Stop or reduce alcohol completely
Avoid sugary drinks (soda, juice, sweet tea, energy drinks)
Cut back on refined carbs (white bread, pastries, sweets, white rice)
Reduce added sugars and fructose in packaged foods
Follow a calorie deficit if overweight (aim for gradual weight loss)
Eat a Mediterranean-style pattern (vegetables, legumes, whole grains, nuts, olive oil, fish)
Increase protein at each meal (fish, poultry, eggs, tofu, Greek yogurt, legumes)
Choose whole grains over refined grains
Limit saturated fats (butter, fatty red meat, full-fat dairy) and avoid trans fats
Include omega-3 sources (salmon, sardines, trout) 2–3 times/week
Avoid “crash diets” and fasting extremes
Exercise 150+ minutes/week of moderate activity (brisk walking, cycling) plus 2 days/week resistance training
Reduce sedentary time (stand and move regularly throughout the day)
Aim for 7–10% body weight loss if overweight (can improve fatty liver)
Take prescribed medications only (do not start supplements to “treat” fatty liver without clinician guidance)
Manage diabetes and insulin resistance (follow treatment plan; monitor glucose/A1c)
Control cholesterol and blood pressure if applicable
Get regular lab follow-up (ALT/AST, lipids, A1c) as advised
Sleep 7–9 hours/night and address sleep apnea if present
Discuss vitamin E or other options with a clinician if you have NASH/advanced risk
Seek urgent care if you have jaundice, severe abdominal pain, vomiting blood/black stools, or confusion