Based on NIH | Does regularly eating fatty fish help reduce liver fat in people with fatty liver disease?

Regularly eating fatty fish is likely to help reduce liver fat for many people with nonalcoholic fatty liver disease (NAFLD), although it may not reverse liver inflammation or scar tissue by itself. Omega‑3 fats in fatty fish (like salmon, mackerel, sardines, herring, trout) have been shown in clinical studies to lower liver fat and blood triglycerides, which are both tied to fatty liver, but they have shown mixed effects on liver enzymes and fibrosis. ^{[1] [2]}

Why fatty fish may help

• Omega‑3 long‑chain polyunsaturated fatty acids (EPA and DHA) can reduce liver fat production, increase fat burning, and lower triglycerides. Deficiency in omega‑3s is linked to liver fat accumulation, while increasing intake can reduce liver triglycerides. ^[3]
• In a randomized, double‑blind trial in people with NASH (a more severe form of NAFLD), 3,000 mg/day of n‑3 fish oil for 1 year did not significantly improve the composite biopsy score versus placebo, but it did lead to measurable reductions in liver fat by MRI and tissue morphometry, especially in those without weight loss. ^[2]

What the evidence shows

• A systematic review and meta‑analysis pooling nine human studies (355 participants) found that omega‑3 supplementation reduced liver fat compared with control, with a notable effect size; effects on ALT and AST were inconsistent and smaller. ^[1]
• Narrative reviews of clinical and pre‑clinical data conclude that supplemental fish oil or purified omega‑3s can safely reduce liver fat in adults with NAFLD, while evidence for improving inflammation or fibrosis remains limited. ^[3]

Dietary guidance and overall lifestyle

• Major clinical guidance emphasizes that weight loss is the most proven therapy for NAFLD: losing about 3–5% of body weight can reduce liver fat, and ~10% can improve inflammation and scarring. ^{[4] [5]}
• Lifestyle advice includes a healthy diet, regular exercise, and careful calorie management, which together can reduce liver fat and improve metabolic health. ^{[6] [7]}

How much fatty fish is reasonable?

• As part of a heart‑healthy or Mediterranean‑style pattern, aiming for at least two servings of fish per week preferably fatty fish fits with general health recommendations and supports omega‑3 intake. ^{[8] [9]}
• Choosing baked or broiled fish (not fried) is recommended to keep saturated fat and added calories low. ^[10]

Fatty fish vs. fish‑oil supplements

• Eating fatty fish brings omega‑3s along with protein, micronutrients, and satiety, and is generally preferred over supplements for most people. ^[10]
• Prescription omega‑3 products are used to lower very high triglycerides, which can indirectly help liver fat, but they are not approved specifically to treat NAFLD. ^[11]
• Fish‑oil supplements can reduce triglycerides, but high doses may increase bleeding risk or cause stomach upset; discuss with a clinician if you are on blood thinners or have bleeding disorders. ^{[12] [10]}

Practical tips to get more omega‑3s

• Choose salmon, sardines, trout, mackerel, or herring 2–3 times per week, using baking, broiling, or grilling. This supports omega‑3 intake while aligning with broader NAFLD lifestyle guidance. ^{[9] [8]}
• Combine fish intake with calorie control, more vegetables and whole grains, and consistent exercise, because these are the strongest levers for reducing liver fat and improving overall liver health. ^{[6] [7]}

Bottom line

• Regular fatty fish intake can meaningfully contribute to lowering liver fat due to omega‑3 effects, but it works best as part of a comprehensive plan focused on weight management, diet quality, and exercise. ^{[1] [4]}
• Evidence suggests reductions in liver fat are achievable; however, fatty fish or omega‑3s alone are unlikely to resolve liver inflammation or fibrosis without broader lifestyle changes. ^{[2] [3]}

---

Quick reference table

Question	What studies suggest	What it means for you
Does omega‑3 lower liver fat?	Meta‑analyses and RCTs show reduced liver fat with omega‑3s. [1] [2]	Eating fatty fish regularly can help decrease liver fat.
Does it fix inflammation or scarring?	Mixed/insufficient evidence for improving NASH activity score or fibrosis. [2] [3]	Don’t rely on omega‑3s alone to reverse liver damage.
Most proven therapy for NAFLD?	Weight loss through diet and exercise. [4] [5]	Target 5–10% weight loss for larger liver benefits.
How much fish?	At least 2 servings/week of fish, preferably fatty fish. [8] [9]	Bake/broil rather than fry to keep it healthy.
Supplements vs. food	Supplements lower triglycerides; food is generally preferred; watch bleeding risk. [12] [10]	Consider supplements only if advised by your clinician.

If you’d like, I can suggest a simple weekly meal plan that adds fatty fish while keeping calories in check and aligned with NAFLD goals.