Anatomy of a healthy human liver, the organ responsible for metabolic health, filtering toxins, and managing blood sugar

Liver disease

Expert Liver Disease Dietitian in Melbourne

Reverse fatty liver, protect your metabolic health, and optimize your liver function with proactive, evidence-based medical nutrition therapy.

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What is liver disease?

Your liver is your body’s ultimate multi-tasking organ. It acts as a chemical processing plant, a metabolic battery, and a toxic waste filter all at once. It regulates your blood sugar, produces essential proteins, creates bile to digest fats, and clears toxins from your blood.

Liver Disease is a broad term, but in the modern metabolic landscape, we are primarily talking about the progressive accumulation of fat and inflammation in the liver.

This condition progresses through clear stages:

1. Healthy Liver: A perfectly functioning liver handling your body’s toxins and helping break down food for energy

2. Steatosis (fat infiltration): The fat buildup triggers chronic inflammation, actively damaging the liver cells.

3. Fibrosis: The chronic inflammation causes scar tissue to form, stiffening the liver.

4. Cirrhosis: Severe, irreversible scarring that drastically impairs liver function and increases the risk of liver failure or cancer.

Progression of liver disease from healthy liver to fat build up in the liver to fibrosis to cirrhosis

-Infographic by Medical News Today

The last and final step of progression is liver cancer. The longer liver stress occurs for and the more severe the damage, the higher the risk of liver cancer.

What causes liver disease?

Historically, liver disease was almost exclusively associated with heavy alcohol consumption (Alcohol-Related Liver Disease). Today, the leading cause of liver disease in Australia is actually driven by metabolism and diet.

This is known as Metabolic dysfunction-Associated Steatotic Liver Disease (MASLD),

  • formerly known as Metabolic Associated Fatty Liver Disease (MAFLD),
    • formerly known as Non-Alcoholic Fatty Liver Disease (NAFLD). 

We know, it’s a headache….

 

The “perfect storm” that causes MASLD includes:

  • Insulin Resistance: When your body stops responding to insulin efficiently, your liver is forced to convert excess blood sugar directly into fat.

  • Visceral Adiposity: Carrying excess weight specifically around your midsection and organs forces fat to “spill over” into the liver.

  • Excess Fructose Consumption: Unlike glucose, which can be used by every cell in your body, high doses of refined liquid fructose (found in soft drinks and highly processed foods) must be processed entirely by the liver, rapidly driving fat accumulation.

  • Genetics: Certain genetic markers can make you more susceptible to storing liver fat.

  • Alcohol: Even moderate alcohol consumption can act as an accelerant when combined with insulin resistance.

Another imge of progression of liver disease and MAFLD/ NASLD

-Infographic by Health Direct

What we can do

How is liver disease diagnosed?

Liver disease is typically diagnosed through a combination of blood tests called Liver Function Tests (measuring ALT, AST, and GGT enzymes) and medical imaging, such as a standard ultrasound or a highly specialised FibroScan (which measures both fat accumulation and liver stiffness).

Common Diagnostic Mistakes:

  • “Normal” blood tests do not mean a healthy liver: This is the most dangerous misconception. Your liver enzymes (ALT and AST) can look completely normal on a blood test, even if you have significant fatty liver disease visible on an ultrasound.

 

  • Dismissing “mild” fatty liver: Often, patients are told they have “a bit of a fatty liver” and that “everyone has it, don’t worry.” Fatty liver is common, but it is never normal. Ignoring the early stage is a massive missed opportunity for reversal.

 

  • Failing to test fasting insulin: Doctors frequently check fasting glucose and HbA1c, but miss checking fasting insulin. High insulin is the smoking gun that drives liver fat long before blood sugars become officially diabetic.

 

How common is liver disease

It is a silent epidemic. It is estimated that 1 in 3 Australian adults currently have MASLD (Fatty Liver Disease).

Because the liver has no pain receptors, you cannot “feel” your liver becoming fatty or inflamed. It is entirely asymptomatic in its early, reversible stages.

At REAL Health & Nutrition, we view the liver as the master regulator of your healthspan. If your liver is compromised, your cardiovascular system, blood sugar control, and energy levels will inevitably follow unless you take the steps to control take control of your health.

How is liver disease treated? (The REAL Nutrition Approach)

The liver is an incredibly resilient, regenerative organ. In the stages of steatosis and early fibrosis, liver disease is highly reversible through targeted Medical Nutrition Therapy. There is no magic pill for fatty liver; your diet is the primary medicine.

Here is how our Accredited Practising Dietitians target liver health:

1. Strategic Body Recomposition

Nutrient dense protein foods to optimise protein intake, bone density, muscle mass and falls risk

If you are carrying excess visceral fat, losing just 7% to 10% of your total body weight can completely clear the fat out of your liver and dramatically reduce inflammation.

We do not use crash diets; we build high-protein, sustainable nutrition strategies that preserve your muscle mass while specifically targeting visceral fat loss.

2. Crushing Insulin Resistance & Refined Sugars

Image of BGL Lancet and measurement device

We aggressively target the root cause of liver fat by lowering your dietary glycemic load.

We focus on eliminating ultra-processed carbohydrates and liquid fructose, replacing them with high-fibre whole foods that stabilise your insulin and force your liver to start burning fat rather than storing it.

3. The Mediterranean & Antioxidant Defence

Nutrient dense high polyphenol, high omega 3 foods to optimise fat matrix and improve beta oxidation while reducing whole body inflammation and CRP

We flood your system with liver-protective nutrients.

Extra Virgin Olive Oil, Polyphenols, Omega-3 fatty acids (from fatty fish), and specific antioxidants like Vitamin E have strong clinical evidence for reducing liver inflammation (steatohepatitis) and protecting cells from oxidative stress.

 

4. Advanced Cirrhosis Management

Image of a cirrhotic liver/ liver with cirrhosis, anatomical demonstration

-Infographic by The Scan Clinic

If your liver disease has progressed to advanced cirrhosis, the strategy shifts entirely.

A cirrhotic liver struggles to store energy, meaning the body quickly begins cannibalising its own muscle tissue for fuel.

We implement specialised protocols involving frequent, high-protein meals and late-evening carbohydrate snacks to prevent life-threatening muscle wasting (sarcopenia) and malnutrition.

When should you see a Doctor?

You should see your GP for a routine liver health check (blood tests and an ultrasound) if you have Type 2 Diabetes, carry excess weight around your midsection, or have high cholesterol.

You must see a doctor immediately if you experience the signs of advanced liver failure, which include jaundice (yellowing of the skin or eyes), severe abdominal swelling (ascites), chronic unexplained itching, dark urine, or sudden confusion.

When should you see a Dietitian for liver disease?

The exact moment your GP mentions the words “mild fatty liver” or notes slightly elevated liver enzymes on your blood test, you should book an appointment with a REAL Dietitian.

Do not wait for the fat to cause irreversible scarring.

We cut through the nonsense of “liver detox teas” and “juice cleanses” (which can actually harm the liver) and provide a realistic, science-backed dietary roadmap to reverse the fat, restore your metabolic health, and protect your long-term vitality.

Why Choose REAL for Supporting Your Liver Health?

At REAL Health & Nutrition, we believe protecting your liver shouldn’t mean giving up the foods you love.

Our Accredited Practising Dietitians use evidence-based Medical Nutrition Therapy to help you navigate liver disease and MASLD, giving you complete confidence in your long-term metabolic health and energy levels.

Realistic nutrition solutions

REAL Health & Nutrition was founded in Melbourne by Matthew Rigoni alongside a passionate team that provides evidence-based nutrition strategies that fit into your life.

Our diverse clientele includes individuals seeking to manage chronic disease, enhance their energy, and those aiming to improve their healthspan and longevity through sustainable health and nutrition strategies.

Matthew Rigoni, expert Dietitian and sports dietitian- REAL Health & Nutrition

Practitioners

Meet the team

Highly skilled and qualified Dietitians and Sport Nutritionists

  • Matthew Rigoni Accredited Practising Dietitian (APD), sport Nutritionist, Accredited Sport Dietitian (ASD)

    Matthew Rigoni

    Head Dietitian (APD) & Sports Nutritionist

    Matthew Rigoni is an Accredited Practising Dietitian and Sports Nutritionist supporting clients across Eltham, Diamond Creek and Melbourne’s North-East. He specialises in weight management, chronic disease care, IBS/low-FODMAP nutrition, and sports-performance nutrition. His approach focuses on evidence-based, realistic strategies tailored to each client’s health goals. Matthew also brings experience in strength training and rehabilitation, helping clients build long-term, sustainable habits.

  • Max Dennehy Dietitian, body building coach

    Max Dennehy

    Dietitian and Bodybuilding Coach

    Max Dennehy is a qualified Dietitian with strong expertise in sports nutrition, weight loss, muscle gain and body recomposition. He has more than seven years of hands-on experience in bodybuilding and strength training, blending clinical nutrition with practical performance coaching. Max supports clients managing chronic conditions, improving metabolic health, and achieving body-composition goals. His coaching style is structured and supportive, helping clients stay consistent and confident.

  • Emma Westlake Accredited Sports Nutritionist

    Emma Westlake

    Accredited Sports Nutritionist

    Emma Westlake is a Nutritionist and Accredited Sports Nutritionist with experience in athletic performance, endurance nutrition, injury recovery and rehabilitation. She brings a strong background in Biomedical Science and works with clients to improve energy, health and long-term wellbeing. Emma has supported athletes across AFL/AFLW, triathlon and running communities, offering clear and practical guidance. Her passion lies in helping active individuals optimise performance through personalised, evidence-based nutrition.

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Qualifcations, profesional interests and why they're unique!

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Certifications & Associations

Maintaining Excellence in Nutrition Care

This commitment ensures you always receive the most current, evidence-based nutrition guidance available.

Frequently Asked Liver Health Questions

Common questions for liver health.

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    Yes! In its early stages (steatosis), Metabolic dysfunction-Associated Steatotic Liver Disease (MASLD) is highly reversible.

    A targeted dietary strategy that promotes a 7-10% weight loss and drastically reduces refined carbohydrates can completely clear the fat from your liver cells.

    Yes. Surprisingly, coffee is one of the most liver-protective beverages you can consume.

    Extensive clinical research shows that drinking 2-3 cups of black or minimally sweetened coffee per day significantly reduces liver inflammation and lowers the risk of developing cirrhosis and liver cancer.

    That being said, just because you drink coffee, doesn’t mean you won’t develop liver disease. You cannot outrun the rest of your dietary intake and lifestyle interventions. That’s why we’re here to help

    There is no safe level of alcohol consumption. Even one drink per day dramatically increases your risk of throat, stomach, liver and bowel cancer.

    If you have alcohol-related liver disease or cirrhosis, complete abstinence is an absolute medical necessity.

    If you have metabolism-driven fatty liver (MASLD), alcohol still acts as an accelerant to the damage.

    If you want optimal health, we highly recommend eliminating or drastically reducing alcohol until the liver fat is reversed.

    They are essentially the same condition, but the medical community recently updated the name. NAFLD (Non-Alcoholic Fatty Liver Disease) only defined the condition by what it wasn’t (alcohol).

    MASLD (Metabolic dysfunction-Associated Steatotic Liver Disease) accurately describes what is causing it: metabolic dysfunction and insulin resistance, boht of which you have control over!

    No. As much as we would like them to actually work, liver “detoxes,” juice cleanses, and specialised teas are a marketing scam. Your liver is the detoxifying organ.

    Drinking a week’s worth of highly concentrated fruit juice (fructose) with zero protein or fiber actively stresses the liver and worsens fatty liver disease.

    This can take away attention from the REAL solution

    No. While concentrated, highly refined liquid fructose (like high-fructose corn syrup in soft drinks) drives liver fat, whole fruit does not appear to have the same impact.

    The fibre, water, and antioxidants in whole fruit slow down absorption and are perfectly safe and beneficial for liver health when eaten in appropriate portions. 

    The most evidence-based dietary pattern for liver healing is the Mediterranean diet.

    It relies heavily on high-polyphenol foods such as Extra Virgin Olive Oil, high Omega 3 intake from fatty fish (like salmon and sardines), and foods such as leafy greens, cruciferous vegetables (like broccoli), legumes, and nuts, all of which actively reduce liver inflammation and improve insulin sensitivity.

Extra reading

Chalasani, N., Younossi, Z., Lavine, J. E., Charlton, M., Cusi, K., Rinella, M., Harrison, S. A., Brunt, E. M., & Sanyal, A. J. (2018). The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases. Hepatology, 67(1), 328–357. https://doi.org/10.1002/hep.29367

 

Gastroenterological Society of Australia. (2023). Metabolic dysfunction-associated steatotic liver disease (MASLD). https://www.gesa.org.au/education/clinical-information/masld/

 

Kennedy, O. J., Roderick, P., Buchanan, R., Fallowfield, J. A., Hayes, P. C., & Parkes, J. (2016). Systematic review with meta-analysis: Coffee consumption and the risk of cirrhosis. Alimentary Pharmacology & Therapeutics, 43(5), 562–574. https://doi.org/10.1111/apt.13523

 

Rinella, M. E., Lazarus, J. V., Ratziu, V., Francque, S. M., Sanyal, A. J., Kanwal, F., Romero, D., Boursier, J., Kamal-Bahl, S., Schattenberg, J. M., Anstee, QM., & NAFLD Nomenclature consensus group. (2023). A multi-society Delphi consensus statement on new fatty liver disease nomenclature. Hepatology, 78(6), 1966-1986. https://doi.org/10.1097/HEP.0000000000000520

 

Romero-Gómez, M., Zelber-Sagi, S., & Trenell, M. (2017). Treatment of NAFLD with diet, physical activity and exercise. Journal of Hepatology, 67(4), 829–846. https://doi.org/10.1016/j.jhep.2017.05.016