Best and Worst Drinks When You Have Fatty Liver

It’s not just the foods you eat but also the beverages you drink that can affect fatty liver, also known as metabolic dysfunction-associated steatotic liver disease (MASLD). Many drinks can boost liver health while others speed up the damage when fat builds up in the liver. A key diet culprit is sweetened beverages, especially high-calorie ones with fructose. The sugar is so easily taken up by the liver and turned to fat. But there are many healthful drinks you can choose from instead.

Getting plenty of water is a must to help your liver (and your entire body) work at peak performance. That’s because water helps regulate all the components of your metabolism. One research analysis found that drinking plenty of water is linked to a lower risk of death from all causes in people with MASLD. Make staying hydrated tastier by flavoring water with slices of citrus fruit or cucumber or a few berries. Not a huge fan of tap? Try seltzer for a fun fizz.

Even though MASLD is not caused by drinking alcohol, all types of alcohol — whether wine, beer, hard liquor, or alcohol-infused carbonated drinks — can make it worse. Also, research suggests there’s no serving size that’s guaranteed to be safe. In fact, even small amounts can speed up liver damage and its progression to advanced stages. This is because of the many pathways alcohol negatively influences from metabolism to the immune system.

According to research on coffee and liver disease, drinking between two and three cups a day cuts the risk for scarring when you have fatty liver. And it doesn’t matter how the coffee was brewed or even if it’s instant. However, the protective effects, which come from caffeine, are strongest with black coffee. Since caffeine affects everyone differently, talk to your doctor before starting or increasing a coffee habit.

Whether your soda is sweetened with high-fructose corn syrup, cane sugar (a mix of fructose and glucose), or any other added sugars, these drinks can both cause and worsen fatty liver. Because the liver metabolizes sugar quickly, drinking soda results in more fatty deposits and leads to insulin resistance and liver scarring. Sugary drinks are also a major cause of overweight, a contributor to MASLD.

As for diet sodas, their artificial sweeteners along with preservatives, flavor enhancers, and dyes upset gut bacteria, triggering inflammation and leaving the liver less able to do its job. Surprisingly, drinks with the artificial sweetener sucralose (Splenda) may leave you hungry because they change the way your brain interprets sweet taste. That makes it hard to lose weight, an important part of a MASLD management plan.

Tea’s health benefits come from its anti-inflammatory and antioxidant phytonutrients. By comparing groups of tea drinkers and non-tea drinkers, one study found that caffeinated black tea may slow MASLD progression. Other research suggests that drinking between two and four cups of tea a day can boost liver health. But cup for cup, tea has about half the caffeine of coffee, and the exact amount to drink isn’t completely clear, including for green tea.

You might like herbal tea for the taste or to cut back on caffeine midday, but there are concerns about them and even more so for herbal supplements that promise to detox the liver. Ironically, some herbal teas, like kava-kava and valerian, may cause liver toxicity, hepatitis, and even liver failure, especially when you have MASLD. Avoid using any herbal or medicinal tea before talking to your doctor.

There aren’t any positives from sugar-sweetened beverages. This wide category ranges from sweet tea and lemonade to sports beverages and energy drinks. As different as these products are, their effect is the same. Your liver converts the sugars in these drinks to fat, worsening MASLD. Adding insult to injury, they do nothing to quell hunger, leading you to take in more calories and, as a consequence, potentially gain more weight.

Although 100% fruit juices don’t contain added sugars, they’re still loaded with fructose, and even natural fructose does little to boost liver health. Of course, fruit juices with added sugars can be downright dangerous. It’s too easy to drink oversized amounts rather than the suggested portion size of a half-cup. Get juicy goodness by eating ripe whole fruits — it’s hard to eat too many.

Full-fat dairy can tax the liver, but drinking fat-free or low-fat milk gives you protein, calcium, and vitamins without all the saturated fat. One study found that milk (and yogurt) can even help people avoid fatty liver. Ask your doctor what’s the right amount of milk for you to have on a daily basis and whether it should be skim, 1%, or 2% fat.

Smoothies are a tasty and convenient drinkable breakfast or snack, but they’ll cause more harm than good if loaded with too much fruit, fruit juice, and high-fat ingredients. To avoid sugar overload, use water or milk as the blending liquid and limit yourself to one cup of fruit (frozen chunks make a thicker drink). Add in leafy greens, like a handful of spinach, a few nuts or seeds, and avocado chunks to boost the nutrients and fiber.