Tips to manage

Diet

Simple sugars such as table sugar or fructose syrups, and fried and oily foods should be avoided. Foods like fish and dry fruits should be increased in the diet. Green leafy vegetables should be regularly consumed as they contain vitamins and antioxidants, which prevent fatty acid oxidation and decrease inflammation. Regular coffee consumption has been shown to reduce the risk of progression to liver fibrosis. So, coffee can be included.

Weight loss

It is the single most important factor in reversing the effects of non-alcoholic fatty liver disease (NAFLD). Weight loss of 7-10% in six months to one year helps in decreasing the amount of fat in the liver and reduce inflammation. A calorie restriction of 500kcal/day or a 30% reduction in calorie intake would be required for achieving this goal.

Exercise

Aerobic exercises at least three times a week can improve insulin resistance, lower diabetes and blood pressure, and help with the goal of lowering weight and liver fat.

Addictions

Reducing the consumption of alcohol, preferably attaining complete abstinence, is important as alcohol increases the risk of fatty liver and the progression to cirrhosis.

Medications

These are not substitutes to the above-mentioned measures as medicines alone will not lead to the complete resolution if the patient is overweight or has no controlled diet. Moreover, no single drug can cure NAFLD or NASH.

(Inputs by Dr Tehsin A Petiwala, consultant gastroenterologist, endoscopist, and hepatologist, Masina Hospital, Mumbai)