The Diet I Used to Reverse Fatty Liver Disease: My Modified Mediterranean Diet

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.

Following a healthy diet is the most important thing to do to reverse fatty liver disease/NALFD. This is what I did to reverse my condition and in this article, I will share every detail of what worked for me, why it did, and how to make it sustainable for the long term.

It’s a long article, with a TON of information offered for free. It’s the only article you’ll ever need about a healthy fatty liver diet, so make sure to put it to good use.

If you want to know even more – including recipes, meal plans, and absolutely EVERYTHING else you should know about reversing NAFLD/MASLD – I recommend checking out my book From Fatty Liver to Healthy Liver, based on my experience reversing this condition, but also all the research I’ve done over the past 10 years.

But even without getting the book, this article has ALL the info you need about the main topic: a healthy diet. It’s the main thing you need to reverse this condition: you have foods to avoid, but no magic pill that cures it, although small steps have been made in this direction.

The closest thing to a pill is the supplement Milk Thistle (affiliate link), which most doctors and health experts recommend, or a complex liver tonic like LivCare, with plenty of natural ingredients, including milk thistle. It has no side effects and is considered helpful in our fight against fatty liver. I took it, for example, so it might’ve been a factor, too.

But apart from this, it’s entirely up to you to follow a healthy, liver-friendly diet and make the required lifestyle changes to regain your health. Today, I will give you, for FREE, my epic article about what I consider to be the best diet to reverse fatty liver disease.

I wrote it over a span of a couple of weeks, and I am updating this article annually since initially publishing it some 10 years ago. I can only hope that you will read it entirely and put it to good use to reverse your condition. It’s possible – I’m living proof for that!

I need your help to keep this website alive! Consider becoming a Patron to help me achieve that. Thank you!

Here’s How I Created This Diet

To reverse my fatty liver, I decided to follow what countless health experts, doctors and nutritionists consider the healthiest diet in the world: the Mediterranean Diet.

The advantage is that it’s flexible, offers tasty food and plenty of options. I had to tweak it a little bit – mostly eliminating alcohol (even if your diagnosis is “non-alcoholic” hepatic steatosis), added sugar, and some ingredients or methods of cooking. But overall, it’s pretty much the same thing – I did not re-invent the wheel here!

To be completely honest, I am 100% sure that when it comes to reversing fatty liver, there are multiple approaches and diets that work. But this is what I ate and it surely works, as it healed my liver. Others followed it and have also reversed their condition (read Melissa’s story here).

IMPORTANT: If you’re doing research, you will find many people recommending crazy things and strange diets. Make sure to always read between the lines and truly understand who and what is recommended. At least some of the people recommending a diet or another don’t have a fatty liver and never had one, and are not doctors or nutritionists.

They don’t really understand all the implications, they haven’t tested their diet and some even did just minor (if any) research on the matter.

My Modified Mediterranean Diet: What and How to Eat

While extremely healthy to start with, the basic Mediterranean Diet without modifications is just a healthy way of eating and living, but not aimed directly at curing MASLD/fatty liver disease. But with a few minor changes, it works better to keep a liver happy and healthy. Let’s check it out below!

1. Fruits and vegetables

These should be the main things that you eat from now on, with vegetables being the bulk of your meals, no matter if we’re talking breakfast, lunch or dinner. Eat them raw, boiled, steamed, baked (without any added fat) or grilled.

When it comes to vegetables, mixing and matching is the best route to follow. We still need to keep an eye out on the carb intake, and some of the vegetables out there (usually the tastiest ones) have slightly more carbs than others, but generally, they are all allowed as long as you don’t have other conditions preventing you from having them.

Check out the list below for some of the vegetables that have the highest amount of carbohydrates per 100 grams. These are the ones you should consume less:

• Sweet Potatoes: 23g
• Potatoes: 20g
• Sweet corn: 19g
• Parsnip: 18g
• Green Peas: 14.5g
• Acorn squash: 12g

Also, although not vegetables – but consumed as vegetables, Plantains have 32% carbs, while Cassava – which is not popular in all areas – has around 38 grams of carbs out of 100.

All in all, most vegetables have less than 10 grams of carbs per 100 grams of product, so they can be considered safe to eat. Go heavy on low-carb, high-fiber options: leafy greens, cucumbers, peppers, tomatoes, zucchini, broccoli, cauliflower, carrots, mushrooms, and so on.

Even those listed above are still OK – especially if we compare them with raw sugar which is 100% carbs, or your regular chocolate which can have up to 60% sugar.

As far as fruits go, despite what some say, you can still consume them. Yes, they have more carbs than vegetables, but they also have fiber and various other healthy nutrients and should be still consumed for that.

Also, as I already mentioned in other articles, the fructose from the fruits, combined with the rest of the nutrients, is something that our bodies have been processing for hundreds of thousands of years – so they’re more accustomed to it than they are with processing raw sugar, which was introduced into our diets much, much later.

Just like with vegetables, try to choose low-carb fruits instead of high-carb ones. Here is a list of fruits with a high carb count, to know what to avoid:

• Bananas
• Grapes
• Melons
• Mangoes
• Apples
• Pineapples

Lower carb fruits include:

• Watermelon
• Strawberries
• Cantaloupe
• Raspberries
• Oranges
• Peaches

Most fruits have under 20% carbs, which is still in the safe zone, especially if you’re counting your nutrients and, at the end of the day, you haven’t eaten too much sugar. Even eyeballing it should be safe, generally.

Sure, you can’t eat 10 bananas each day and claim you’re following a healthy diet! Instead, have fruits as snacks in between your main meals (1 larger fruit is a portion, or a handful of berries, for example) or add them in small amounts to yogurt, oatmeal/porridge (here’s the recipe I use), and other dishes.

IMPORTANT: Eat the whole fruit and vegetable! While smoothies are great as long as you don’t add extra sugar or unhealthy ingredients, juices (including freshly squeezed ones at home) are a no-go, as they are mostly sugar, with no fiber and most of the other nutrients removed.

2. Legumes

All legumes are excellent as side dishes and can always be a small part of your meals, as they are high in protein and fiber, low in fats and very filling, but also with lower carb values (usually under 15%, depending on what you’re eating).

The legumes to include in your diet, even in higher quantities, include all types of beans (red beans, cannellini, kidney beans, etc), lentils and dried green peas (as they are actually legumes, not vegetables). Soy/edamame are also good choices. 

Make sure that legumes become a staple of your diet, following vegetables and fruits.

3. Nuts and seeds

I usually use them as one of my snacks throughout the day, but keep the amount you eat low, as they have plenty of calories and healthy fats.

Choose your favorite nuts and/or seeds, anything goes: peanuts (which are technically legumes), cashews, walnuts, almonds, Macadamia nuts, pistachio, sunflower seeds, pumpkin seeds… anything you can think of can be consumed in small quantities each day.

Just make sure that whatever you eat is not fried/roasted with added oils (as some are) or with additional flavors/sugars or such. You should only eat the plain varieties.

4. Dairy products

You can keep dairy in your diet, but go for low-fat, unsweetened versions. NEVER touch (or only have tiny amounts once a month if you miss the taste): butter of any type, any type of cheese with more than 20% fat, full-fat yogurt (including Greek yogurt – learn why here), milk varieties that are high in fat (full-fat milk, half-and-half, heavy cream, condensed milk, etc).

So… what type of dairy can you have?

• Low-fat yogurt (as long as it doesn’t have added sugar – read the list of ingredients, as many do!)
• Low-fat milk (again, make sure there’s no added sugar).
• Various low-fat types of specialty yogurt (Skyr, Kefir, Ayran, etc.)
• Low-fat cheese including Cottage Cheese, Ricotta, or anything else – both maturated or not – as long as it has less than 20% fat.

Many people decide to stay away from all dairy products, and that is completely fine as well.

However, dairy is an important source of Calcium and I personally like the taste. So, since you still have options, you can still have them – and getting used to the low-fat varieties isn’t difficult at all.

5. Low fat meat

You can consume low-fat meat a few times per week. I had moments when I ate some type of meat daily, so it’s not the end of the world – but don’t make this a habit.

The best options are chicken or turkey breast, as well as lean fish like cod, pollock, flounder, haddock, and so on.

Despite popular belief, you can still have some types of red meat – as long as you go for the leanest parts. Here are some options:

• Pork tenderloin: This is the leanest part of the pork and is similar in fat content to a skinless chicken breast (but with a bit more iron). Read more about eating pork meat with a fatty liver here.
• Eye of round roast (aka round steak): It’s the leanest beef cuts, with around 7% fat and plenty of iron.
• Salmon: Only go for the wild varieties. Although high in fat, it has omega-3 fatty acids, which are essential for our health. Read more about eating salmon with a fatty liver here.

IMPORTANT: The red meats recommended above are acceptable, but they are also high in cholesterol, so they shouldn’t be consumed often and never in large quantities. If you have meat three times per week, for example, eat red meat just once.

Also, portion sizes should be kept under control. Remember that one portion of any type of meat should be between 85 grams to 125 grams (3 – 5 ounces), roughly the size of an adult’s palm, but cut thinly.

The only exception is with fish and seafood – as long as you go for the leanest varieties available, you can eat them more often, in addition to consuming other types of meat.

Only eat the meats grilled, boiled, or roasted in the oven, with no added fats or sugars (including marinades made with sugars, honey or anything similar). Add plenty of herbs for extra flavor and always pair with a hearty side of vegetables and leafy greens salads (made with my recommended, liver-friendly dressings).

6. Grains and pseudocereals

While most grains are on the “foods to avoid” page I linked to in the intro (mainly white wheat, white rice, and any highly processed/bleached grains), you can still have some every now and then – as long as you go for the healthier alternatives.

You can consume, in moderation:

• Whole wheat flour
• Whole grain flour: Barley, Millet, Rye
• Pseudocereals: Quinoa, Amaranth, Chia, Buckwheat
• Whole grain rice: Brown, Black, Red, Wild, etc

Ideally, you should cut bread completely off your diet. If you are like me and simply can’t do it, try to eat a maximum of 2 slices of healthy, whole-wheat or whole-grain bread (without added sugar or other chemicals) per meal or a keto bread replacement.

But also keep your daily slices to a maximum of 3, no matter what type of bread you’re eating! If you can have days without eating any bread, it’s even better.

Make sure to read the list of ingredients if you don’t cook your own at home. Healthy bread only needs a few ingredients (flour, water, salt, and yeast).

Stay clear away from bread that comes with added sugars, additives, flavorings, preservatives, and such. If mixes of flour are used, make sure that they are all whole wheat/grains.

Usually, healthy breads are difficult to find in stores, so it’s better to prepare yours at home. I purchased a bread maker like this one (affiliate link) and I am happy with it, so you can try investing in one if you don’t have time for manually preparing your bread.

Rice & Pasta are considered an important part of the Mediterranean diet, but they are unfortunately on our “don’t eat” list, generally speaking. But, just with the other grains and pseudocereals listed above, we can still find some alternatives.

Since white rice and regular pasta are highly processed foods with quickly absorbed carbs, we should go for brown, wild, or black rice instead, as well as pasta made with whole wheat flour, and various alternatives (like lentil, chickpea, or green pea pasta) as long as they have no added sugars or other unhealthy ingredients.

You can get more in-depth here by checking out my article about eating pasta with NAFLD, as well as the one about rice.

Also, keep in mind that eating a portion of pasta or rice replaces one of your daily slices of bread.

7. Sugar & sweetened foods/drinks

While it’s true that sugars, like all carbohydrates, give our bodies energy, we should eliminate all added sugar from our diet. We’ll still get enough carbs from the healthy foods we’re going to eat, mainly from cereals, fruits, and vegetables.

You can read this article from Harvard University to learn why our bodies don’t need any added sugar.

If you really, really have to (although you don’t!) add just a quarter of the amount you normally would and ideally replace white sugar with more natural alternatives like honey, maple, or agave syrup.

Even better, try to replace it with safe sugar alternatives such as Stevia, Sugar alcohols (erythritol, maltitol), or mashed fruits (like banana or apple puree) if you’re baking something. But say no to sugar.

You will have to stop eating almost all sweets that you can buy in stores, restaurants, and pastry shops: candies, cakes, chocolates (although some chocolate is still OK), pastries, frozen desserts (ice cream, gelato, sorbet), milkshakes and so on…

All sweets are extremely bad for our health. Not only they have a ton of sugar, but they’re also usually paired with a similar ton of unhealthy fat, making sweets tasty, but caloric bombs that destroy our bodies – including the liver.

I have to admit that I had cheat days to beat dieting fatigue (try to aim for at most two cheat days per month) and it wasn’t the end of the world. It’s important though to keep the foods with added sugars to a minimum even during the cheat days.

Even better, make your own sweets at home, using sugar alternatives, less sugar than the recipe recommends (it’s too much anyway, in most cases) and healthier ingredients overall. They will still be tasty and healthier overall.

Sooner rather than later, you will learn to go for the less sweet and unhealthy options and you will find the sweets you used to eat gross and horrible. And yes, there are some acceptable deserts you can find in specialty shops. Just read the list of ingredients and only have them as a treat.

8. Alcohol

Alcohol is something that I gave up completely – and you should do the same. There are plenty of studies showing that alcohol is extremely dangerous for a fatty liver, even if it was called “non-alcoholic fatty liver disease”.

While some claim that a small drink every few days will do no harm, I am not willing to take the risk and I wouldn’t recommend anyone to take it.

Note: I have never drank, not even a sip of alcohol, since being diagnosed in 2014 and I don’t plan to ever drink alcohol again to help my liver and general health as much as I can.

You can still live a happy life without it, and you can still have an active, solid social life too. I wasn’t a big drinker in the first place, but like most people out there, I drank on social occasions.

Transitioning to never having alcohol at all was easier than I had initially thought. Eventually, I switched to drinking non-alcoholic beer (usually when going out, but not always) a year after reversing my MASLD/NAFLD, and it doesn’t seem to have done any harm.

But I only did this AFTER reversing my disease and even now I am drinking non-alcoholic beer – and sometimes non-alcoholic wine – in moderation (maybe a total of 4 drink per month, but I have many months when I drink none).

What to drink, then?

I only drink plain water or lemon water most of the time, as well as tea and coffee. It appears that coffee actually helps the liver (according to several studies that I have read), but only if it’s without sugar, artificial flavors, and/or coffee creamers. You can add milk as an alternative or read my in-depth article about coffee creamer alternatives.

Smoothies are also fine, but I personally don’t like them – if you do though, you can have them too! I also treat myself to sparkling water every now and then as a replacement for fizzy drinks, sodas, and alcohol.

You can read my in-depth article on what to drink if you have a fatty liver for all the options.

Eating tips & other thoughts

Here are some other important things to have in mind when it comes to making this fatty liver diet work for you:

– Cook your own food. One of the most important aspects here, because you can easily reduce the amount of fat used and completely eliminate added sugars and other chemicals or additives.

I only use extra virgin olive oil and very small amounts of it, mostly for salads. Combine it with Apple Cider Vinegar, which is also considered great for MASLD and you have a perfect, healthy dressing instantly available.

I cook most of the other dishes without using any kind of fat, or adding just a bit when the cooking’s almost over.

After just a few days, you will get used to eating everything without the added oil and you will find out that most foods still taste delicious! And if you’re still wondering what oil to use, read my article here (spoiler: it’s extra virgin olive oil).

Paying attention to HOW you cook your food is extremely important. Simply cooking your food at home – but using a lot of the bad stuff you shouldn’t, frying ingredients and adding sugars and other chemicals won’t give you many benefits.

Eating Out & On the Go

It’s very difficult to find 100% healthy foods when eating out, as even foods labeled or considered “healthy” still have sugar, plenty of fat, and even other unhealthy ingredients. But since you can’t always cook at home, here is what to keep in mind when eating out:

• Choose grilled meats or fish with salad or steamed veggies.
• Ask for salads with sauces/dressings on the side, or none at all. If the restaurant offers them, you can add olive oil and/or vinegar only.
• Avoid bread baskets, fried appetizers, and any deep-fried foods or foods whose entire list of ingredients is unknown to you.
• Eat smaller portions – restaurants usually give us more food than we should eat.
• Don’t be afraid to ask for modifications or at least details about the ingredients.

If possible, prepare ahead with healthy snacks on hand (a handful of nuts, a fruit, even 100% fruit bars are better than most foods you can order).

How often should you eat?

When you’re following this fatty liver diet, you can eat up to five times per day, but smaller quantities. It’s ideal to eat just the three main meals, but since it’s going to be smaller portions, you will probably need the snacks too in order to reach your required daily caloric intake.

I have many days when I actually eat six times per day, like this:

– breakfast between 6:30 AM – 7:00 AM.
– morning snack (at around 10:30 AM)
– lunch (at 1 PM)
– afternoon snack (at around 4 PM)
– dinner (at 6 PM)
– sometimes a late snack at around 8 PM (I’m working to cut out this final snack)).

You can adapt this to your own schedule, of course. The golden rule of thumb here is to eat multiple times per day in order to reduce hunger (the hungrier you get and the longer this lasts, the higher your chances of making bad choices).

Also, try to eat your last meal or snack at least 2 hours before sleeping – the longer you can go, the better.

If you are comfortable eating just the three main meals of the day, it’s even better. You don’t HAVE to eat the snacks, but if you are hungry (and most likely you will be!) it’s best to have them. Always keep quantities in check though and never overeat. Which gets us to…

How much should you eat?

Portions should be small, but you don’t have to eat like a supermodel that wants to lose even more weight. You still need to meet the daily calorie intake that you’re aiming for (which, for most adults, is around 2,000 kcal/day – make sure you know your numbers!).

If you are used to eating large portions, and until you feel full (that was my thing), don’t try to drastically reduce the size of the portion to, let’s say, a quarter of what you used to eat.

Instead, reduce them gradually, taking out a bit more every few days, over the duration of a month, until you reach the perfect amount. It’s very easy to overeat, so make sure that you keep portion sizes under control!

Of course, this only goes if you must lose weight, as most of us do. You will also have to learn to eat like this forever, because you will also need to keep your weight under control after you reverse your fatty liver.

It’s a complete and permanent lifestyle change that might sound horrible now, but it’s one you will not only get used to, but you will start to appreciate sooner rather than later.

When losing weight, the key to achieving it is caloric deficit: this is the only thing that you need to lose weight. Caloric deficit can only be obtained in two ways: eating less and/or exercising or increasing your physical activity.

So if you need, let’s say, 2,500 calories to keep your current weight, reduce the daily calories to 2,000 – 2,200. This will see you lose around half a kilogram (1.1 pounds) per week, which is considered a safe amount.

Then, if you still need to lose weight, reduce the daily calories even more, until you reach your ideal weight and then keep consuming the required amount of calories each day to stay there.

This way, you will give yourself time to gradually get used to the smaller portions, and taking it slower will have the benefit of making it easier for you long term.

If you’re currently eating 4,000 calories and cut down to 2,000 per day, it will be a huge shock – and more difficult to stick to long term. So take it slow, and let your body adjust, without taking it TOO slow.

Also look into high volume, low calorie foods, at least at first. These are foods that let you eat larger portions, but have few calories and are still healthy, like zucchini, cucumber, leafy greens, or watermelon (among many others).

You can use these too during your transition period, but the main goal is to teach your body to adapt to small portion sizes eventually.

You will naturally lose weight!

One of the things that I was advised to do after being diagnosed with a fatty liver was to lose weight. Most likely, this will be your situation, too.

And that’s a good thing, because usually, losing at least 10% of your weight will greatly improve (or even cure) your condition. (Read the study about this here).

When I started the diet recommended above, I weighed 210 lbs. (I am a 5.11″ guy). I naturally lost weight without any extra exercise, and without starving.

I went down to 190 lbs in three months, which is why I didn’t add extra exercise: losing weight too quickly can put extra pressure on your liver.

Please have in mind, though, that this fatty liver diet is not a weight loss diet. In my case, it helped a lot because I used to eat huge portions in the past and unhealthy foods.

Just switching to lower portions and eating completely healthy helped me lose weight, then stick to my new weight over the years. I was so surprised to see how much eating habits affect our weight!

Eventually, your weight loss may plateau or slow down. That’s normal, but also when you should start bringing exercising into your life.

From personal experience, I can say that this happens after three months of changing to the Mediterranean diet and losing weight.

Exercising is extremely important, so do something extra even if it’s just walking 10,000 steps per day. But more intense forms of exercising like running, cycling, or going to the gym is preferred.

The higher the intensity, the better. Aim to exercise at least 3 times per week, ideally every day. Also take it slow if you are out of shape, increasing your intensity every few days/sessions. Read more about exercising and fatty liver here.

When I started exercising, I only did cardio training: “running” on a treadmill three times per week.

However, I was so out of shape that when I first started doing it, I was only able to run for about 3 minutes straight at a very low pace during my 45-minute session and only walked briskly for the rest.

But just a month later I was running almost half of the time (alternating 3-4 minutes of running with 4-5 minutes of fast walking).

Today, I can easily run, without taking a break, for 35 minutes straight (and I could probably do more if I wanted to). So take things slowly, but be consistent: you will get there! You just need time to adjust.

Is this fatty liver diet an easy one to follow?

From personal experience, I can honestly say that it’s not easy. In my case, it came as a drastic change, and cutting all those unhealthy foods off the menu was difficult.

There were cravings, there were times when I just broke down and ate a lot, feeling miserable with myself afterward.

So probably you will find it at least a bit difficult too – there’s no need for me to sugarcoat it. Be prepared!

Fortunately, the diet itself still allows you to eat a huge variety of dishes and you’ll never get bored eating the same thing over and over again.

The most difficult parts (at least in my case) were reducing the portion sizes, reducing the amount of fats, and eliminating sugars (the latter being the hardest!).

I always used to have a cake or some candy lying around before being diagnosed, and it was really difficult to put them away. But looking back, this habit was probably one of the main reasons why I developed a fatty liver in the first place…

Fortunately, you will soon get used to eating apples as dessert instead of sugary sweets, so it’s not a never-ending hell you’re going to go through (but the first two weeks will be tough!)

You will get used to this new life quickly and you will start to love all the foods you’re eating every day, knowing the fact that you’re eating your way to a healthier life. And you will feel AMAZING!

Actually, if you will taste any fried food or fatty food a few months after switching to this diet, you will find it yucky and way too greasy.

I think that you will start seeing major improvements after the first month of following this modified Mediterranean diet, and at around the 6-month mark, you will feel like another person (slimmer, healthier, and full of energy) and have no more pain under the right rib, nor any of the regular symptoms.

There is one important thing to have in mind: it probably took you years (if not decades) of eating unhealthy and being unfit to get where you are now.

You can’t expect things to change in a week or a month. Healing also takes time – but fortunately, not years or decades if you do it right.

And after you reverse your fatty liver, make sure to stick to this Mediterranean diet. Don’t get back to old habits, as your fatty liver will most likely come back too. Continue eating healthy, follow this balanced diet, and enjoy your new self!

IMPORTANT: Don’t forget to bookmark this page to be able to easily visit it in the future to make sure that you are indeed following the correct steps and eating the right things for your body. I know it’s a lot of information to take – but you’ll start getting used to it with practice.

Or just PIN it using the image below:

If you still have questions, don’t hesitate to ask them by commenting down below.