How to Prevent Fatty Liver Disease If You Have PCOS

Non-alcoholic fatty liver disease (NAFLD), commonly referred to as fatty liver, is highly prevalent in women with PCOS, affecting 15 percent to 55 percent of women depending on the diagnostic criteria used. NAFLD occurs as a result of excess triglycerides (fat) stored in the liver, which causes damage and inflammation. The liver isn’t meant to store fat; its role is to serve as the detox organ for the body filtering out harmful substances. Having fatty liver or NAFLD increases the risk of cardiovascular disease. If not treated, NAFLD can progress to more advanced stages of liver damage.

Factors contributing to fatty liver disease in PCOS women include the following:

  • Excess abdominal weight
  • High triglycerides
  • High LDL cholesterol level
  • Low HDL cholesterol level
  • High consumption of fat, sugar, and refined foods
  • Sedentary lifestyle
  • Genetics

Preliminary evidence suggests that high levels of androgens may also contribute to fat storage in the liver. While fatty liver disease is serious, it can easily be reversed and prevented with diet and lifestyle changes.

Casserole dish with salmon, tomatoes, and other vegetables ready to go in the oven
Ekaterina Smirnova / Getty Images

Here are four ways to prevent fatty liver disease if you have PCOS.

Change Your Diet

Fat, sugar, and excessive intake of processed foods are the main nutrition contributors to fatty liver disease. Consumption of trans fats, fats typically found in processed and fast food, is linked to insulin resistance, inflammation, and increased triglycerides. Likewise, high consumption of fructose, a sweetener found in corn syrup, juice, and other flavored beverages, is associated with fatty liver disease. Fructose is also linked to worsening insulin resistance and inflammation. A study published in the American Journal of Clinical Nutrition found that increased soft drink intake led to individuals having significantly more liver and visceral fat, the fat that surrounds internal organs and is linked with chronic diseases.

Keeping trans fats, sugar, and processed foods out of your diet will improve the condition of your liver. You can also boost your liver’s health by eating a healthy diet rich in whole grains, lean proteins, beans and legumes, fish, and plenty of fruits and vegetables. Following a Mediterranean-style diet that is rich in olive oil and other monounsaturated fats may also be beneficial to improve insulin, fight inflammation, and reduce liver fat.

Lose Weight

Weight loss is effective at improving fatty liver disease as it can improve insulin resistance, triglycerides, and visceral fat. One study showed that people who lost 5 percent of their total body weight saw significant improvements in insulin sensitivity and liver fat loss. A woman who weighs 200 pounds, for example, can expect to see a big improvement in the health of her liver if she loses 10 pounds.

Get Moving

A sedentary lifestyle is one of the contributing factors to NAFLD. Engaging in regular physical activity consisting of aerobic and resistance training can decrease fatty liver even without weight loss. Participants who engaged in 30 to 60 minutes of exercise two to three times each week saw significant reductions in liver fat. To make physical exercise a regular routine, prioritize it by scheduling it in your calendar. Performing activities that are fun and enjoyable to do will also help increase your commitment.

Take Fish Oil

Omega-3 fatty acids like the ones found in cold water fish such as salmon, tuna, and trout are effective at reducing triglycerides, inflammation, and insulin in women with PCOS. However, a fish oil supplement is probably needed since it’s quite a challenge to eat enough fish to meet therapeutic amounts of omega-3 fats. A study published in the Journal of Clinical Endocrinology and Metabolism showed that women with PCOS who supplemented their diets with 4 grams of fish oil for eight weeks saw a significant decrease in liver fat and triglycerides.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Cusons A, Watts G, Mori T. Omega-3 fatty acid supplementation decreases liver fat content in polycystic ovary syndrome: a randomized controlled trial employing proton magnetic resonance spectroscopyJ Clin Endocrinol Metb. 2009;94(10):3842-3848. doi:10.1210/jc.2009-0870

  2. Chalasani N, Younossi Z, Lavine JE. The diagnosis and management of nonalcoholic fatty liver disease: practice guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological AssociationHepatology. 2012;142:1592-1609. doi:10.1002/hep.25762

  3. Hallsworth K, Fattakhova G, Hollingsworth KG. Resistance exercise reduces liver fat and its mediators in nonalcoholic fatty liver disease independent of weight lossGut. 2011;60:1278-1283. doi:10.1136/gut.2011.242073

  4. Maersk M, Belza A. Sucrose-sweetened beverages increase fat storage in the liver, muscle, and visceral fat depot: a 6-month randomized intervention studyAm J Clin Nutr. 2012;95:283-289. doi:10.3945/ajcn.111.022533

Additional Reading

By Angela Grassi, MS, RDN, LDN
 Angela Grassi, MS, RDN, LDN, is the founder of the PCOS Nutrition Center.