If you’ve been diagnosed with a type of liver disease called metabolic dysfunction-associated steatohepatitis (MASH), it’s important to know how your diet and supplement choices can make a difference in the health of your liver.
MASH happens when too many fat cells build up in your liver. They can cause inflammation and liver damage. MASH used to be called nonalcoholic fatty liver disease.
Food and nutrition play a big role in MASH. Some food choices and supplements can help, while others may be harmful. Some “liver detoxes” could be a waste of money or could even be bad for you. Understanding what to eat and what to avoid can make a difference in keeping your liver as healthy as possible.
Why nutrition matters if you have MASH
MASH happens when fat builds up in the liver. Over time, the damage MASH causes can lead to thickening (fibrosis), scarring (cirrhosis) or even liver failure.
MASH is closely linked to obesity, type 2 diabetes, high cholesterol, poor diet and a sedentary lifestyle.
“A balanced diet, weight control and a personalized nutrition approach can help,” said Margaret O’Brien, a registered dietitian with Banner - University Medicine.
A healthy MASH diet can help:
- Reduce fat in the liver
- Lower liver inflammation
- Improve blood sugar and cholesterol levels
- Reverse early-stage liver damage, in some cases
Supplements and MASH: Helpful or harmful?
Supplements are widely available but they are not regulated by the U.S. Food and Drug Administration (FDA). Labels may be incomplete and some products may contain unlisted or contaminated ingredients and/or additives that could be harmful to your liver.
“The current, evidence-based science for the risks and benefits of supplements remains limited and inconsistent. More research is needed,” O’Brien said.
It’s a common myth that you need supplements to “detox” your liver. In fact, detox supplements can sometimes do more harm than good, causing dehydration, electrolyte imbalances, medication interactions and even make your liver less healthy.
Supplements that may offer benefit (with caution)
Some supplements have shown potential benefits for people with MASH but they should only be used under medical guidance:
- Vitamin E: May reduce liver inflammation in some people but high doses can be harmful
- Omega-3 fatty acids: Found in fish oil, they can improve triglyceride levels and reduce inflammation
- Milk thistle: A plant extract often used for liver health, though scientific evidence is still limited
- Vitamin D: Supports bone and metabolic health; many people with MASH have low vitamin D levels
- Betaine: Early research suggests it may help but more studies are needed
“These supplements have been determined to be unlikely to cause liver injury. However, it is important to review any supplements with your provider as there may be a risk of medication interactions or contraindications if you have other medical concerns,” O’Brien said. “Be sure to take only the recommended doses as extremely high doses can put a strain on the liver, especially if you have already been diagnosed with liver disease.”
Supplements to avoid if you have MASH
Other supplements have been linked to liver damage and are generally not recommended for people with liver disease:
- Herbal blends (including Herbalife) and detox products, which could have unlisted ingredients or contaminants
- Ashwagandha
- Black cohosh
- Garcinia cambogia
- Green tea extract (brewed tea is safe but concentrated extracts are risky)
- Red yeast rice
- Turmeric/curcumin in high-dose extract form
- Kava
- Comfrey
- Chaparral
Weight-loss and bodybuilding supplements can also be risky because of unlisted ingredients or harmful additives. Always talk to your health care provider before taking anything new.
Smart snacking with MASH: What to eat instead
“Food choices matter when living with MASH because diet directly influences the underlying causes and progression of the disease,” said Beril Hezer, a registered dietitian with Banner - University Medicine.
Healthy snacks can help control your blood sugar, reduce cravings and keep your liver as healthy as possible.
Follow these label-reading tips to find healthier choices:
- Low added sugars: Aim for less than 5 grams per serving (ideally none); it’s especially important to avoid fructose
- Low total sugars: Less than 8 grams per serving unless it’s naturally occurring, like in fruit
- High fiber: Choose snacks with 3 grams or more
- Low sodium: Keep under 140 milligrams per snack or 400 milligrams per meal
- Low saturated fat: Less than 2 grams per serving (choose healthy fats instead)
Better-for-you snack ideas
“People with MASH should focus on lowering added sugar intake and choosing natural sweetness like fruits. Snacks should have a lower glycemic index to avoid spikes in blood sugar. High-fiber options are good choices,” Hezer said.
Choosing the right snacks can give you protein, healthy fats, fiber, omega-3s and antioxidants. These nutrients can help manage blood sugar, reduce insulin resistance and lower inflammation. Reach for:
- A handful of unsalted nuts like almonds, walnuts or pistachios
- Plain Greek yogurt with berries
- Veggie sticks with hummus or guacamole
- Unsweetened chia seed pudding
- Air-popped popcorn
- Roasted, low-sodium chickpeas
- Low-sodium cottage cheese
- Apple slices with almond butter that doesn’t have added sugar or hydrogenated oil
- Whole grain crackers with nut butter or hummus
- Baked sweet potato slices
- Plain oatmeal with cinnamon
- Hard-boiled egg
- Fresh berries, which have a lower glycemic index than many other fruits
“Watch out for marketing traps like ‘natural,’ ‘organic’ or ‘heart healthy.’ These don’t mean it's liver-friendly,” Hezer said. “Look for certifications like ‘non-GMO,’ ‘no added sugar’ and ‘low sodium’ but still verify the nutrition label. When in doubt, go for single-ingredient snacks like fresh fruit, boiled eggs or unsalted nuts.”
The Mediterranean-style diet: A sustainable approach
“A nutrient-dense, Mediterranean-style diet has been associated with slower progression of liver scarring in people with MASH,” Hezer said.
The Mediterranean diet is often recommended for people with MASH. It emphasizes:
- Fruits and vegetables
- Whole grains and legumes
- Fish and seafood
- Nuts and seeds
- Olive oil
It also supports heart health, which is important since many people with MASH are at higher risk for cardiovascular disease.
Putting it all together: Supporting your liver health
Managing MASH is not about quick fixes. It’s about making consistent, healthy choices. Some of the best steps you can take are:
- Eating a balanced, whole-foods diet and drinking plenty of water
- Limiting added sugars, saturated fats and alcohol
- Choosing snacks that stabilize your blood sugar
- Talking to your doctor before starting any supplement
- Staying active and maintaining a healthy weight
Your care team can help you create a personalized nutrition plan that fits your lifestyle.
Next steps with Banner Health
If you’ve been diagnosed with MASH or you want advice for protecting your liver, Banner Health’s dietitians and specialists are here to help. Together, we’ll create a plan that supports your liver health and your overall well-being. Reach out to connect with one of our experts today.
