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Cirrhosis, often casually referred to as the liver “falling apart,” is commonly associated in the public mind with alcoholism. However, 70% of liver transplants today are performed on patients diagnosed with non-alcoholic fatty liver disease (NAFLD), which has no link to alcohol consumption. The main risk factors for NAFLD include overeating, metabolic syndrome, obesity, and type 2 diabetes. With the rising prevalence of diabetes and obesity, NAFLD is increasingly common, now affecting roughly one in three adults, according to gastroenterologists.
While liver fat accumulation can be triggered by alcohol or viral hepatitis, specialists are seeing a growing number of cases unrelated to either infection or alcohol. Nine out of ten patients diagnosed with NAFLD are overweight or obese (BMI over 27) and have diabetes and lipid metabolism disorders (high cholesterol).
In simple terms, fatty liver can result from overeating. The consequences are serious: fat accumulates in liver cells (steatosis), leading to inflammation, then fibrosis (replacement of liver cells with connective tissue), impairing liver function. The final stage can be cirrhosis or even liver cancer, with liver transplantation as the only treatment for advanced cases.
Currently, 70% of liver transplant patients had cirrhosis as the final stage of NAFLD. Over the past 20 years, the number of such patients has increased sevenfold. Viral hepatitis and alcohol-related fibrosis have become less common. The good news: early detection and proper treatment can slow disease progression, with diet playing a crucial role.
Dietary approaches:
Low-calorie diet: Studies show losing just 5–7% of body weight reduces liver steatosis and fibrosis, shrinking liver fat and returning the organ closer to normal weight. However, adherence is very low—only about 5% of patients can maintain such a diet long-term due to psychological effects like depression or irritability.
Mediterranean diet: Calories are not strictly limited, and olive oil is a main component. Patients may not lose weight, but fat metabolism improves, benefiting liver health.
DASH diet: Originally designed for hypertension (Dietary Approaches to Stop Hypertension), it limits salt and animal fats and is also effective for obesity and liver function improvement.
General nutritional principles remain similar to standard weight-loss guidance. Prioritize vegetables and greens, while limiting fruit intake due to fructose, which affects carbohydrate metabolism.
Micronutrient support: Calorie restriction can lead to nutrient deficiencies, which should be compensated through vitamins, supplements, or fortified foods. One key element is boron, which influences fat metabolism. Daily intake should be 1–2 mg, found in raisins, nuts, dried apricots, and black olives. Studies indicate that diets high in boron promote gradual fat loss rather than loss of water or muscle mass.
