Nutraceutical and dietary measures with potential for preventing/controlling non-alcoholic fatty liver disease and its complications

Non-alcoholic fatty liver disease (NAFLD), a frequent complication of metabolic syndrome and visceral obesity, is characterized by marked accumulation of lipids in hepatocytes, accompanied by oxidant stress. In a substantial minority of cases, this progresses to steatohepatitis, which in turn can lead to life-threatening hepatic fibrosis and/or hepatocarcinogenesis. This essay analyzes the molecular biology underlying fat accumulation and oxidant stress in NAFLD and identifies targets that can be addressed by nutraceutical or dietary measures. Nutraceuticals with potential for prevention or control of NAFLD as suggested on theoretical grounds, and borne out by experience in rodent studies and/or clinical trials include ferulic acid, melatonin, methyl nicotinamide, tetrahydro curcumin, nicotinamide riboside, carnosic acid, urolithin A, quercetin, high-dose biotin, citrulline, astaxanthin, long-chain omega-3 fatty acids, berberine, lipoic acid, silibinin, N-acetylcysteine, taurine, capsaicin, spermidine, spirulina, and carnitine. Some of these agents can also address the NLRP3 inflammasome activation and transforming growth factor-β signaling that play a role in driving the transition to steatohepatitis and fibrosis. In addition, soy isoflavones, via estrogen receptor-beta agonism, have anti-fibrotic potential, and supplemental glycine may blunt the contribution of Kupffer cells to the progression of NAFLD.

Methods

The research articles to carry out this work were focused based on many searches and reviews in the following databases: Google Scholar, MDPI, PubMed, ScienceDirect and using the following keywords and combined synonyms: ("nutraceuticals" or " dietary measures " or " Non-alcoholic fatty liver disease (NAFLD) " or "Nrf2″ or "Vegan diet”) AND (“NAFLD” or “vascular function” or “inflammation”). The keywords were also searched in the references of the original articles included in this study Whole-food plant-based diets of modest protein content, owing to their impact on hormones such as fibroblast growth factor 21 and adiponectin, as well as on the obesity and metabolic syndrome underlying NAFLD, may also be protective in this syndrome. There is considerable potential for complex medical foods or nutraceutical supplementation regimens of rational design to aid prevention and control of NAFLD.