Browse the evidence

Insulin resistance is a major feature of NAFLD that drives hepatic fat accumulation through increased free fatty acid delivery and stimulation of de novo lipogenesis, and treatments improving insulin sensitivity (weight loss, metformin, thiazolidinediones) show benefit in reducing liver fat.

If you have fatty liver, focusing only on low-fat diets may not be enough. The underlying issue is often how your body handles insulin. Strategies that improve insulin sensitivity, such as weight loss, exercise, or medications like metformin or thiazolidinediones (under doctor supervision), are more likely to reduce liver fat than diet alone.

Coffee consumption (>3 cups/day) has a protective role and improves liver enzymes in individuals at risk of liver diseases.

Drinking more than 3 cups of coffee daily may help protect liver health and improve enzymes.

Farm-to-school programs and school gardens show promise in increasing fruit and vegetable intake and meal participation, but rigorous evaluation is lacking.

Schools interested in improving student diets should consider farm-to-school or garden programs. While they cost more in labor, they can increase fruit/vegetable intake and meal participation. More research is needed to confirm long-term impacts.

The protective effect of high folate intake against coronary heart disease is significantly stronger in women who consume alcohol, particularly those drinking more than one drink per day.

If you are a woman who drinks alcohol, ensuring you have high levels of folate and vitamin B6 is particularly important. The study found that the heart-protective benefits of these vitamins were strongest in women who drank more than one drink per day. This suggests that alcohol consumers should pay extra attention to their B-vitamin intake, potentially through diet or supplements.

Some dietary supplements contain nutrients at or above the Upper Intake Levels (UL), posing a risk of excessive intake, especially when multiple supplements are used.

Check your supplement labels. Some contain nutrients at or above the Upper Intake Levels. Taking multiple supplements can increase the risk of exceeding safe limits.

Continuously high levels of exercise (e.g., marathon running) may have detrimental effects on cardiovascular health, including increased coronary artery calcification, suggesting a U-shaped or J-shaped dose-response curve.

For most people, moderate exercise is optimal. If you are an endurance athlete, be aware that very high volumes (like multiple marathons per year for decades) may increase coronary calcification, though this does not necessarily mean higher event rates due to potentially more stable plaques. Consult a physician if you engage in extreme endurance training.

Dried Moringa oleifera leaves serve as a high-quality nutritional supplement containing 30.3% crude protein, essential amino acids, and significant minerals, making them effective for improving animal health and nutrition.

Incorporate dried Moringa leaf powder into your diet or animal feed to boost intake of protein, iron, calcium, and vitamins. It is a nutrient-dense supplement that can help address deficiencies, particularly in protein and minerals.

Time-restricted feeding (TRF) that aligns food intake with circadian rhythms (e.g., restricting eating to 8-12 hours during the day) improves metabolic health, including weight loss, insulin sensitivity, and lipid profiles, independent of caloric restriction.

Restrict your eating to an 8-12 hour window each day, ideally finishing dinner early and skipping late-night snacks. This aligns with your body's natural circadian rhythms, improving insulin sensitivity and potentially aiding weight loss, even if you don't count calories.

Alternate-day fasting (ADF) and modified fasting (e.g., 5:2 diet) result in weight loss comparable to continuous energy restriction, with mixed effects on metabolic biomarkers.

If you prefer intermittent fasting, try the 5:2 diet (eating normally 5 days, restricting calories to ~25% on 2 non-consecutive days). It leads to weight loss similar to daily calorie restriction, but may be easier to adhere to for some people. Be prepared for hunger on fasting days.

Consumption of 3-4 cups of coffee per day is associated with the largest reduction in relative risk for all-cause mortality, cardiovascular mortality, and cardiovascular disease compared to non-consumption.

If you drink coffee, 3-4 cups a day appears to offer the greatest protection against early death and heart disease based on current observational data. If you do not drink coffee, this review does not strongly recommend starting, as causation is not proven, but it suggests that moderate consumption is likely safe and potentially beneficial for most adults.

Coffee consumption is associated with a lower risk of several specific cancers (e.g., liver, colorectal) and metabolic conditions (e.g., type 2 diabetes, gout).

Regular coffee consumption is linked to a lower risk of certain cancers and metabolic diseases. This adds to the potential benefits of moderate coffee drinking.

Dietary fat co-ingestion significantly enhances the absorption of quercetin aglycone supplements.

Take quercetin aglycone supplements with a meal containing fat to maximize absorption. Studies show high-fat meals can increase plasma quercetin concentration by 45% compared to fat-free meals.

Omega-3 fatty acid supplementation reduces pro-inflammatory cytokines (e.g., IL-6) and may improve outcomes in viral infections, though excessive inflammation reduction during active infection could potentially be detrimental.

Consider supplementing with Omega-3 fatty acids (1.25-2.5g/day) to help manage inflammation. While generally beneficial, be aware that the timing of supplementation relative to an active infection might matter, as excessive anti-inflammatory effects could theoretically interfere with necessary immune responses.

Intermittent fasting regimens that induce the metabolic switch (shifting from glucose to fatty acid/ketone oxidation) preserve lean muscle mass more effectively than continuous caloric restriction.

If you are trying to lose weight while keeping your muscle, try intermittent fasting. It helps your body switch to burning fat and ketones, which protects your muscle better than just eating less all the time. Make sure you fast long enough (12+ hours) to trigger this switch.

Kefir consumption improves lactose digestion and reduces flatulence severity in individuals with lactose malabsorption, performing similarly to plain yogurt.

If you get bloated or gassy from milk, try kefir. It contains natural enzymes that break down the lactose, so you get the nutrients without the stomach upset. One study showed it caused less gas than milk and was just as easy to handle as yogurt.

Females, particularly premenopausal women, exhibit a greater relative increase in serum CK and potentially greater muscle disruption in response to eccentric exercise compared to males.

Women may experience greater muscle disruption from eccentric exercises than men, indicated by higher CK peaks. Adjust recovery strategies for women to account for potentially slower recovery from high-intensity eccentric work.

Selenium supplementation reduces liver cancer incidence by 35% in a community with low baseline selenium status, but may increase the risk of type 2 diabetes in individuals with high baseline plasma selenium levels.

In selenium-deficient populations, supplementation (e.g., 200 μg/day) can significantly reduce liver cancer risk. However, individuals with high baseline selenium levels should avoid supplementation due to an increased risk of type 2 diabetes.

Consumption of added sugars promotes body weight gain and fat accumulation indirectly by failing to stimulate satiety hormones (leptin) and altering brain response to energy intake, leading to increased energy consumption.

Eating high-sugar foods, especially in liquid form, may make it harder to feel full and control your overall calorie intake because sugar doesn't trigger satiety signals as effectively as other nutrients. This can lead to unintentional weight gain.

Vitamin D supplementation (1100 IU/day) combined with Calcium (1400-1500 mg/day) reduces the relative risk of cancer incidence by ~60% in postmenopausal women.

Postmenopausal women may consider 1100 IU of Vitamin D3 and 1400-1500 mg of Calcium daily, as one major trial showed a 60% reduction in cancer risk. However, consult your doctor, as causality is not fully proven and individual needs vary.

Significant weight loss (mean 34 kg) achieved via laparoscopic adjustable gastric banding leads to major improvement or resolution of nonalcoholic steatohepatitis (NASH) and hepatic fibrosis in severely obese patients.

For severely obese individuals with fatty liver disease, achieving significant and sustained weight loss is the most effective way to reverse liver damage, including fibrosis and NASH. While lifestyle changes are the foundation, surgical interventions like gastric banding can facilitate the substantial weight loss (often >50% excess weight) required to resolve these conditions, which is difficult to maintain with diet alone.

Patients with metabolic syndrome experience greater initial histological abnormalities and greater improvement in liver histology with weight loss compared to those without metabolic syndrome.

If you have metabolic syndrome (high blood pressure, high blood sugar, excess body fat around the waist, and/or abnormal cholesterol or triglyceride levels), your liver may be more severely affected by fatty liver disease, but you may also see more dramatic improvements in liver health when you lose weight.

Higher protein doses (up to 2 g/kg/day) may be appropriate for persons with severe illness, injury, or pro-inflammatory/catabolic states.

If you have a severe illness, injury, or are in a catabolic state, your protein intake might need to be increased to up to 2 grams per kilogram of body weight, but this should be determined by your healthcare provider.

Living in neighborhoods with ready access to healthy foods (e.g., supermarkets) is associated with more healthful diets and lower prevalence of obesity, whereas high density of fast-food restaurants has weak or mixed evidence for causing obesity.

Prioritize living in or supporting communities that have accessible supermarkets or fresh food options. Be aware that simply having fast food nearby does not necessarily dictate your weight, but having access to healthy options supports better dietary choices. Look for communities that offer both access and safety.

Sarcopenic obesity, characterized by low muscle mass combined with high body fat, is a distinct condition that increases the risk of metabolic disorders and mortality more than either condition alone.

If you are normal weight but weak, you may have sarcopenic obesity. This combination is dangerous for your metabolism and heart. Focus on building muscle and managing fat, not just weight.