Managing fatty liver disease and type 2 diabetes can be challenging, but by working with your doctor and making the right dietary choices, you can improve your health, prevent complications, and start feeling better.

Fatty liver disease and type 2 diabetes are closely related. They share some underlying conditions, like insulin resistance, when your cells can’t use insulin effectively, and inflammation.

Fortunately, there are some simple dietary and lifestyle changes that can help with both fatty liver disease and type 2 diabetes. Here are five essential food tips that can support liver health while keeping blood sugar levels in check.

Fatty Liver Disease and Diabetes Connection

In 2023, nonalcoholic fatty liver disease (NAFLD) was renamed metabolic dysfunction-associated steatotic liver disease (MASLD). It occurs when too much fat (triglycerides) builds up in your liver, even though you haven’t been drinking excessive amounts of alcohol. Some people with MASLD have metabolic syndrome, which raises their risk of type 2 diabetes.

Type 2 diabetes and liver disease share common risk factors, including obesity, high cholesterol levels, and unstable blood sugar. Type 2 diabetes can damage internal organs, including the liver. In fact, individuals with type 2 diabetes are up to three times more likely than the general population to develop liver cancer, and 60 percent to 70 percent of people with type 2 diabetes live with MASLD. Fortunately, lifestyle changes like healthier eating habits can help you manage both fatty liver disease and diabetes.

5 Food Tips for Fatty Liver Disease and Type 2 Diabetes

To manage fatty liver disease and type 2 diabetes through diet, choose foods that support liver health while keeping your blood sugar stable. Experts often recommend a balanced diet that’s rich in fiber, healthy fats, and nutrients, but low in added sugars, refined carbohydrates, and excess calories. Make sure to check with your doctor or dietitian before making any changes to your diet. They know your medical history and can help you explore which foods are best for you.

1. Fill Up on Fiber

Dietary fiber, also known as roughage, is the part of plant foods that your body can’t absorb. It adds bulk to your food intake, which helps you feel full and enables food to move through the digestive tract more easily. There are two kinds of fiber: soluble and insoluble.

Soluble fiber is especially important for people with diabetes because it helps lower glucose levels. It’s found in foods like beans, apples, and oats. Research has shown that fiber-rich foods like vegetables, fruits, whole grains, and legumes can prevent obesity and MASLD.

Get more fiber in your diet by filling half of your plate with vegetables or by adding a side of legumes or whole grains, such as quinoa or brown rice, to your meal.

2. Limit Sugar and Refined Carbohydrates

Reducing or eliminating foods that are high in added sugars and refined carbohydrates — such as sugary drinks, white bread, pastries, ice cream, and candy — can improve the symptoms of fatty liver disease and high blood sugar.

Research has shown that added sugars and refined carbohydrates are a major contributor to MASLD. That’s because your body converts excess sugar into fat, which can build up in the liver. Consuming too much added sugar can also trigger hyperinsulinemia (too much insulin in the blood). Hyperinsulinemia is associated with type 2 diabetes.

Try swapping refined carbohydrates for complex carbohydrates like whole grains, brown rice, and legumes like beans or lentils, which are digested more slowly and have less immediate impact on blood sugar levels. These changes to your diet will keep you healthy and energized. Whenever possible, avoid added sugars by passing on the sweets and checking the nutritional information on packaged foods.

3. Get a Helping of Healthy Fat

Healthy fats — and particularly omega-3 fatty acids, which you’ll find in fish, nuts, and seeds — reduce liver inflammation and improve insulin resistance.

Recent studies suggest that omega-3 fatty acids could be beneficial for people with MASLD. Although further research is needed to determine the best doses, omega-3s may reduce the production of proinflammatory substances in the liver, which can lower the risk of liver damage.

For people with type 2 diabetes, omega-3 fatty acids can improve the body’s response to insulin, making it easier for cells to absorb glucose from the blood. This improved insulin sensitivity helps regulate blood sugar levels and reduces the risk of type 2 diabetes, which is often associated with fatty liver disease.

Aim to include fatty fish like salmon, mackerel, sardines, or trout in your diet at least twice a week. Not a fish fan? Add a handful of nuts (such as walnuts) or seeds (like flax or chia) to your daily snacks or meals. These can be sprinkled over yogurt, added to smoothies, or mixed into salads.

4. Include Antioxidant-Rich Foods

Antioxidants are plant-based nutrients that can reduce inflammation and protect cells from damage. Antioxidant-rich foods include berries, leafy greens, nuts, and seeds. Leafy greens, for instance, contain a powerful antioxidant called glutathione, which can be good for liver health, and green tea is rich in antioxidants called catechins, which may help prevent liver cancer.

High blood sugar, which commonly occurs in people with uncontrolled type 2 diabetes, can lead to the production of unstable molecules known as free radicals, which damage your cells. The antioxidants you obtain through your diet are effective at reducing this damage.

Add antioxidants to your meals by tossing a handful of leafy greens into your eggs, topping yogurt or oats with berries and nuts, or sipping a cup of green tea.

5. Regulate Portions and Balance Meals

Eating a lot of food at once can also create extra work for your liver. When you consume a large amount of food, especially if it’s high in fats and sugars, your liver has to process and store the excess nutrients. This can lead to an increase in fat deposits in the liver, eventually contributing to fatty liver disease.

The glycemic index is a measurement of how different foods impact our blood sugar. Our bodies quickly absorb foods with a higher glycemic index, like white bread, white rice, and sugar. This causes a drastic rise in blood sugar. But foods with a lower glycemic index — like nonstarchy vegetables, whole grain breads, and legumes — are absorbed more slowly, resulting in healthier blood sugar levels.

You can lower your food’s glycemic index by pairing protein (eggs, lean meat, tofu, fish, low-fat dairy) with fiber (fruits, vegetables, whole grains). This is why balanced diets are the way to go. When it comes to portion sizes, you can use this handy guide to build your meals.

Talk With Others Who Understand

On DiabetesTeam, the social network for people with type 2 diabetes and their loved ones, more than 157,000 members come together to ask questions, give advice, and share their stories with others who understand. Many members also live with fatty liver disease.

Which of these tips are you ready to try? Have you found other recipes or food substitutions that work for you? Share your experience in the comments below, or start a conversation by posting on your Activities page.