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• Vitamin D supplementation lowered multiple risk markers — Across the pooled trials, vitamin D supplementation consistently led to improvements compared with placebo. People taking vitamin D saw reductions in body weight, body mass index, and waist circumference, pointing to shifts in fat distribution and metabolic balance.

In addition, fasting blood sugar levels and HOMA-IR — a measure of insulin resistance — improved, indicating better blood sugar control. Liver enzymes also decreased, suggesting less active damage within the liver.

• Protective effects reached beyond the liver — The review showed that vitamin D increased HDL cholesterol, the “good” cholesterol that helps clear fats from the bloodstream. This means the benefits extended into heart health, reducing the load on the cardiovascular system at the same time that liver health improved.

Beyond bone health, vitamin D helps regulate blood sugar, calm inflammation, and keep fat metabolism in balance. When levels run low, your liver takes a hit — inflammation gets worse, fat piles up, and scarring speeds along.²

• Consistency emerged across different trials — While individual studies had mixed findings, this large-scale analysis confirmed that the benefits were not isolated results but part of a broader pattern. Improvements were seen regardless of study duration or location, with especially strong effects in trials lasting longer than 12 weeks or using higher vitamin D doses.

• Overall, the review positioned vitamin D as a low-cost, effective strategy — By addressing weight, blood sugar, cholesterol balance, and liver enzymes at once, vitamin D created a ripple effect across multiple systems. For people with fatty liver disease, this means that restoring vitamin D status is more than a supportive step — it directly influences the disease process.

• Worse deficiency meant worse disease — The more severe the vitamin D deficiency, the more advanced the liver problems. Patients with the lowest levels were significantly more likely to have enlarged liver, enlarged spleen, and fluid buildup in the abdomen. These conditions signal progression beyond simple fat accumulation toward more serious stages of liver dysfunction.

• Obesity and deficiency overlapped — Among overweight participants, 91.7% were deficient in vitamin D compared to 39.1% of those with normal body weight. This points to a strong interplay between excess body fat, vitamin D status, and the worsening of fatty liver disease.

• Liver fat and vitamin D were directly correlated — Ultrasound findings showed that patients with more severe fatty liver consistently had lower vitamin D levels. The statistical link was strong, confirming that deficiency isn’t just present in NAFLD patients but tied to how much damage is visible inside the liver.

• Vitamin D deficiency linked to insulin resistance — Patients with low vitamin D also had higher levels of insulin resistance, one of the main drivers of NAFLD. This means deficiency could worsen not only liver outcomes but also the broader metabolic problems that often travel with fatty liver disease, such as diabetes and high blood pressure.

• Liver enzymes reflected the same pattern — Vitamin D-deficient patients were more likely to have elevated enzymes that signal liver injury. This shows the deficiency wasn’t just linked to structural changes on imaging but also to active, ongoing liver damage.

Taken together, this study highlights vitamin D deficiency as a powerful predictor of NAFLD severity. Rather than being an incidental finding, low vitamin D was consistently tied to worse liver outcomes, greater metabolic dysfunction, and faster progression of disease.

1. Eliminate vegetable oils and alcohol — If you’re eating packaged foods made with soybean, canola, corn, sunflower, or generic “vegetable oil,” your liver is under nonstop attack. These oils are high in linoleic acid (LA), a polyunsaturated fat that oxidizes and turns into toxic byproducts that damage your mitochondria — the “engines” of your cells.

Alcohol is just as destructive, since it breaks down into a substance that injures your liver cells. The fastest way to give your liver breathing room is to cut both alcohol and vegetable oils right now. For cooking, switch to grass fed butter, ghee, tallow, or coconut oil.

2. Eat choline-rich foods to support liver health — Think of choline as traffic control for your liver. Without it, fat builds up inside your liver cells, leading to dysfunction and damage. Choline helps package up fats and ship them out so your liver doesn’t become clogged. The best food sources are pastured egg yolks and grass fed beef liver. If you regularly skip these foods, there’s a good chance your liver isn’t getting the support it needs.

3. Use a choline supplement if your diet falls short — If you don’t eat eggs or meat, reaching adequate choline intake through food alone is a challenge. In that case, supplementation is not optional — it’s required. Citicoline is one of the most effective forms, and doses between 500 milligrams (mg) and 2,500 mg per day have been shown to help your liver export fat while also boosting brain function. If you’re noticing brain fog, low energy, or signs of fatty liver, this is a simple but powerful step.

4. Repair with sunlight and smart vitamin D use — Your skin is designed to make vitamin D from sunlight, and daily exposure supports not only your bones and immune system but also your liver’s ability to metabolize fat. But here’s the catch: if you’re still using vegetable oils, the LA stored in your skin increases your risk of sun damage.

Eliminate those oils for at least six months before getting peak sun exposure (10 a.m. to 4 p.m.). When sunlight isn’t an option, supplement with vitamin D3.⁴

5. Test and track your vitamin D to stay on target — Instead of guessing, check your vitamin D levels with a simple blood test at least twice a year. Aim for 60 to 80 ng/mL (150 to 200 nmol/L). This range supports healthy liver function, balanced immunity, and energy production. Testing gives you a clear starting point and a way to measure progress over time.