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You go to the doctor for your yearly checkup, and no one talks about your liver. Time goes by, and you hear more people saying they have something called “fatty liver.” You think, “That’s not me.”

But without knowing it, you might already have it—and it could be getting worse.

Then one day, your doctor says your liver enzymes don’t look good. You get an ultrasound, and they say you have non-alcoholic fatty liver. You feel nervous, but your doctor says, “Don’t worry. Just lose a few pounds.”

Because they don’t seem worried, you don’t feel worried either.

What you might not know is that non-alcoholic fatty liver can get worse over time. And when it does, it can lead to other health problems like high blood pressure, type 2 diabetes, heart disease, and liver failure.

I wrote this article to give you helpful information. The kind of information most checkups miss. It can help you take control—before non-alcoholic fatty liver harms your health.

Keep reading. And if you have questions, you can email me at robert@dietfreelife.com.

What Is the Liver and What Does It Do?

Your liver is one of the most important organs in your body. It’s about the size of a football and sits just under your rib cage on the right side of your belly. The liver has over 500 jobs, but here are a few of the most important:

• It helps clean your blood by removing toxins.
• It breaks down fats and helps your body use them for energy.
• It stores vitamins and minerals.
• It helps control your blood sugar.
• It makes and clears cholesterol from your body.

Simply put, your liver is your body’s built-in detox system—and you can’t live without it.

What Is Non-Alcoholic Fatty Liver Disease (NAFLD)?

Non-alcoholic fatty liver disease (NAFLD) happens when too much fat builds up in the liver. This isn’t caused by drinking alcohol—that’s a different type of liver disease. In contrast, alcoholic fatty liver disease (AFLD) is caused by excessive alcohol use over time, which also leads to fat buildup and liver damage. NAFLD, however, occurs in people who drink little or no alcohol and is driven mostly by poor diet, insulin resistance, and lifestyle factors [9].

The scary part? Most people don’t know they have it.

And here’s what’s more alarming: In 1975, NAFLD was nearly unheard of. It wasn’t even formally recognized in medical literature until the 1980s. Today, it is the most common liver disease in the world.

Recent estimates suggest that by 2025, up to 50% of U.S. adults may have some form of NAFLD, particularly under the expanded definition of metabolic dysfunction-associated fatty liver disease (MAFLD). Globally, the condition affects about 25–30% of adults, and the number continues to rise [6][9].

Equally concerning is the growing number of children with fatty liver. NAFLD is now the most common liver disease in children, especially those with overweight or obesity. Prevalence in U.S. children ranges from 5–10% in the general population and up to 38% in children with obesity [2][3].

Symptoms of NAFLD and the Four Stages of Fatty Liver Disease

NAFLD often has no symptoms. When symptoms do occur, they may include:

• • Fatigue
  • Not feeling well, or general malaise
  • Pain or discomfort in the upper right belly area

As NAFLD progresses to NASH (non-alcoholic steatohepatitis) or cirrhosis, more serious symptoms may appear:

• • Itchy skin
  • Abdominal swelling (ascites)
  • Shortness of breath
  • Swelling of the legs
  • Spider-like blood vessels just beneath the skin’s surface
  • Enlarged spleen
  • Red palms
  • Yellowing of the skin and eyes (jaundice)

NAFLD progresses in four stages:

1. 1. Simple fatty liver (steatosis): Extra fat builds up in the liver, but there’s no damage—yet.
   2. Non-alcoholic steatohepatitis (NASH): Fat in the liver causes inflammation and damage.
   3. Fibrosis: Inflammation leads to scarring (like small cuts that don’t heal right).
   4. Cirrhosis: Severe scarring makes the liver stiff and unable to work properly. This can lead to liver failure or liver cancer [5].

How Fatty Liver Hurts Your Health

When fat builds up in your liver, it gets in the way of the liver doing its job. Even in the early stages, a fatty liver can:

• • Make it harder for your liver to break down fats, which leads to higher triglycerides and cholesterol in the blood
  • Lower your liver’s ability to filter toxins, which can affect your immune system and overall energy
  • Disrupt blood sugar control, increasing the risk of insulin resistance and type 2 diabetes
  • Slow down bile production, which affects how you digest fats and absorb vitamins like A, D, E, and K
  • Increase whole-body inflammation, which raises your risk for heart disease, stroke, and other chronic conditions [4]

So even if you don’t feel sick, a fatty liver quietly increases your risk for many health problems. That’s why catching it early—and taking action—is so important.

Why NAFLD Is Often Missed in Medical Checkups

Many doctors don’t routinely screen for fatty liver unless a person has abnormal liver enzymes on blood tests. But even then, many people with NAFLD have normal lab results [1].

Unlike blood sugar or cholesterol, there is no simple test done at a standard physical exam to detect liver fat. Diagnosis often requires imaging like an ultrasound or specialized blood tests, which are not always ordered unless there are other warning signs.

What Causes Fatty Liver?

Fatty liver is often caused by a mix of poor nutrition and metabolic imbalance. The most common drivers include:

• • Diets high in sugar (high fructose corn syrup), soda, and refined carbs
  • Insulin resistance and elevated insulin levels
  • Sedentary lifestyle
  • Too much omega-6 fat (from seed oils) and not enough omega-3
  • Low intake of polyphenols (antioxidants from plants like berries, olives, and green tea)

How Omega-3s and Polyphenols Can Help Reverse Fatty Liver

The exciting news? Fatty liver can be reversed—especially in its early stages. Two of the most well-studied and effective nutrients for reversing NAFLD are omega-3 fatty acids and polyphenols.

Omega-3 Fatty Acids

Omega-3s (from fish like salmon, sardines, and anchovies) reduce liver fat, lower inflammation, and improve insulin sensitivity. A 2016 meta-analysis confirmed that omega-3 supplements significantly reduce liver fat in people with NAFLD [8].

Polyphenols

Polyphenols are antioxidants found in olives, berries, grapes, and green tea. They help protect the liver and reduce inflammation. When combined with omega-3s, they are even more powerful at reducing liver fat and improving liver enzyme levels [7].

Real-Life Success: Reversing Fatty Liver With Nutrition

In my work with clients, I’ve seen firsthand how test-based nutrition and targeted support using a supplement like BalanceOil+—which combines omega-3s and polyphenols—can make a big difference.

Many clients who started with elevated liver enzymes and fatty liver saw measurable improvements within a few months. Energy came back. Blood pressure and insulin levels improved. Liver health markers returned to normal. And in some cases, fatty liver completely reversed.

What You Can Do Today

If you’re concerned about fatty liver, here are smart, simple steps to begin healing:

• • Reduce sugar, processed food, and refined carbs
  • Move your body daily (walking counts!)
  • Eat more fiber and whole plant foods
  • Add healthy omega-3 fats from fish or supplements
  • Include polyphenol-rich foods (berries, olives, dark chocolate, green tea)
  • Consider a supplement like BalanceOil+ to support liver repair

Final Thoughts

Fatty liver disease is silent—but not hopeless. With the right support, many people can reverse fatty liver and reclaim their energy, health, and quality of life.

You don’t need extreme diets or medications. You need the right food, the right fats, and a science-based strategy.

Let your liver do what it was made to do—and give it the support it needs.

Lastly, if you have more questions, feel free to email me at robert@dietfreelife.com. You can also schedule a free consultation to talk about what options are best for you. I’m here to help!

References

1. 1. Adams, L. A., Angulo, P., & Lindor, K. D. (2005). Nonalcoholic fatty liver disease. CMAJ, 172(7), 899–905. https://doi.org/10.1503/cmaj.045232 
   2. Al Dayel, F., Alqahtani, A. R., & Al Anazi, W. (2023). Non-alcoholic fatty liver disease in children and adolescents: Epidemiology and implications. World Journal of Hepatology, 15(5), 510–522. https://doi.org/10.4254/wjh.v15.i5.510
   3. Anderson, E. L., Howe, L. D., Jones, H. E., Higgins, J. P. T., Lawlor, D. A., Fraser, A. (2015). The prevalence of non-alcoholic fatty liver disease in children and adolescents: A systematic review and meta-analysis. PLoS One, 10(10), e0140908. https://doi.org/10.1371/journal.pone.0140908
   4. Buzzetti, E., Pinzani, M., & Tsochatzis, E. A. (2016). The multiple-hit pathogenesis of non-alcoholic fatty liver disease (NAFLD). Metabolism, 65(8), 1038–1048. https://doi.org/10.1016/j.metabol.2015.12.012
   5. Chalasani, N., Younossi, Z., Lavine, J. E., et al. (2018). The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases. Hepatology, 67(1), 328–357. https://doi.org/10.1002/hep.29367
   6. Paik, J. M., Henry, L., De Avila, L., Younossi, E., Racila, A., Younossi, Z. M. (2022). Mortality related to nonalcoholic fatty liver disease is increasing in the United States. Hepatology Communications, 6(6), 1520–1530. https://doi.org/10.1002/hep4.1903
   7. Tarantino, G., Citro, V., Finelli, C., & Capone, D. (2020). Polyphenols: Benefits to the cardiovascular system in health and in aging. Nutrients, 12(5), 1384. https://doi.org/10.3390/nu12051384 
   8. Yan, J. H., Guan, B. J., Gao, H. Y., Peng, X. E., & Peng, Y. D. (2016). Omega-3 polyunsaturated fatty acid supplementation and non-alcoholic fatty liver disease: A meta-analysis of randomized controlled trials. Clinical Nutrition, 35(1), 153–160. https://doi.org/10.1016/j.clnu.2015.02.003
   9. Younossi, Z. M., Koenig, A. B., Abdelatif, D., Fazel, Y., Henry, L., & Wymer, M. (2016). Global epidemiology of nonalcoholic fatty liver disease—Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology, 64(1), 73–84. https://doi.org/10.1002/hep.28431

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Robert Ferguson is a California- and Florida-based single father of two daughters, nutritionist, researcher, best-selling author, speaker, podcast and television host, health advisor, NAACP Image Award Nominee, creator of the Diet Free Life methodology, and Chief Nutrition Officer for iCoura Health. He also serves on the Presidential Task Force on Obesity for the National Medical Association and the Health and Product Advisory Board for Zinzino, Inc.

You can reach Robert via email at robert@dietfreelife.com.

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