Fatty liver: what to eat to ease the load.

Fatty liver. A scan you had for something else picked it up, and now you're wondering what to eat. Your GP was calm: 'Nothing serious for now, but your eating needs to change.' Your first instinct is to cut out fat.

'But I hardly use any oil,' people often tell me when they arrive with that scan. Then there's orange juice at breakfast, a smoothie mid-morning and a glass of wine in the evening. The liver is filling up from somewhere else.

Fatty liver: which foods to avoid?

First, the sugar you drink: fizzy drinks, fruit juice, iced tea. Then shop-bought sweet things and alcohol, which weigh on your liver more than good fats do.

• Liquid sugar. Fructose doesn't fill you up, so one juice follows another and you're still hungry.
• Shop-bought sweet things. Biscuits, cereal bars, filled pastries, fruit yoghurts: the label often says 'glucose-fructose syrup'.
• The evening glass. Alcohol fills the liver with fat too. I cover it in the article on wine.
• Margarine, snacks and fried food. Crackers, crisps, takeaway fried food. Trans fats can encourage a fatty liver.

Why the liver fills up

Your liver has a small tank. Fructose is handled almost entirely by the liver, which stores some of it as a sugar reserve. Once that's full, the rest is turned into fat and stays put.

Belly fat empties into the liver. Deep fat around the abdomen releases its fats into a vein that runs straight to the liver. That's why a big waist and a fatty liver tend to go together, and insulin tends to work less well.

It matters more than you think. Liver fat tends to upset your blood sugar, sometimes more than belly fat. And liver and kidneys are linked: when the liver gets lighter, the kidneys usually work better too.

What to eat, from breakfast to dinner

A savoury breakfast. Eggs, Greek yoghurt, nuts, and a piece of whole fruit if you fancy it. After the night, the liver's tank is empty, so it's the best time for fruit. Skip the juice. It's the fruit's sugar without its fibre.

At lunch and dinner, the oil stays. Vegetables and protein before carbs. Fish and chicken more often than red meat, extra virgin olive oil and a handful of walnuts. When two diets were compared over eighteen months, a Mediterranean diet with olive oil, nuts and few refined carbs cleared more fat from the liver than a low-fat diet.

Fruit, counted. One or two pieces at breakfast, then one before lunch and one late in the afternoon, with a few nuts or almonds. Better not straight after a meal. Dried figs, dates and grapes carry the most: a hundred grams of dried figs is already a whole day's fruit.

Moving matters as much as your plate. Ten to fifteen minutes on foot after meals, and two strength sessions a week. Working muscles take up the sugar that's just arrived, and weights help reduce deep belly fat.

Start this week with fizzy drinks and juice, the simplest lever. Keep your new habits going for a month, then tell your doctor about them at your next check-up.