Gastro Mafld

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Nutrition
Metabolic Associated Fatty Liver Disease (MAFLD)
This resource is for people with metabolic associated fatty liver disease (MAFLD). It
provides nutrition and lifestyle information to help you manage your condition.
What is MAFLD?
MAFLD is a condition where excess fat builds up in the liver. Risk factors include:
• Being obese or overweight
• Having diabetes
• Having high blood cholesterol and triglyceride (a type of blood fat) levels
Are MAFLD and NAFLD the same?

• In the past, fatty liver was called non-alcoholic fatty liver disease, also known as NAFLD.
Recently however, a decision was made between clinicians and patients to change the
name to MAFLD to better describe the condition.
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What are the effects of MAFLD? My
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MAFLD does not always cause harm to the liver, but it can:
• Increase your risk of diabetes, heart attack or stroke
• Progress to more severe liver disease. The fat around the liver can cause inflammation
of the liver. Ongoing inflammation may cause cirrhosis (irreversible scarring of the liver),
which can lead to liver failure.
What should you do if you have MAFLD?

• Avoid smoking and alcohol
• Participate in regular exercise
• Eat a healthy balanced diet
• Have good blood sugar control (if you have diabetes)
• Treat high blood pressure and high cholesterol
This is a consensus document from Dietitian/ Nutritionists from the Nutrition Education Materials Online, "NEMO", team
Disclaimer: www.health.qld.gov.au/global/disclaimer Reviewed: January 2021
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Copyright: www.health.qld.gov.au/global/copyright-statement Due for review: January 2023
To reduce the risk of developing MALFD you can:
1. Eat a healthy diet
2. Reach a healthy weight
3. Increase exercise
1. Eat a healthy diet

Make changes slowly so you can continue them long-term, maintain weight loss and keep
your liver healthy.
Base your meals on whole foods from the Mediterranean diet

1. Vegetables – add as many vegetables as you can to your meals and snacks.
2. Fruit – eat at least two pieces of fruit per day.
3. Add olive oil to your food (up to 3 tablespoons per day).
4. Include fish at least twice weekly.
5. Choose low fat meat or meat alternatives like chicken, eggs, and legumes (e.g.
chickpeas, kidney beans, and nuts).
6. Reduce red meat to once per week or on special occasions.
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7. Choose grainy breads and cereals, rice and
Mypasta.
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8. Nutrition
Choose low fat dairy (e.g. milk, yoghurt, cheese).
Eating foods from these main food groups will help keep you full and reduce the need to
snack on high fat or high sugar foods.
Refer to the NEMO Mediterranean diet sheet for more information
(www.health.qld.gov.au/nutrition/patients).
This is a consensus document from Dietitian/ Nutritionists from the Nutrition Education Materials Online, "NEMO", team.
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Image reproduced with permission from Oldways - oldwayspt.org

NOTE: When you have liver disease, it is best to avoid alcohol. But this should be discussed with
your GP or liver doctor.
Switch to healthier drinks

Choose water as your main drink. Replace sugary drinks like soft drinks, cordials, sports
drinks and juices with ‘no added sugar’ or ‘diet’ alternatives. Talk to your doctor to check if
you should avoid alcohol.
Reduce your portion sizes

Use smaller plates and bowls to help reduce calories for weight loss.
Fill up on high fibre foods
Eat high fibre foods such as grainy breads and cereals, vegetables, legumes and fruit. By
choosing these foods, you may find you can eat more food but with less calories.
Examples of higher fibre choices with more food and less calories include:
• 2 pieces of fruit instead of 1 glass of fruit drink
• 1 medium jacket potato instead of ½ bucket of hot chips
• 2 cups air-popped popcorn instead of ½ small packet chips
Plan your meals

This can help you avoid making impulse decisions or reduce the temptation to grab
takeaway, which may lead to overeating.
Build a balanced plate

Include a large serve of vegetables (1/2 of the plate), a palm sized protein portion (1/4 of the
plate), and a small serve of carbohydrate (1/4 of the plate).
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Image reproduced with permission from Healthy Food Guide Magazine www.healthyfoodguide.com.au.
Not all fats are equal
All fats are high in energy, however there are several different types of fat.
Unsaturated fats are a healthy type of fat. Include these fats in your diet to reduce your risk
of heart disease.
They include:
 Monounsaturated fats – found in extra virgin olive oil, avocados, olives and nuts
(almonds and cashews).
 Polyunsaturated fats – found in sunflower seeds and oil, canola oil, soybeans and
soymilk, nuts (walnuts, hazel and Brazil), seeds (chia, flaxseed and sunflower), oily
fish and seafood (salmon, sardines, tuna and mussels).
Saturated fats are not so good for our health and should be limited in your diet.
 Saturated fats – found in animal fats (butter, lard, ghee), coconut oil, full fat dairy, deep
fried foods and pastries, fat on meat, cream, sour cream and deli meats.
Limit added sugars

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Added sugars can increase the calories in yourMy
diet and are low in nutrients. Ideas to reduce
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added sugar include: Nutrition
• Use less/no sugar in your tea/coffee
• Try fruit instead of sugar on cereal
• Use sugar free spreads instead of jam and honey. Options include vegemite, peanut
butter (no added sugar) or spreads sweetened with artificial sweeteners or stevia.
• Replace fruit juice with fresh fruit
• Eat tinned fruit in water/natural juice instead of syrup
• Use unsweetened yoghurt (natural/Greek) instead of sweetened yoghurt
• Eat less biscuits and cakes
2. Reach a healthy weight

If you are overweight, losing 5-10% of your body weight can:
• Decrease fat in the liver
• Improve blood sugar control
• Improve blood pressure
Aim for a loss of 0.5-1kg per week.
Your current weight: ____________
Your goal weight: ____________
Your waist circumference: ____________
Goal waist circumferences:

Females: Initially: less than 88cm
Long term: less than 80cm
Males: Initially: less than 102cm
Long term: less than 94cm
3. Increase exercise
• Increasing activity can help you reach a healthy weight. It can also decrease your risk
of developing diabetes and help control your blood sugar.
• Try to do at least 150 minutes of moderate intensity exercise per week (30 minutes of
activity 5 times per week), increasing to 30-45 minutes daily. Examples of moderate
intensity exercise include brisk walking, dancing and gardening.
• Talk to your doctor before starting anyMy
physical activity if you have existing medical
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conditions, as you may benefit from Nutrition
a referral to an exercise physiologist. It’s also
important to keep in touch with your diabetes educator and manage your blood sugar
well if you have diabetes.
Ideas to increase activity

• Aim to be active every day in as many ways as you can (e.g. join a dance class or walking
group).
• Think of movement as an opportunity, not an inconvenience (e.g. go for a
bike ride or play tennis with friends).
• Increase your incidental exercise (e.g. walk briskly, clean the house, sit less).
• Choose activities that you can do often and find easy and enjoyable, such as walking.
• Find an activity that best matches your current level of fitness (e.g. break exercise up
into 2-3 x 15 min blocks).
• Consider including resistance (strength) training to maintain muscle strength.
Suggested meal plan
BREAKFAST
1 cup cooked oats (1/2 cup raw oats) or ½ - 1 cup high fibre cereal with low fat milk
OR
2 slices of multigrain bread with baked beans / tomato / mushrooms / peanut butter (no
added sugar) / cottage cheese
AND
1 piece of fruit
Water to drink
MORNING TEA
See snack ideas
LUNCH
2 slices multigrain bread OR 1 bread roll / wrap
AND / OR
Salad with tuna / salmon / chicken / low fat cheese
Water to drink
AFTERNOON TEA
See snack ideas
DINNER
100 – 120g lean chicken (no skin) / fish / eggs / legumes
AND My
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Large serve of vegetables (e.g. beans,Nutrition
broccoli, cabbage, carrots, cauliflower, peas,
spinach, zucchini) Nutrition
AND
1 cup pasta / 2/3 cup rice / 1/2 cup sweet potato / 1 medium potato
Water to drink
SNACK IDEAS:
Fruit
Low fat natural / Greek / diet yoghurt (100-200g)
2 oatmeal biscuits
2-3 grainy crackers with cottage cheese and tomato
1 thin slice of fruit bread
Raw, unsalted nuts (5-6)

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Are MAFLD and NAFLD the same?

What should you do if you have MAFLD?

1. Eat a healthy diet

Base your meals on whole foods from the Mediterranean diet

Image reproduced with permission from Oldways - oldwayspt.org

Switch to healthier drinks

Reduce your portion sizes

Plan your meals

Build a balanced plate

Limit added sugars

2. Reach a healthy weight

Goal waist circumferences:

Ideas to increase activity

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