Are Lentils Good for Fatty Liver?

Lentils are good for fatty liver disease and offer a practical, evidence-informed dietary choice for people managing this condition. Rich in plant protein, dietary fibre, and polyphenols, lentils have a low glycaemic index and help stabilise blood glucose, addressing key drivers of hepatic fat accumulation. Fatty liver disease, known medically as non-alcoholic fatty liver disease (NAFLD) or metabolic dysfunction-associated steatotic liver disease (MASLD), is closely linked to diet quality and insulin resistance. Lentils support liver health as part of a broader balanced diet, though they are not a standalone treatment. Always discuss dietary changes with your GP.

Are lentils good for fatty liver disease?

Lentils are beneficial for fatty liver disease as they are low glycaemic, high in fibre and plant protein, and help reduce insulin resistance and hepatic fat accumulation as part of a balanced diet.

Lentils are a beneficial food choice for people with fatty liver disease, primarily because they are rich in plant protein, dietary fibre, and compounds that support healthy liver function without contributing excess fat or refined carbohydrates. Fatty liver disease is known medically as non-alcoholic fatty liver disease (NAFLD), a term still widely used in NHS and NICE guidance, and increasingly referred to as metabolic dysfunction-associated steatotic liver disease (MASLD) in international clinical literature following a nomenclature update in 2023. Both terms describe the same condition, and this article uses them interchangeably.

Fatty liver disease is closely linked to diet quality, insulin resistance, and excess calorie intake. Lentils address several of these factors simultaneously. They have a low glycaemic index, meaning they cause a slower, more gradual rise in blood glucose compared with refined carbohydrates such as white bread or sugary foods. This is particularly relevant because high blood sugar and insulin resistance are key drivers of fat accumulation in the liver. By helping to stabilise blood glucose levels, lentils may reduce the metabolic signals that encourage the liver to store excess fat.

There is growing evidence from nutritional research that plant-based diets rich in legumes, including lentils, are associated with lower rates of liver fat accumulation and improved liver enzyme levels.^[12] While lentils alone cannot reverse fatty liver disease, they form a valuable part of a broader dietary approach. Overall energy balance and achieving a healthy weight remain the most important dietary goals for managing NAFLD or MASLD; lentils are a helpful component rather than a treatment in themselves.

Bolt Pharmacy is a GPhC-registered UK online pharmacy offering online weight-management consultations, with prescriber review and pharmacist support, for those seeking structured guidance alongside dietary changes.

It is important to note that dietary changes should complement, not replace, medical advice. Anyone who has been diagnosed with fatty liver disease, or who suspects they may have it, should speak to their GP for appropriate assessment and management.

What nutrients in lentils support liver health?

Lentils support liver health through dietary fibre, plant protein, folate, polyphenols, and non-haem iron, which collectively help reduce liver fat, lower inflammation, and support metabolic function.

Lentils support liver health through several key nutrients, including dietary fibre, plant-based protein, folate, iron, and polyphenols, each of which plays a distinct role in reducing liver fat and supporting metabolic function. Understanding these mechanisms helps explain why lentils are consistently highlighted in dietary guidance for liver conditions.

Dietary fibre is one of the most important components. Lentils contain both soluble and insoluble fibre. Soluble fibre, in particular, helps to:

• Slow glucose absorption, reducing insulin spikes

• Lower LDL cholesterol levels

• Feed beneficial gut bacteria, which produce short-chain fatty acids; some research suggests these may play a role in reducing hepatic inflammation, though the evidence in humans is still developing

Plant protein in lentils provides amino acids without the saturated fat found in many animal protein sources. Reducing saturated fat intake is a recognised strategy for managing fatty liver disease, and substituting some animal protein with plant protein from lentils may help lower hepatic fat over time. It is worth noting that lentils do not provide a complete amino acid profile on their own; eating a varied diet that includes other plant proteins such as wholegrains, nuts, and seeds across the day supports a full range of essential amino acids.

Folate (vitamin B9) is abundant in lentils and plays a role in one-carbon metabolism, a biochemical process important for liver cell function and the regulation of fat metabolism.^[19] Some observational studies have found an association between adequate folate intake and reduced liver fat, though this does not establish a direct causal relationship.

Polyphenols, the naturally occurring plant compounds found in lentil seed coats, have antioxidant and anti-inflammatory properties. Chronic low-grade inflammation is a feature of fatty liver disease, and dietary antioxidants may help to reduce oxidative stress within liver tissue, though clinical evidence in humans remains an active area of research.

Iron is present in lentils in a non-haem form, which is absorbed less readily than haem iron from meat. For most people with fatty liver disease, this is appropriate, as excessive iron accumulation can worsen liver damage in certain conditions.^[11]

How much should you eat and how often?

A typical serving is around 80 g of cooked lentils, counting as one five-a-day portion; eating lentils regularly throughout the week, rather than occasionally, is most beneficial for liver health.

There is no single officially recommended portion of lentils specifically for fatty liver disease. NHS Eatwell Guide and broader dietary guidance encourage regular consumption of beans, pulses, and legumes as part of a balanced, varied diet, and lentils fit well within this pattern. Eating them regularly throughout the week, rather than only occasionally, is likely to produce more meaningful benefits for liver health over time.

A typical serving of cooked lentils is around 80 grams (roughly three heaped tablespoons), which counts as one of your five-a-day portions. However, it is important to note that beans and pulses, including lentils, count as a maximum of one five-a-day portion per day, however much you eat. Other vegetables and fruits are needed to make up the remaining portions.

Practical ways to include lentils more frequently include:

• Adding red or green lentils to soups, stews, and curries

• Using lentils as a partial replacement for minced meat in dishes such as bolognese or shepherd's pie

• Preparing lentil-based salads with vegetables and olive oil

• Using tinned or pre-cooked lentils for convenience on busy days; if using tinned lentils, rinsing them under cold water helps to reduce their salt content, and choosing no-added-salt varieties is preferable for cardiometabolic health

It is worth noting that lentils are high in fibre, and people who are not accustomed to eating them regularly may initially experience bloating or digestive discomfort. Introducing them gradually, starting with smaller portions and increasing over several weeks, can help the digestive system adjust. People with irritable bowel syndrome (IBS) who follow a low-FODMAP diet may need specific guidance from a registered dietitian on how to include lentils appropriately.

People with certain conditions, such as chronic kidney disease, may need to moderate their intake of high-potassium or high-phosphorus foods, including lentils. If you have a coexisting condition alongside fatty liver disease, it is advisable to discuss dietary changes with your GP or a registered dietitian before making significant adjustments.

Which other foods help or harm a fatty liver?

Oily fish, olive oil, wholegrains, nuts, and coffee support liver health, while alcohol, ultra-processed foods, sugary drinks, and refined carbohydrates worsen hepatic fat accumulation.

Alongside lentils, several other foods are supported by evidence as beneficial for fatty liver disease, while others are known to worsen liver fat accumulation and should be limited or avoided. A whole-diet approach is more effective than focusing on any single food.

Foods that support liver health:

• Oily fish (such as salmon, mackerel, and sardines): rich in omega-3 fatty acids, which have been shown in clinical studies to reduce liver fat and inflammation

• Olive oil: a source of monounsaturated fats and polyphenols associated with improved liver enzyme levels

• Vegetables and salad leaves: particularly cruciferous vegetables such as broccoli, which contain compounds that may support liver function; the evidence is largely from laboratory and observational studies

• Wholegrains (such as oats, brown rice, and wholemeal bread): provide fibre and have a lower glycaemic impact than refined grains

• Nuts and seeds: associated with reduced liver fat in observational studies, likely due to their healthy fat and fibre content

• Coffee: observational research has consistently found an association between moderate coffee consumption and lower rates of liver fibrosis; the evidence is largely observational and the optimal amount is not firmly established, but most studies have examined consumption in the range of two to three cups per day^[17]

Foods and substances that harm a fatty liver:

• Alcohol: alcohol can worsen liver fat and inflammation. NHS guidance recommends that adults do not regularly drink more than 14 units of alcohol per week.^[8][9] For people with fatty liver disease, your GP or specialist may advise reducing intake further or avoiding alcohol altogether, particularly if there is evidence of more advanced liver damage such as fibrosis or cirrhosis

• Ultra-processed foods: high in refined carbohydrates, added sugars, and saturated fats, all of which promote hepatic fat accumulation

• Sugary drinks: including fizzy drinks and fruit juices, which are high in free sugars. The NHS recommends limiting fruit juice and smoothies to no more than 150 ml per day, and choosing whole fruit in preference to juice where possible, as whole fruit provides fibre and is less rapidly absorbed^[6]

• Red and processed meats: associated with higher liver fat in some observational studies; where possible, replacing some red meat with plant proteins such as lentils is a practical step

• Refined carbohydrates: white bread, pastries, and white rice cause rapid blood glucose rises that stimulate insulin and promote fat storage in the liver

What does the NHS recommend for managing fatty liver through diet?

NHS and NICE guideline NG49 recommend lifestyle modification as the primary treatment for NAFLD, focusing on achieving a healthy weight, reducing calories and free sugars, limiting alcohol, and following a Mediterranean-style diet.

The NHS recommends that the primary treatment for non-alcoholic fatty liver disease (NAFLD, also referred to as MASLD) is lifestyle modification, with diet and physical activity forming the cornerstone of management. At the time of writing, there is no licensed medication specifically indicated for fatty liver disease in the UK, making dietary change particularly important; however, you should discuss current treatment options with your GP, as guidance in this area continues to develop.^[4][16]

NHS guidance emphasises the following dietary principles for people with fatty liver disease:

• Achieving and maintaining a healthy weight: even a modest weight loss of 5 to 10 per cent of body weight has been shown to significantly reduce liver fat and improve liver enzyme levels, as supported by NICE guideline NG49^[1][3]

• Reducing calorie intake: particularly from high-fat and high-sugar foods

• Limiting alcohol: NHS guidance recommends not regularly exceeding 14 units of alcohol per week; your GP or specialist may advise abstinence if you have more advanced liver disease or if clinically indicated^[8][9]

• Eating a balanced diet: based on vegetables, wholegrains, lean proteins, and healthy fats, consistent with a Mediterranean-style pattern

• Reducing intake of free sugars: including those found in sugary drinks, sweets, and processed foods

NICE has published guidance on the assessment and management of non-alcoholic fatty liver disease (NICE guideline NG49), which supports a structured lifestyle intervention approach. As part of this, your GP may assess your risk of liver fibrosis using a blood test called FIB-4, or arrange further tests such as an enhanced liver fibrosis (ELF) test or transient elastography (a type of liver scan). Depending on the result, you may be referred to a hepatologist or liver specialist for further assessment. NICE guideline NG49 also supports referral to dietetic services for people who would benefit from personalised dietary advice.^[1][3]

If you are concerned about fatty liver disease, the appropriate first step is to contact your GP, who can arrange blood tests and imaging to assess liver health and refer you to specialist services if needed. For urgent symptoms such as severe abdominal pain, jaundice, vomiting blood or passing black stools, marked confusion or drowsiness, or rapidly increasing abdominal swelling, seek assessment via NHS 111 or attend A&E if symptoms are severe. Suspected adverse effects from any medicine should be reported via the MHRA Yellow Card scheme at yellowcard.mhra.gov.uk.

Scientific References

1. Metabolic dysfunction-associated steatotic liver disease (NAFLD/MASLD) – Guideline NG49.
2. Metabolic dysfunction-associated steatotic liver disease – NG49 Recommendations for Research.
3. Non-alcoholic fatty liver disease (NAFLD) – NG49 Short version of draft guideline.
4. GID-TA11477 Draft scope post-referral (MASLD/MASH) – no medicines currently approved for MASLD/MASH in the UK.
5. Non-alcoholic fatty liver disease (NAFLD).
6. 5 A Day: what counts?.
7. 5 A Day portion sizes.
8. Alcohol units.
9. The risks of drinking too much.
10. Drink less alcohol – Better Health.
11. Haemochromatosis – Complications.
12. Eating Well with Liver Disease. Milton Keynes University Hospital NHS Foundation Trust.
13. BDA. Fruit and vegetables – how to get five-a-day.
14. Government 5 a day logo: licensing guidelines.
15. Delivering Better Oral Health – Chapter 12: Alcohol.
16. Resmetirom (Rezdiffra) authorised to treat metabolic dysfunction-associated steatohepatitis (MASH) in adults.
17. Ebadi M et al. Effect of Coffee Consumption on Non-Alcoholic Fatty Liver Disease. 2021. PMID 34578919.
18. Kjaergaard M et al. Using the ELF test, FIB-4 and NAFLD fibrosis score to assess liver fibrosis. 2023. PMID 37088311.
19. One-Carbon Metabolism in Fatty Liver Disease and Fibrosis. 2020. PMID 32119738.

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