Jewels Doskicz, RN, is a freelance writer, patient advocate, health coach, and long-distance cyclist. She and her daughter both live healthfully with type 1 diabetes.

Preventing and managing non-alcoholic fatty liver disease (NAFLD) has traditionally focused heavily on food choices. But the timing of when we nosh may be equally important for our liver health, according to recent research.

The liver has its own circadian rhythm, James Esteban, MD, of the Medical College of Wisconsin in Milwaukee, told Medpage Today. How we regulate our metabolism and energy may depend on the timing of foods we consume.

By studying data from the National Health and Nutrition Examination Survey (NHANES), Esteban and his colleagues discovered, “Meal timing and how calories are distributed during the day may be associated with the presence of fatty liver."

Learning more about how to deal with NAFLD is important because no medical treatments are available. It’s one of those diseases that comes with a prescription for exercise and diet, not medications.

What is NAFLD?

The liver works as a filter, supporting our body’s needs even while we’re asleep. It converts what we eat into energy, while protecting the body and removing what’s harmful.

The American Liver Foundation describes NAFLD as “the buildup of extra fat in liver cells that is not caused by alcohol. It is normal for the liver to contain some fat. However, if more than five to 10 percent of the liver’s weight is fat, then it is called a fatty liver.”

A fatty liver may or may not cause noticeable symptoms, but behind the scenes it could lead to swelling, scarring, liver cancer, or liver failure. NAFLD affects up to 25 percent of the United States population. It’s diagnosed through blood work and ultrasound.

What the research reveals

Esteban and his colleagues made three very interesting findings:
• Skipping morning and midday meals was closely associated with NAFLD.
• When the largest percentage of the day’s calories were consumed in the morning, there was a 14 to 21 percent decrease in the risk of NAFLD.
• Eating between 10:00 p.m. and 4:00 a.m. increased liver disease risk by 61 percent.

Putting the findings into practice

Even small lifestyle adjustments could have large paybacks in liver health. In addition to recommendations for a healthy diet and regular exercise, think about focusing on these areas:
• Keep a food log. Track the timing of when you eat.
• Aim to distribute calories more evenly over more meals throughout the day.
• Don’t skip your breakfast or lunch; you’re not doing yourself any favors.
• Avoid foods, at all costs, between midnight and 4:00 a.m.
• If you work at night, consider moving to a day-shift job to stay in your body’s natural circadian rhythm.
• See a nutritionist or a dietitian for personalized diet advice and support.
• Discover what your healthy weight is and set plans in motion to achieve it.
Discuss the options above with your healthcare provider. Also ask about the need for cholesterol and blood pressure medications, diabetes education, and avoiding alcohol.

Are you high risk?

Ask your healthcare provider if you are considered high risk for NAFLD. Patients living with high blood pressure, diabetes, obesity, high cholesterol, and/or poor dietary habits should flash a red light for healthcare providers to consider running tests.

Damage to the liver can be devastating. It is best caught in its infancy, with healthy changes initiated as soon as possible.

Have you been diagnosed with a fatty liver? What measures have you and your doctor taken to deal with it? Share your experience by commenting below.