Natural Compounds for Counteracting Nonalcoholic Fatty Liver Disease (NAFLD): Advantages and Limitations of the Suggested Candidates

Abstract

The booming prevalence of nonalcoholic fatty liver disease (NAFLD) in adults and children will threaten the health system in the upcoming years. The “multiple hit” hypothesis is the currently accepted explanation of the complex etiology and pathophysiology of the disease. Some of the critical pathological events associated with the development of NAFLD are insulin resistance, steatosis, oxidative stress, inflammation, and fibrosis. Hence, attenuating these events may help prevent or delay the progression of NAFLD. Despite an increasing understanding of the mechanisms involved in NAFLD, no approved standard pharmacological treatment is available. The only currently recommended alternative relies on lifestyle modifications, including diet and physical activity. However, the lack of compliance is still hampering this approach. Thus, there is an evident need to characterize new therapeutic alternatives. Studies of food bioactive compounds became an attractive approach to overcome the reticence toward lifestyle changes. The present study aimed to review some of the reported compounds with beneficial properties in NAFLD; namely, coffee (and its components), tormentic acid, verbascoside, and silymarin. We provide details about their protective effects, their mechanism of action in ameliorating the critical pathological events involved in NAFLD, and their clinical applications.

Efficacy and safety of dietary polyphenol supplementation in the treatment of non-alcoholic fatty liver disease: A systematic review and meta-analysis

“…For safety, silymarin was found to be safe and well tolerated (68). The current study found that silymarin has antiinflammatory, immunomodulatory, antifibrotic, antioxidant, and liver regeneration properties in the treatment of NAFLD (152,153). This meta-analysis and systematic review showed that silymarin was effective in improving ALT and AST and reducing hepatic fat accumulation and liver stiffness in NAFLD patients.…”

The Role of Phytosterols in Nonalcoholic Fatty Liver Disease

“…Lifestyle interventions, like dietary changes and exercise, should be combined with the administration of so-called bio-active natural compounds, such as polyphenols, polyunsaturated fatty acids, vitamin E, quercetin, phytosterols, fructo-oligosaccharides, and carbohydrate-dietary fibers [ 2 , 22 ]. Numerous clinical studies confirmed the ability of some of this natural product metabolites to exert beneficial effect(s) in the cellular mechanisms involved in the onset and progression of NAFLD [ 20 , 23 ]. Moreover, several studies published in the literature in recent years have confirmed the beneficial effects of phytosterols (PSs) on lipid metabolism, as serum cholesterol-lowering, and the evolution of NAFLD [ 24 ].…”

Multi-Omics Reveals Inhibitory Effect of Baicalein on Non-Alcoholic Fatty Liver Disease in Mice

“…Some natural compounds such as coffee (and its components), tormentic acid, verbascoside, and silymarin showed protective effects in ameliorating the critical pathological events involved in NAFLD. For example, silymarin has been widely used in the treatment of various liver disorders because of its hepatoprotective properties, including anti-inflammatory, antiproliferative, immunomodulatory, and nticholesterolemic properties ( Salvoza et al, 2022 ). Baicalein, a bioactive flavone, is isolated from Scutellariae baicalensis , which is a traditional Chinese herb.…”