of crushed tomatoes, a drizzle of extra virgin olive oil, chopped Kalamata olives, and fresh basil picked straight from my balcony planters.

There are many other options for increased variety, most of them mixing tomatoes with various vegetables and spices, but also lean healthy meats and even a bit of cheese sprinkled on top (no more than a tablespoon of grated Parmesan or something similar).

You can try and mix all sorts of vegetables to find your perfect sauce. You can also use broccoli, cauliflower, spinach, or zucchini in various combinations.

The important thing to know is that you should not add sugars or any high-fat products, nor use highly processed ingredients.

Related reading: Cornbread without Cornmeal recipe

My recommended store-brought pasta sauces

There are some solid store-brought healthy options that you can try – and I am sharing them below, but I recommend preparing your own sauces at home from scratch.

If you can’t, these are only using high quality ingredients and are fatty-liver friendly if consumed in moderation (affiliate links below):

• My favorite, affordable, organic, with no added sugars: Marinara, Italian Herbs or Portobello Mushroom.
• If you like it spicy, try this Arrabiata Sauce.
• Finally, add some variety with an added mix of vegetables with this organic Seven Veggie Pasta Sauce.

Best pasta alternatives

There are some yummy alternatives to pasta – much healthier than even than the whole-wheat ones, mainly because they offer a lot less in terms of carbs.

The offer is varied and I have tried most of these with more or less success. Some do taste like “real” pasta, but most don’t. However, once you add the sauces, you can barely tell the difference. Here are your options (affiliate links below):

• Konjac Noodles: an amazing find, pasta with under 10 calories per portion and 0 carbs. A bit chewy and smelly, but a perfect alternative in my opinion.
• Zucchini Noodles aka zoodles: all time favorites of the reversing fatty liver community (make sure to join if you haven’t already!)
• Palmini Linguine Pasta: a newer option on the market, but very interesting, made from palm hearts, with only 4 grams of carbs per serving. Worth trying if you haven’t already.
• Bean Pasta: Made from just one ingredient (either Soy, Black Bean, or Edamame), these do have some carbs (20g/100 grams, so half of what regular white pasta has), but are also high in protein, gluten-free, and delicious. (Learn more about protein powder and fatty liver here).

Not all pasta alternatives are necessarily better. Most of the other options on the market (like green pea pasta, chickpea pasta, and so on) have similar amounts of carbs and are created mainly for those who can’t consume gluten.

Wrapping up

In conclusion, pasta is not one of the foods that you must completely cut out from your diet, but you must only eat whole grain pasta with healthy sauces and toppings.

You can also choose one of the pasta alternatives I have mentioned above – or anything else that you find as long as they come with fewer carbs and fats, as well as no other preservatives or unhealthy ingredients.

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The Bottom Line

Reversing MASLD does not necessarily mean a lifetime ban on pasta, especially if you enjoy eating it. So they don’t follow the same route that instant noodles follow.

As long as you eat whole-grain pasta (or the healthy alternatives), use the resistant starch cooking method, keep portion sizes under control and use clean, vegetable-heavy sauces, you should be good to go.

If you still have questions or comments, don’t hesitate to let me know by posting below.

Now that we’ve tackled the topic of pasta, let’s turn our attention to breakfast and see if cereal is a suitable choice.