You probably know that heavy drinking is hard on the liver. What most of us never think about is that the organ can get into trouble without any alcohol at all.
The real culprits often sit on the kitchen counter and in your medicine cabinet.
About 1 in 4 US adults now has non-alcoholic fatty liver disease, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
It is usually a silent condition, meaning most people have no symptoms until the damage is well under way.
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The disease, also called MASLD (metabolic dysfunction-associated steatotic liver disease), is driven mostly by diet and lifestyle.
Here are seven everyday habits that may quietly feed it, and a simple swap for each.
Drinking sweet drinks every day
Fructose is the sugar in soda, sweetened iced tea, sports drinks and fruit juice.
The NIDDK says diets high in fructose may increase the risk of fatty liver disease, because the liver turns much of it into fat.
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A reasonable swap is water, unsweetened tea or sparkling water as the default, with sugary drinks saved for occasions.
Sitting most of the day
Long stretches of sitting have been linked to higher rates of fatty liver, even in people with a normal weight and even in those who exercise.
A simple fix is a short walk every hour or two during the workday, not just one workout at the end of it.
Taking acetaminophen more freely than you should
Acetaminophen is the active ingredient in Tylenol, and taking too much of it can cause liver damage serious enough to require a transplant.
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MedlinePlus, the NIH's consumer health service, warns adults not to take more than 4,000 mg from all sources in a single day.
The trap is that acetaminophen hides in cold, flu and sleep combination products, so doses can stack up without you noticing. Reading every label and keeping a running total protects the liver.
Stacking herbal supplements that promise liver support
A study in JAMA Network Open from August 2024 estimated that about 15.6 million US adults had used at least one of six botanicals linked to liver injury in the past 30 days.
The list is turmeric, green tea extract, ashwagandha, Garcinia cambogia, black cohosh and red yeast rice.
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The safer habit is to run any supplement, especially a weight-loss or "detox" product, past your doctor or pharmacist first.
Carrying extra weight around the middle
NIDDK data show fatty liver turns up in up to 75% of people who are overweight and in more than 90% of people with severe obesity. Belly fat in particular tracks with liver fat.
Gradual weight loss works. Even a 3% to 5% drop in body weight can reduce liver fat.
Making ultra-processed food the default
Packaged snacks, fast food and sweetened cereals pile on added sugar, refined carbs and saturated fat.
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NIDDK guidance for people with fatty liver recommends replacing saturated and trans fats with unsaturated fats, and leaning on vegetables, fruit and whole grains.
A workable swap is making one home-cooked meal with a vegetable the anchor of most days.
Letting prediabetes or type 2 diabetes drift
Between one-third and two-thirds of people with type 2 diabetes have fatty liver, per NIDDK.
High blood sugar and insulin resistance (the body's cells responding less effectively to insulin) push the liver to store fat.
Ask your doctor about an A1C test if you have not had one recently, and take the numbers seriously if they are creeping up.
When to bring this up with your doctor
Fatty liver often shows no symptoms. If it does, the NIDDK says you may feel tired or have discomfort in the upper right side of the abdomen.
People with obesity, type 2 diabetes or high triglycerides should ask their doctor whether a liver check belongs in their routine blood work.
This article is made and published by Mie Hermansen, who may have used AI in the preparation.