Steatotic liver disease (previously called fatty liver disease) is when fat builds up in the liver. This makes it difficult for the liver to work like it should. It is a common liver disease worldwide that affects more than 30% of the population.

There are different types of steatotic liver disease depending on the cause of the fat accumulation. Drinking high amounts of alcohol can be one cause, but it can also occur in people who do not drink alcohol. The following is a list of what increases the risk of fat buildup in the liver:

• obesity
• type 2 diabetes
• heart disease
• insulin resistance (when insulin does not work to take sugar from the blood)
• high cholesterol
• high triglycerides (a type of fat in the blood)
• high blood pressure

How do you know if you have fat built up in the liver?

Steatotic liver disease is diagnosed by a physician using a variety of tests. These might include physical exams, blood tests, imaging tests, or a biopsy.

Most people with early liver disease have no symptoms. If there are symptoms, people may feel very tired, weak, and have pain or discomfort in the upper right side of the belly.

If steatotic liver disease is managed early, it is possible to reduce fat buildup and slow down or reverse damage to the liver.

Treatment involves managing pre-existing health conditions (example, managing blood sugars or cholesterol) and making lifestyle changes. Together with the healthcare team, it’s important to discuss diet, exercise, medication, sleep, stress and more.

Preventing Steatotic liver disease

Some of the lifestyle changes that can help to prevent and treat steatotic liver disease include:

• Eating a healthy diet -- A Mediterranean-style of eating includes the following strategies. Try these tips or ask to speak to a registered dietitian about eating for your liver health.

o Add enough vegetables and fruits each day: Add frozen vegetables like peas or spinach to sauces, soups, stews, chili or casseroles. Eat raw vegetables like carrot, celery, bell pepper, or cucumber as a snack. Eat fruit like a fresh apple, thawed from frozen blueberries, or peaches canned in water for breakfast.
o Choose whole grains most often: Eat whole grain cereals, like oatmeal, for breakfast. Add cooked brown rice or barley into soups, stews, or salads. Eat plain air-popped popcorn as a snack.
o Choose lower fat protein foods at each meal: Drink smoothies made with skim, 1%, or 2% milk, Greek yogurt. Choose lean cuts of meat, like beef loin and skinless turkey breast. Add plant proteins like tofu, beans, or lentils to stews, salads, and stir-fries.
o Eat foods with omega-3s fats: Eat fatty fish like trout, sardines, tuna, or salmon a few times a week. Add walnuts or ground flaxseed to cereal or yogurt. Eat eggs fortified with omega-3 fats.
o Limit saturated fats: Choose meat with less marbling and trim the fat from meat like steak or pork chops before eating. Cook with vegetable oils, like canola or olive, instead of butter. Limit processed meats like bacon, hot dogs, sausages, and bologna.
o Limit added sugars: Added sugars are different from natural sugars found in fruit and milk. Added sugars are put into a food or drink by manufacturers. Drink water instead of sweetened drinks, like soft drinks, energy drinks, or juice. Choose fruit that is fresh, frozen, or canned in water as a dessert or sweet snack.

• Move your body -- Adding movement in your day can reduce your risk of some types steatotic liver disease and can increase chances of reversal. Movement and activity can be any movement that takes some effort, for example: gardening, carrying laundry, or walking a dog

. • Limiting sedentary time – Reducing the time when you are not active can also help to improve your liver health. Canadian guidelines recommend:

o Keep low-energy activities, like sitting or reclining, to less than 8 hours a day.
o Take the time to move in between low-energy activities.
o Limit screen time, like watching television or browsing social media, to less than 3 hours a day.

• Try to get enough sleep – Quality sleep can help your body work the best it can, including your liver. Having quality sleep means sleeping for the recommended hours and limiting interruptions. For good quality sleep, the Canadian guidelines recommend:

o Getting 7-9 hours of sleep per night for adults.
o Consistent bedtimes and wake times, even on weekends.
• Avoid or limit alcohol – When steatotic liver disease is caused by alcohol, it is recommended to completely stop drinking alcohol. When steatotic liver disease is caused by metabolic risk factors, limiting alcohol can help to protect your liver. Any amount of alcohol can increase your health risks. For more information on Canadian guidelines, visit ccsa.ca/Alcohol and click on the “Canada’s Guidance on Alcohol and Health” tab.

For more support

If you need help or are concerned with someone else’s substance use, call:

• Health Link at 811 or 1-866-332-2322.
• Call Health Link at 811 and ask to talk to a dietitian or complete a self-referral form on ahs.ca/811.
• Visit ahs.ca/NutritionHandouts for handouts on related health conditions and on healthy eating.
• Call, text, or chat with 211 Alberta (ab.211.ca/) to find out about financial benefits, programs, and services.

For more information on liver health, look to Canadian Liver Foundation at liver.ca.
For more information on movement guidelines for health, look to The Canadian Society for Exercise Physiology (CSEP) at CSEPGuidelines.ca.