Harvard doctors' surprising ranking: The best and worst foods for fatty liver

The liver is often one of the most overlooked organs in the body. It quietly performs over 500 essential functions — from detoxifying blood to breaking down fats and processing nutrients. However, modern eating habits, high in sugar, processed fats, and quick-fix meals, are placing immense strain on this vital organ.

Fatty liver disease, once thought to affect mainly heavy drinkers, is now increasingly seen in non-drinkers as well. This silent condition is becoming more widespread in India and globally.

To help separate fact from fiction, Dr. Saurabh Sethi — a Harvard- and Stanford-trained liver specialist — has ranked some of the most common and healthy foods from best to worst for managing fatty liver. Here’s his list, along with the reasoning behind each ranking.

Store-bought juices
Even those labelled “100% fruit” are often stripped of fibre and loaded with fructose and added sugars. Without fibre, sugar is absorbed too quickly, leading to fat build-up in the liver. Dr. Sethi ranks this as the worst food for fatty liver, as the excess sugar “eventually turns into fat, worsening fatty liver.”

Fresh fruit juice
Though better than packaged versions, freshly squeezed juices still lack fibre. The quick fructose hit, even from natural sources, can encourage liver fat accumulation. Whole fruits are a healthier choice than their juiced form.

Overripe bananas
These have a higher glycaemic index and more sugar. While not inherently harmful, for those with fatty liver, sugar spikes can add extra strain. Pairing bananas with protein or fibre can help slow the sugar impact.

Sugar-heavy smoothies
It depends on the ingredients. Many store-bought or café smoothies contain sugary fruits, syrups, or ice cream. As Dr. Sethi warns, such blends can “actually accelerate liver fat build-up.” Without careful choices, what seems like a health drink can turn into a liver burden.

Green tea
Supported by research, green tea is rich in catechins that help lower liver inflammation and may reduce fat levels. Dr. Sethi ranks it highly for its antioxidants, which aid liver regeneration. However, more than 4–5 cups a day should be avoided.

Beets
Packed with betaine, beets may assist liver detox pathways and reduce oxidative stress. Dr. Sethi recommends them for those with fatty liver, whether eaten raw, juiced, or roasted.

Berries
Berries such as blueberries, raspberries, and strawberries are loaded with polyphenols and anthocyanins, linked to improved liver health and reduced inflammation. Their low sugar and high fibre content make them a top choice.

Chia and basil seeds
Dr. Sethi notes these seeds expand in water, helping slow sugar absorption and lower cholesterol. Their omega-3 fats and fibre indirectly support liver health by boosting metabolic function. Just a spoonful in water or a smoothie can be beneficial.

Avocados
Rich in monounsaturated fats and glutathione, avocados support liver function. Dr. Sethi ranks them highly for reducing inflammation and improving good cholesterol. They remain underused in Indian diets but are worth adding in moderation.

Black coffee
Black coffee (without sugar or milk) has liver-protective effects backed by numerous studies. It may reduce the risk of liver fibrosis and improve enzyme levels. Dr. Sethi calls it the best for fatty liver when made with quality beans and consumed in moderation.

[With TOI inputs]