Nutraceutical Approach to Non-Alcoholic Fatty Liver Disease (NAFLD): The Available Clinical Evidence

Abstract

Non-alcoholic fatty liver disease (NAFLD) is a clinical condition characterized by lipid infiltration of the liver, highly prevalent in the general population affecting 25% of adults, with a doubled prevalence in diabetic and obese patients. Almost 1/3 of NAFLD evolves in Non-Alcoholic SteatoHepatitis (NASH), and this can lead to fibrosis and cirrhosis of the liver. However, the main causes of mortality of patients with NAFLD are cardiovascular diseases. At present, there are no specific drugs approved on the market for the treatment of NAFLD, and the treatment is essentially based on optimization of lifestyle. However, some nutraceuticals could contribute to the improvement of lipid infiltration of the liver and of the related anthropometric, haemodynamic, and/or biochemical parameters. The aim of this paper is to review the available clinical data on the effect of nutraceuticals on NAFLD and NAFLD-related parameters. Relatively few nutraceutical molecules have been adequately studied for their effects on NAFLD. Among these, we have analysed in detail the effects of silymarin, vitamin E, vitamin D, polyunsaturated fatty acids of the omega-3 series, astaxanthin, coenzyme Q10, berberine, curcumin, resveratrol, extracts of Salvia milthiorriza, and probiotics. In conclusion, Silymarin, vitamin E and vitamin D, polyunsaturated fatty acids of the omega-3 series, coenzyme Q10, berberine and curcumin, if well dosed and administered for medium–long periods, and associated to lifestyle changes, could exert positive effects on NAFLD and NAFLD-related parameters.

Coenzyme Q10: Clinical Applications in Cardiovascular Diseases

“…To date, the treatment of NAFLD is essentially based on lifestyle optimization because there are currently no specific drugs approved on the market for this condition. At the same time, few nutraceuticals have been adequately studied for their effects on NAFLD [48]. Among these, CoQ 10 is a well-known anti-adipogenic molecule and thus could have a positive impact on NAFLD, even if its exact mechanism is still unclear.…”

The effects of black seed supplementation on cardiovascular risk factors in patients with nonalcoholic fatty liver disease: A randomized, double‐blind, placebo‐controlled clinical trial

“…NAFLD includes a variety of disorders like nonalcoholic steatohepatitis, liver fibrosis, and liver cirrhosis. The pathogenesis of NAFLD is associated with metabolic diseases such as diabetes mellitus, hyperlipidemia, and obesity, which are also the main risk factors of cardiovascular disorders (Cicero, Colletti, & Bellentani, ; Patti et al, ). Currently, there is no approved treatment for NAFLD although health promotion strategies and lifestyle modifications are recommended as the primary steps in disease management (Emamat et al, ; Hekmatdoost et al, ; Mokhtari, Poustchi, Eslamparast, & Hekmatdoost, ; Noori, Jafari, & Hekmatdoost, ; Rahimlou, Ahmadnia, & Hekmatdoost, ; Rahimlou, Yari, Hekmatdoost, Alavian, & Keshavarz, ).…”

Does turmeric/curcumin supplementation improve serum alanine aminotransferase and aspartate aminotransferase levels in patients with nonalcoholic fatty liver disease? A systematic review and meta‐analysis of randomized controlled trials

“…In modern medicine, lifestyle modification (calorie restriction, weight loss, and physical exercise) is considered as the best solution to managing NAFLD, but these approaches have limited success over a long time period (Cicero, Colletti, & Bellentani, 2018;Haghighatdoost, Salehi-Abargouei, Surkan, & Azadbakht, 2016;Kani, Alavian, Haghighatdoost, & Azadbakht, 2014). Therefore, a number of auxiliary treatments including some herbs and their products such as ginger (Rahimlou, Yari, Hekmatdoost, Alavian, & Keshavarz, 2016), silymarin (Hashemi, Hajiani, & HEYDARI, 2009), and turmeric (Navekar, Rafraf, Ghaffari, Asghari-Jafarabadi, & Khoshbaten, 2017) have been taken into consideration in this regard.…”