These 2 Dietary Patterns Reduce Liver Disease Risk By Almost A Third
The liver is a key player in metabolic health. And declining metabolic health (like insulin resistance, elevated blood glucose, and excess fat), can take a toll on the liver. Conditions including metabolic dysfunction-associated steatotic liver disease or MASLD (which now affects nearly 38% of adults worldwide), cirrhosis, and liver cancer can all result from metabolic health complications.
However, improving your metabolic health, particularly through diet, is an effective prevention tactic. But what does "eating healthy" actually mean for your liver? A new meta-analysis outlines two dietary patterns that are supportive of liver health.
About the study
The study set out to determine whether two well-established measures of diet quality — the Healthy Eating Index (HEI) and the Alternative Healthy Eating Index (AHEI) — are linked to chronic liver disease risk, including MASLD, fibrosis, cirrhosis, and liver cancer.
- The Healthy Eating Index1 scores diet quality based on adequacy (getting enough fruits, vegetables, whole grains, dairy, protein, and healthy fats) and moderation (limiting refined grains, sodium, added sugars, and saturated fat).
- The Alternative Healthy Eating Index focuses on foods and nutrients consistently linked to chronic disease prevention in research. It rewards higher intakes of vegetables, fruit, whole grains, nuts, legumes, omega-3 fatty acids, and moderate alcohol, while penalizing red and processed meat, sugar-sweetened beverages, trans fats, and sodium.
To find out how adhering (or not adhering) to these diets impact risk of liver conditions, researchers conducted a systematic review and meta-analysis of 28 articles comprising 50 studies and 624,914 total participants (from relevant studies published before February 2025).
Higher diet quality scores linked to lower liver disease risk
People with higher AHEI scores had a 29% lower risk of chronic liver disease, while those with higher HEI scores had a 32% lower risk.
Subgroup analyses revealed that the AHEI was protective against MASLD, liver cancer, and overall chronic liver disease, with particularly strong associations in Asia and North America. The HEI showed similar benefits, plus an additional link to lower fibrosis risk.
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Building a liver-supportive plate
You don't need to track points to eat in a way that supports liver health. Based on what these indices reward, here's what that looks like in practice:
- Fill half your plate with vegetables and fruit: Aim for variety and color (leafy greens, cruciferous vegetables, berries, and citrus all count).
- Choose whole grains over refined: Swap white bread, pasta, and rice for whole-grain versions, oats, quinoa, or farro.
- Include fiber-rich nuts and seeds: Beans, lentils, nuts, and seeds are staples in both high-scoring dietary patterns.
- Prioritize healthy fats: Olive oil, avocado, nuts, and fatty fish (rich in omega-3s) support metabolic health.
- Limit ultra-processed foods: Sugary drinks, packaged snacks, and processed meats are penalized by both indices — and consistently linked to poorer liver outcomes.
You don't need to track points to eat in a way that supports liver health. Based on what these indices reward, here's what that looks like in practice:
The takeaway
This large meta-analysis reinforces that overall diet quality (rather than individual foods or nutrients) offers strong metabolic protection against liver disease. Both indices point to the notion of including more whole foods and limiting processed ones, maintaining that consistency over time.