In one study, obese adults who consumed a diet high in calories and refined carbs for three weeks experienced a 27% increase in liver fat, on average, even though their weight only increased by 2% ( 15 ).



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What’s more, it appears that the improvements in liver fat and insulin sensitivity may persist even if some of the weight is regained ( 25 ).

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Obesity: Obesity involves low-grade inflammation that may promote liver fat storage. It’s estimated that 30–90% of obese adults have NAFLD, and it’s increasing in children due to the childhood obesity epidemic ( 2 , 3 , 9 , 10 ). Excess belly fat: Normal-weight people may develop fatty liver if they are “viscerally obese,” meaning they carry too much fat around the waist ( 11 ). Insulin resistance: Insulin resistance and high insulin levels have been shown to increase liver fat storage in people with type 2 diabetes and metabolic syndrome ( 12 , 13 ). High intake of refined carbs: Frequent intake of refined carbs promotes liver fat storage, especially when high amounts are consumed by overweight or insulin-resistant individuals ( 14 , 15 ). Sugary beverage consumption: Sugar-sweetened beverages like soda and energy drinks are high in fructose, which has been shown to drive liver fat accumulation in children and adults ( 16 , 17 ). Impaired gut health: Recent research suggests that having an imbalance in gut bacteria, problems with gut barrier function (“leaky gut”) or other gut health issues may contribute to NAFLD development ( 18 , 19 ).

In this study, 14 obese men with NAFLD followed a Mediterranean ketogenic diet. After 12 weeks, 13 of the men experienced reductions in liver fat, including three who achieved complete resolution of fatty liver ( 31 ).

Unfortunately, it is difficult to predict whether fatty liver will progress to NASH, which greatly increases the risk of cirrhosis (severe scarring that impairs liver function) and liver cancer ( 4 , 5 ).




NAFLD is also linked to an increased risk of other diseases, including heart disease, diabetes and kidney disease ( 6 , 7 , 8 ).


NASH involves greater fat accumulation and inflammation that damages the liver cells. This can lead to fibrosis, or scar tissue, as liver cells are repeatedly injured and die off.