What is fatty liver (NAFLD)?
Nonalcoholic fatty liver disease (also called metabolic dysfunction-associated steatotic liver disease in newer terminology) involves excess fat in the liver. Obesity, metabolic syndrome, and type 2 diabetes are important risk factors.
Many people have no symptoms early on. Blood tests (ALT, AST, GGT) and imaging can detect it. This guide is educational only — diagnosis and treatment require a healthcare provider.
Why low carb comes up in conversation
The liver plays a central role in glucose and fat metabolism. Diet quality, energy intake, body weight, activity, medicines, and other conditions can all affect liver health.
Some dietary interventions improve liver-fat measures, but this does not make a ketogenic diet the standard treatment for every patient. NIDDK emphasizes clinician-guided weight management and diet changes.
Practical steps (with your doctor)
Never stop medications or ignore elevated liver enzymes without medical guidance.
- Reduce sugar, soda, juice, and refined grains first.
- Choose an eating pattern and any carbohydrate target with your care team.
- Avoid aggressive extended fasting until liver and kidney function are evaluated.
- Follow the testing schedule recommended by your clinician.
Lifestyle stack for NAFLD
- Cut refined carbs and fructose-heavy drinks first
- Do not assume a fixed net-carb target treats fatty liver
- Add walking after meals — independent of weight loss
- Review liver tests and imaging on the schedule your doctor recommends
- See getting started keto for food lists