If you have Type 2 diabetes or prediabetes—or are at high risk of the disease—you should know about fatty liver disease. Although it’s not talked about as much as diabetes, it’s another condition that’s becoming increasingly common.
“Both diabetes and fatty liver disease are metabolic-associated diseases in which genetics play a role,” says Nancy Park, M.S. R.D.N., a registered dietitian at Henry Ford Health. “They are part of a constellation of diseases that we now understand are also related (in part) to dietary choices.”
One of the best ways to manage—or even prevent —these conditions is to make healthy changes to your diet and lifestyle.
What Is Fatty Liver Disease?
Fatty liver disease (FLD) is a condition that causes an unhealthy amount of fat to build up and be stored in the liver. When there’s too much fat stored in the liver, it can start to affect the liver’s ability to function properly.
In some cases, fat buildup in the liver is the result of alcohol abuse. But nonalcoholic fatty liver disease can occur in people who drink moderate amounts, or even no alcohol.
FLD is a metabolic-associated disease. That means it’s more common among people with other metabolic disorders—such as diabetes, high blood pressure, high cholesterol and obesity.
That connection has led to nonalcoholic fatty liver disease being renamed. Doctors now often refer to it as metabolic dysfunction-associated fatty liver disease (MAFLD) or metabolic dysfunction-associated steatotic liver disease (MASLD).
How Is Fatty Liver Disease Connected To Diabetes?
If you look at the risk factors for Type 2 diabetes and those for fatty liver disease, you’ll notice they’re pretty much identical. These include:
- Diet that’s high in saturated fat, sugar and sodium
- Eating too many calories
- High blood pressure
- High blood sugar
- High cholesterol and triglycerides
- Lack of physical activity
- Overweight and obesity
The overlap helps explain why the two conditions often go hand in hand. At least 50% of people with Type 2 diabetes also have fatty liver disease.
The Role Of Diet In Fatty Liver Disease
Even if you’ve already been diagnosed with diabetes, your food choices can help lower your risk of getting fatty liver disease. And even if you’ve already been diagnosed with FLD, a smart diet can slow its progression and minimize liver damage.
“When we take in more calories than our bodies can use at the time, the excess is stored in the liver for later use,” says Park. “But when the stores in the liver build up so much that we can’t use them, the excess starts to cause inflammation in the cells and irritation to the liver.”
In addition to moderating calorie intake, Park recommends following an overall healthy, anti-inflammatory diet (like the DASH or Mediterranean diet). This means:
- Avoiding high-fructose corn syrup (found mainly in sugar-sweetened sodas)
- Cutting back or eliminating alcohol consumption
- Eating at least 5 servings a day of fresh fruits and vegetables
- Emphasizing plant-based proteins (like beans and lentils)
- Limiting red and processed meats
- Reducing or eliminating ultra-processed foods
- Swapping white bread, rice and pasta for whole grain versions
Need A Liver Specialist?
The Importance Of Exercise And Weight Loss
“Obesity is a major contributor to risk of both diabetes and fatty liver disease,” says Park. “Even a modest amount of weight loss—just 5% to 10% of your current weight—can significantly reduce your risk.”
A combination of savvy diet choices and increased activity can help you achieve a healthy weight. “Most people are too sedentary,” says Park. “Starting with just 20 minutes total of movement every day is a good goal.”
If you develop fatty liver disease early and start making changes to improve your overall health, you can slow progression of the disease and help heal your liver.
“Diabetes and fatty liver disease are very intertwined, and both have the common denominator of lifestyle,” says Park. “And while we can’t change our genetics, we can make small, manageable behavioral changes that can improve diabetes control, liver health and your overall well-being.”
Reviewed by Nancy Park, a registered dietitian for transplant patients at Henry Ford Health.
