Fatty liver, or hepatic steatosis, occurs when excess fat accumulates within the liver cells, often without symptoms until the condition is advanced. Non-alcoholic fatty liver disease (NAFLD) is the most common form, affecting a significant portion of the adult population globally. This article summarizes the specific health recommendations of Dr. Eric Berg, D.C., who advocates for a multi-faceted approach to addressing this condition.
Understanding Insulin Resistance as the Cause
Dr. Berg’s approach is founded on the premise that the primary cause of fatty liver is not dietary fat, but rather the metabolic consequence of consuming excessive sugars and refined carbohydrates. This dietary pattern leads to insulin resistance, where the body’s cells become unresponsive to the hormone insulin. When insulin levels are chronically high, the hormone signals fat storage throughout the body, including the liver.
The liver is forced to convert the constant influx of excess glucose and fructose from the bloodstream into triglycerides, which are then stored as fat within the liver cells—a process called de novo lipogenesis. Fructose is particularly problematic because it is almost entirely metabolized by the liver, accelerating this fat-creation process.
The fatty liver is essentially a symptom of underlying metabolic dysfunction, specifically hyperinsulinemia (high insulin). By addressing the root cause of elevated insulin through dietary and lifestyle changes, the goal is to reverse the signal that forces the liver to store fat. This perspective shifts the focus to strategically controlling the hormonal environment.
The Primary Dietary Strategy
The core strategy recommended by Dr. Berg to lower insulin and reduce liver fat is the adoption of a very low-carbohydrate, high-healthy-fat diet, often referred to as a Healthy Ketogenic Diet. The primary mechanism is to drastically reduce carbohydrate intake, which minimizes the release of glucose and insulin production. By keeping carbohydrates below 50 grams per day, the body switches its fuel source from glucose to fat, entering a metabolic state called ketosis.
This shift to burning fat for fuel mobilizes and breaks down the accumulated triglycerides stored in the liver cells. Foods to eliminate include all forms of sugar, refined grains, and processed foods that contain hidden sugars or poor-quality oils. The diet prioritizes nutrient-dense foods:
- Large quantities of non-starchy vegetables, which provide fiber and essential nutrients.
- Healthy fats, such as olive oil, avocados, nuts, and seeds, consumed for satiety and energy without stimulating a major insulin response.
- Quality protein sources, like grass-fed beef, organic poultry, and wild-caught fish, included in moderate amounts to maintain muscle mass.
Leveraging Intermittent Fasting
Intermittent Fasting (IF) is presented as a complementary tool to the ketogenic diet, significantly accelerating the reduction of liver fat. IF involves cycling between periods of eating and extended periods of not eating, allowing insulin levels to drop to their lowest point for a sustained duration. This prolonged period of low insulin signals the body to start burning stored fat, including the fat residing in the liver.
Dr. Berg often recommends fasting windows like an 18/6 schedule, or even One Meal A Day (OMAD) for those who are metabolically adapted. During the fasting period, the body mobilizes fatty acids from storage, which the liver uses to produce ketones for energy. This process directly targets the fat accumulation in the liver.
Consistency in fasting is emphasized to continually challenge the body to utilize its fat reserves. The combination of restricted carbohydrates and extended fasting creates the hormonal environment necessary for the liver to heal.
Specific Supplements and Supporting Foods
Beyond the foundational diet and fasting protocol, certain supplements and foods are recommended as supportive elements for liver function and fat metabolism:
- Choline: This nutrient is highlighted for its role in transporting fat out of the liver cells, helping to prevent and reverse fat accumulation. It can be sourced from foods like egg yolks and beef liver.
- Apple Cider Vinegar (ACV): Frequently suggested before meals, ACV may help improve digestion and assist with blood sugar regulation, indirectly supporting a healthier liver environment.
- Specific B Vitamins: B1 and B3 are mentioned for their general support of the liver and in helping the body adapt to burning fat instead of sugar.
- Bile Salts or Ox Bile Supplements: Recommended for those experiencing digestive issues or a lack of bile flow. Bile is necessary for the proper breakdown and absorption of dietary fats and fat-soluble vitamins, assisting the overall digestive load while the liver heals.