By SmashMeals Editorial · Published · Updated
Fatty liver disease is one of the most common conditions most people have never heard of. Now called metabolic dysfunction-associated steatotic liver disease, or MASLD, it affects up to 30% of the U.S. population, according to Oregon Health & Science University researchers. Most people feel nothing until it is advanced. The good news is that food, weight and activity are the foundation of treatment, and they work.
This guide is general information, not medical advice. If you have MASLD or MASH, work with your clinician or a registered dietitian.
The names, briefly
- MASLD (formerly NAFLD): extra fat in the liver tied to metabolic risk factors such as excess weight, type 2 diabetes, high blood pressure or abnormal cholesterol.
- MASH (formerly NASH): MASLD with inflammation and liver-cell injury, which can lead to scarring (fibrosis) and eventually cirrhosis.
What the guidance says to eat
The American Gastroenterological Association's patient guidance on MASLD is practical and specific:
| Guidance | In practice |
|---|---|
| Follow a Mediterranean-style diet | Vegetables, fruit, beans, whole grains, fish, olive oil, nuts |
| Half the plate non-starchy vegetables | Spinach, broccoli, peppers, green beans, salad |
| Limit added sugar | Under 36 g a day for men and 24 g for women |
| Limit saturated fat | About 7% to 10% of total calories |
| Choose drinks without added sugar | Water, sparkling water, unsweetened tea or coffee |
| Avoid alcohol | Experts recommend not drinking; if you do, no more than 1 drink a day |
| Lose weight gradually | About 1/2 to 2 pounds a week; avoid crash diets and fasting |
| Move | At least 150 minutes of moderate activity a week |
Does timing matter?
An October 2026 OHSU study of nearly 200,000 adults, published in Clinical Gastroenterology and Hepatology, linked regular late-night eating with a 20% to 30% higher risk of MASLD and cirrhosis. It was observational, so it does not prove cause, but finishing dinner a few hours before bed is a low-cost habit. Our guide to late-night eating and meal timing explains the evidence.
Medicines now exist, alongside food
For years there was no approved drug for fatty liver disease. That has changed:
- Resmetirom (Rezdiffra) became the first FDA-approved treatment for MASH with moderate to advanced liver scarring in March 2024.
- Semaglutide 2.4 mg (Wegovy) received accelerated approval for MASH with moderate to advanced fibrosis, without cirrhosis, in August 2025. In the ESSENCE trial, steatohepatitis resolved without worsening fibrosis in 63% of people on semaglutide versus 34% on placebo at 72 weeks.
Both are used alongside a reduced-calorie diet and more activity, not instead of them.
A sample day
This is an illustration, not a prescription.
- Breakfast: Eggs scrambled with spinach and peppers, berries, black coffee.
- Lunch: Grilled chicken over a big salad with beans, olive oil and lemon.
- Snack: A small handful of nuts and an apple.
- Dinner, by 7 p.m.: Baked salmon, roasted broccoli and a half cup of brown rice or quinoa.
- Drinks: Water and unsweetened tea; no alcohol.
Foods to cut back on
Sugary drinks, sweets, refined white starches, fried foods, processed meats and alcohol are the usual targets. The point is not perfection. Each swap, repeated, adds up.
If you also have celiac disease
People with celiac disease can develop fatty liver disease too, and some gluten-free packaged foods are higher in sugar and fat than the products they replace. Choose naturally gluten-free whole foods first. Our fiber guide lists gluten-free whole grains and beans.
Make the plate easier
A Mediterranean-style plate is simple on paper and hard at 6:30 p.m. on a Tuesday. SmashMeals cooks portioned meals with vegetables and lean proteins in a dedicated gluten-free kitchen and posts nutrition for each one. See our heart-healthy meals and anti-inflammatory meal delivery pages, or order this week's meals.
Sources
Frequently asked questions
- What is the best diet for fatty liver?
- A Mediterranean-style diet built on vegetables, fruit, beans, whole grains, fish, olive oil and nuts, with limited added sugar, saturated fat and alcohol.
- Can fatty liver be reversed?
- Gradual weight loss, better diet and more activity can reduce liver fat and inflammation for many people. Your clinician can track progress with tests.
- Are there medicines for fatty liver disease?
- Yes. Resmetirom (Rezdiffra) was approved in March 2024 and semaglutide 2.4 mg (Wegovy) in August 2025 for certain adults with MASH and moderate to advanced fibrosis, used alongside diet and exercise.