{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T13:33:28Z","timestamp":1791812008959,"version":"4.3.4"},"reference-count":83,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T00:00:00Z","timestamp":1747094400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) is a growing global concern. Nutraceuticals offer an appealing approach by targeting key mechanisms, such as oxidative stress, inflammation, lipid metabolism, and insulin resistance. This narrative review examines the role of various nutraceuticals in MASLD treatment, including silymarin, vitamin E, omega-3, curcumin, berberine, and coenzyme Q10. Some of them show promising biochemical and metabolic changes, while others produce conflicting results due to relevant studies\u2019 design and endpoints. To bridge the gap between research and reality, we summarize the data, create an interpretation heatmap, and develop a practical supplement guide. Regardless of their potential, nutraceuticals should be viewed as add-ons to lifestyle interventions rather than standalone treatments. Future research should focus on well-designed, long-term studies to prove efficacy, dosing, and combination strategies for personalized MASLD management.<\/jats:p>","DOI":"10.3390\/nu17101657","type":"journal-article","created":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T06:40:23Z","timestamp":1747118423000},"page":"1657","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Nutraceutical Strategies for Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): A Path to Liver Health"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-2157-0814","authenticated-orcid":false,"given":"Emmanouil","family":"Vrentzos","sequence":"first","affiliation":[{"name":"4th Department of Internal Medicine, Medical School, Attikon University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3220-3446","authenticated-orcid":false,"given":"George","family":"Pavlidis","sequence":"additional","affiliation":[{"name":"4th Department of Internal Medicine, Medical School, Attikon University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7813-5488","authenticated-orcid":false,"given":"Emmanouil","family":"Korakas","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine, Research Unit and Diabetes Center, Medical School, Attikon University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5829-7327","authenticated-orcid":false,"given":"Aikaterini","family":"Kountouri","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine, Research Unit and Diabetes Center, Medical School, Attikon University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8693-4443","authenticated-orcid":false,"given":"Loukia","family":"Pliouta","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine, Research Unit and Diabetes Center, Medical School, Attikon University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0315-9936","authenticated-orcid":false,"given":"George D.","family":"Dimitriadis","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine, Research Unit and Diabetes Center, Medical School, Attikon University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaia","family":"Lambadiari","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine, Research Unit and Diabetes Center, Medical School, Attikon University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Guo, X., Yin, X., Liu, Z., and Wang, J. (2022). Non-Alcoholic Fatty Liver Disease (NAFLD) Pathogenesis and Natural Products for Prevention and Treatment. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms232415489"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1038\/s41575-023-00800-4","article-title":"Lifestyle interventions in nonalcoholic fatty liver disease","volume":"20","author":"Younossi","year":"2023","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"105517","DOI":"10.1016\/j.phrs.2021.105517","article-title":"Current innovations in nutraceuticals and functional foods for intervention of non-alcoholic fatty liver disease","volume":"166","author":"Zhao","year":"2021","journal-title":"Pharmacol. Res."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Tang, G.Y., Xu, Y., Zhang, C., Wang, N., Li, H.B., and Feng, Y.B. (2021). Green Tea and Epigallocatechin Gallate (EGCG) for the Management of Nonalcoholic Fatty Liver Diseases (NAFLD): Insights into the Role of Oxidative Stress and Antioxidant Mechanism. Antioxidants, 10.","DOI":"10.3390\/antiox10071076"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"James, A., Wang, K., and Wang, Y. (2023). Therapeutic Activity of Green Tea Epigallocatechin-3-Gallate on Metabolic Diseases and Non-Alcoholic Fatty Liver Diseases: The Current Updates. Nutrients, 15.","DOI":"10.3390\/nu15133022"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1876","DOI":"10.1002\/ptr.6130","article-title":"Green tea as a safe alternative approach for nonalcoholic fatty liver treatment: A systematic review and meta-analysis of clinical trials","volume":"32","author":"Hadi","year":"2018","journal-title":"Phytother. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1587","DOI":"10.1002\/ptr.6637","article-title":"Effects of green tea or green tea catechin on liver enzymes in healthy individuals and people with nonalcoholic fatty liver disease: A systematic review and meta-analysis of randomized clinical trials","volume":"34","author":"Mahmoodi","year":"2020","journal-title":"Phytother. Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"G419","DOI":"10.1152\/ajpgi.00026.2023","article-title":"Coffee as chemoprotectant in fatty liver disease: Caffeine-dependent and caffeine-independent effects","volume":"324","author":"Dranoff","year":"2023","journal-title":"Am. J. Physiol. Gastrointest. Liver Physiol."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Kositamongkol, C., Kanchanasurakit, S., Auttamalang, C., Inchai, N., Kabkaew, T., Kitpark, S., Chaiyakunapruk, N., Duangjai, A., Saokaew, S., and Phisalprapa, P. (2021). Coffee Consumption and Non-alcoholic Fatty Liver Disease: An Umbrella Review and a Systematic Review and Meta-analysis. Front. Pharmacol., 12.","DOI":"10.3389\/fphar.2021.786596"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Vargas-Pozada, E., Ramos-Tovar, E., Rodriguez-Callejas, J.D., Cardoso-Lezama, I., Galindo-G\u00f3mez, S., Talam\u00e1s-Lara, D., V\u00e1squez-Garz\u00f3n, V.R., Arellanes-Robledo, J., Tsutsumi, V., and Villa-Trevi\u00f1o, S. (2022). Caffeine Inhibits NLRP3 Inflammasome Activation by Downregulating TLR4\/MAPK\/NF-\u03baB Signaling Pathway in an Experimental NASH Model. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23179954"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"100671","DOI":"10.1016\/j.aohep.2022.100671","article-title":"Caffeine mitigates experimental nonalcoholic steatohepatitis and the progression of thioacetamide-induced liver fibrosis by blocking the MAPK and TGF-\u03b2\/Smad3 signaling pathways","volume":"27","author":"Tsutsumi","year":"2022","journal-title":"Ann. Hepatol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"G488","DOI":"10.1152\/ajpgi.00179.2022","article-title":"Coffee modulates insulin-hepatocyte nuclear factor-4\u03b1-Cyp7b1 pathway and reduces oxysterol-driven liver toxicity in a nonalcoholic fatty liver disease mouse model","volume":"323","author":"Kakiyama","year":"2022","journal-title":"Am. J. Physiol. Gastrointest. Liver Physiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"100254","DOI":"10.1016\/j.aohep.2020.08.071","article-title":"The effect of coffee consumption on the non-alcoholic fatty liver disease and liver fibrosis: A meta-analysis of 11 epidemiological studies","volume":"20","author":"Hayat","year":"2021","journal-title":"Ann. Hepatol."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Sewter, R., Heaney, S., and Patterson, A. (2021). Coffee Consumption and the Progression of NAFLD: A Systematic Review. Nutrients, 13.","DOI":"10.3390\/nu13072381"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"103025","DOI":"10.1016\/j.ctim.2024.103025","article-title":"Curcumin effects on glycaemic indices, lipid profile, blood pressure, inflammatory markers and anthropometric measurements of non-alcoholic fatty liver disease patients: A systematic review and meta-analysis of randomized clinical trials","volume":"80","author":"Ebrahimzadeh","year":"2024","journal-title":"Complement. Ther. Med."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"R\u00f3\u017ca\u0144ski, G., Kujawski, S., Newton, J.L., Zalewski, P., and S\u0142omko, J. (2021). Curcumin and Biochemical Parameters in Metabolic-Associated Fatty Liver Disease (MAFLD)\u2014A Review. Nutrients, 13.","DOI":"10.3390\/nu13082654"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Lukkunaprasit, T., Tansawet, A., Boonmanunt, S., Sobhonslidsuk, A., McKay, G.J., Attia, J., and Thakkinstian, A. (2023). An updated meta-analysis of effects of curcumin on metabolic dysfunction-associated fatty liver disease based on available evidence from Iran and Thailand. Sci. Rep., 13.","DOI":"10.1038\/s41598-023-33023-3"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Safari, Z., Bagherniya, M., Khoram, Z., Ebrahimi Varzaneh, A., Heidari, Z., Sahebkar, A., and Askari, G. (2023). The effect of curcumin on anthropometric indices, blood pressure, lipid profiles, fasting blood glucose, liver enzymes, fibrosis, and steatosis in non-alcoholic fatty livers. Front. Nutr., 10.","DOI":"10.3389\/fnut.2023.1163950"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"102843","DOI":"10.1016\/j.ctim.2022.102843","article-title":"Curcumin as adjuvant treatment in patients with non-alcoholic fatty liver (NAFLD) disease: A systematic review and meta-analysis","volume":"68","author":"Ngu","year":"2022","journal-title":"Complement. Ther. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"299","DOI":"10.3138\/canlivj-2023-0022","article-title":"Effects of curcumin in patients with non-alcoholic fatty liver disease: A systematic review and meta-analysis","volume":"7","author":"Malik","year":"2024","journal-title":"Can. Liver J."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1007\/s12325-020-01251-y","article-title":"Silymarin as Supportive Treatment in Liver Diseases: A Narrative Review","volume":"37","author":"Gillessen","year":"2020","journal-title":"Adv. Ther."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Garc\u00eda-Mu\u00f1oz, A.M., Victoria-Montesinos, D., Ballester, P., Cerd\u00e1, B., and Zafrilla, P. (2024). A Descriptive Review of the Antioxidant Effects and Mechanisms of Action of Berberine and Silymarin. Molecules, 29.","DOI":"10.3390\/molecules29194576"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"101174","DOI":"10.1016\/j.aohep.2023.101174","article-title":"Administration of silymarin in NAFLD\/NASH: A systematic review and meta-analysis","volume":"29","author":"Li","year":"2024","journal-title":"Ann. Hepatol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"40","DOI":"10.3138\/canlivj-2023-0021","article-title":"Effects of silymarin use on liver enzymes and metabolic factors in metabolic dysfunction-associated steatotic liver disease: A systematic review and meta-analysis","volume":"7","author":"Malik","year":"2024","journal-title":"Can. Liver J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"7273","DOI":"10.1002\/fsn3.4348","article-title":"Impact of silymarin-supplemented cookies on liver enzyme and inflammatory markers in non-alcoholic fatty liver disease patients","volume":"12","author":"Jaffar","year":"2024","journal-title":"Food Sci. Nutr."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Wang, H., Zhang, H., Gao, Z., Zhang, Q., and Gu, C. (2022). The mechanism of berberine alleviating metabolic disorder based on gut microbiome. Front. Cell. Infect. Microbiol., 12.","DOI":"10.3389\/fcimb.2022.854885"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Koperska, A., Weso\u0142ek, A., Moszak, M., and Szuli\u0144ska, M. (2022). Berberine in Non-Alcoholic Fatty Liver Disease-A Review. Nutrients, 14.","DOI":"10.3390\/nu14173459"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1186\/s12967-024-05011-2","article-title":"The clinical efficacy and safety of berberine in the treatment of non-alcoholic fatty liver disease: A meta-analysis and systematic review","volume":"22","author":"Nie","year":"2024","journal-title":"J. Transl. Med."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Ionita-Radu, F., Patoni, C., Nancoff, A.S., Marin, F.S., Gaman, L., Bucurica, A., Socol, C., Jinga, M., Dutu, M., and Bucurica, S. (2024). Berberine Effects in Pre-Fibrotic Stages of Non-Alcoholic Fatty Liver Disease-Clinical and Pre-Clinical Overview and Systematic Review of the Literature. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms25084201"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"5503","DOI":"10.1038\/s41467-021-25701-5","article-title":"A phase 2, proof of concept, randomised controlled trial of berberine ursodeoxycholate in patients with presumed non-alcoholic steatohepatitis and type 2 diabetes","volume":"12","author":"Harrison","year":"2021","journal-title":"Nat. Commun."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1382","DOI":"10.1002\/ptr.6073","article-title":"Efficacy of artichoke leaf extract in non-alcoholic fatty liver disease: A pilot double-blind randomized controlled trial","volume":"32","author":"Panahi","year":"2018","journal-title":"Phytother. Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"6324","DOI":"10.1002\/ptr.7279","article-title":"The effects of co-administration of artichoke leaf extract supplementation with metformin and vitamin E in patients with nonalcoholic fatty liver disease: A randomized clinical trial","volume":"35","author":"Majnooni","year":"2021","journal-title":"Phytother. Res."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e14726","DOI":"10.1111\/ijcp.14726","article-title":"The effects of Cynara scolymus L. supplementation on liver enzymes: A systematic review and meta-analysis","volume":"75","author":"Moradi","year":"2021","journal-title":"Int. J. Clin. Pract."},{"key":"ref_34","first-page":"931","article-title":"Therapeutic Potential of Artichoke in the Treatment of Fatty Liver: A Systematic Review and Meta-Analysis","volume":"25","author":"Kamel","year":"2022","journal-title":"J. Med. Food"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Podszun, M.C., and Frank, J. (2021). Impact of vitamin E on redox biomarkers in non-alcoholic fatty liver disease. Redox Biol., 42.","DOI":"10.1016\/j.redox.2021.101937"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Podszun, M.C., Alawad, A.S., Lingala, S., Morris, N., Huang, W.C.A., Yang, S., Schoenfeld, M., Rolt, A., Ouwerkerk, R., and Valdez, K. (2020). Vitamin E treatment in NAFLD patients demonstrates that oxidative stress drives steatosis through upregulation of de-novo lipogenesis. Redox Biol., 37.","DOI":"10.1016\/j.redox.2020.101710"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Qi, X., Guo, J., Li, Y., Fang, C., Lin, J., Chen, X., and Jia, J. (2024). Vitamin E intake is inversely associated with NAFLD measured by liver ultrasound transient elastography. Sci. Rep., 14.","DOI":"10.1038\/s41598-024-52482-w"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Vogli, S., Naska, A., Marinos, G., Kasdagli, M.I., and Orfanos, P. (2023). The Effect of Vitamin E Supplementation on Serum Aminotransferases in Non-Alcoholic Fatty Liver Disease (NAFLD): A Systematic Review and Meta-Analysis. Nutrients, 15.","DOI":"10.3390\/nu15173733"},{"key":"ref_39","first-page":"e9018","article-title":"Vitamin E as an Adjuvant Treatment for Non-alcoholic Fatty Liver Disease in Adults: A Systematic Review of Randomized Controlled Trials","volume":"12","author":"Usman","year":"2020","journal-title":"Cureus"},{"key":"ref_40","first-page":"e32764","article-title":"Effect of Vitamin E on Clinical Outcomes in Patients With Non-alcoholic Fatty Liver Disease: A Meta-Analysis","volume":"14","author":"Karedath","year":"2022","journal-title":"Cureus"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1756284820974917","DOI":"10.1177\/1756284820974917","article-title":"The efficacy of vitamin E in reducing non-alcoholic fatty liver disease: A systematic review, meta-analysis, and meta-regression","volume":"13","author":"Menshawy","year":"2020","journal-title":"Ther. Adv. Gastroenterol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1002\/hep.30368","article-title":"Vitamin E Improves Transplant-Free Survival and Hepatic Decompensation Among Patients With Nonalcoholic Steatohepatitis and Advanced Fibrosis","volume":"71","author":"Vuppalanchi","year":"2020","journal-title":"Hepatology"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1186\/s12933-024-02326-8","article-title":"Six-month supplementation with high dose coenzyme Q10 improves liver steatosis, endothelial, vascular and myocardial function in patients with metabolic-dysfunction associated steatotic liver disease: A randomized double-blind, placebo-controlled trial","volume":"23","author":"Vrentzos","year":"2024","journal-title":"Cardiovasc. Diabetol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1039\/C8FO01236A","article-title":"Coenzyme Q10 attenuates high-fat diet-induced non-alcoholic fatty liver disease through activation of the AMPK pathway","volume":"10","author":"Chen","year":"2019","journal-title":"Food Funct."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Dludla, P.V., Orlando, P., Silvestri, S., Marcheggiani, F., Cirilli, I., Nyambuya, T.M., Mxinwa, V., Mokgalaboni, K., Nkambule, B.B., and Johnson, R. (2020). Coenzyme Q10 Supplementation Improves Adipokine Levels and Alleviates Inflammation and Lipid Peroxidation in Conditions of Metabolic Syndrome: A Meta-Analysis of Randomized Controlled Trials. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21093247"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"2580","DOI":"10.1002\/fsn3.3315","article-title":"Effects of coenzyme Q10 supplementation on lipid profiles and liver enzymes of nonalcoholic fatty liver disease (NAFLD) patients: A systematic review and meta-analysis of randomized controlled trials","volume":"11","author":"Ardekani","year":"2023","journal-title":"Food Sci. Nutr."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1080\/07315724.2015.1021057","article-title":"Functions of Coenzyme Q10 Supplementation on Liver Enzymes, Markers of Systemic Inflammation, and Adipokines in Patients Affected by Nonalcoholic Fatty Liver Disease: A Double-Blind, Placebo-Controlled, Randomized Clinical Trial","volume":"35","author":"Farsi","year":"2016","journal-title":"J. Am. Coll. Nutr."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Curcio, A., Romano, A., Cuozzo, S., Di Nicola, A., Grassi, O., Schiaroli, D., Nocera, G.F., and Pironti, M. (2020). Silymarin in Combination with Vitamin C, Vitamin E, Coenzyme Q10 and Selenomethionine to Improve Liver Enzymes and Blood Lipid Profile in NAFLD Patients. Medicina, 56.","DOI":"10.3390\/medicina56100544"},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Rezaei, S., Tabrizi, R., Nowrouzi-Sohrabi, P., Jalali, M., Shabani-Borujeni, M., Modaresi, S., Gholamalizadeh, M., and Doaei, S. (2021). The Effects of Vitamin D Supplementation on Anthropometric and Biochemical Indices in Patients With Non-alcoholic Fatty Liver Disease: A Systematic Review and Meta-analysis. Front. Pharmacol., 12.","DOI":"10.3389\/fphar.2021.732496"},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Sindhughosa, D.A., Wibawa, I.D.N., Mariadi, I.K., and Somayana, G. (2022). Additional treatment of vitamin D for improvement of insulin resistance in non-alcoholic fatty liver disease patients: A systematic review and meta-analysis. Sci. Rep., 12.","DOI":"10.1038\/s41598-022-11950-x"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"e35717","DOI":"10.1097\/MD.0000000000035717","article-title":"The effect of vitamin D supplementation on some metabolic parameters in patients with nonalcoholic fatty liver disease: A systematic review and meta-analysis of 8 RCTs","volume":"102","author":"Chen","year":"2023","journal-title":"Medicine"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"e97205","DOI":"10.5812\/ijem.97205","article-title":"Effects of Vitamin D Supplementation in Patients with Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis","volume":"18","author":"Wei","year":"2020","journal-title":"Int. J. Endocrinol. Metab."},{"key":"ref_53","first-page":"e68002","article-title":"Effectiveness of Omega-3 Polyunsaturated Fatty Acids in Non-alcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis","volume":"16","author":"Aziz","year":"2024","journal-title":"Cureus"},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Lee, C.H., Fu, Y., Yang, S.J., and Chi, C.C. (2020). Effects of Omega-3 Polyunsaturated Fatty Acid Supplementation on Non-Alcoholic Fatty Liver: A Systematic Review and Meta-Analysis. Nutrients, 12.","DOI":"10.3390\/nu12092769"},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Yang, J., Fern\u00e1ndez-Galilea, M., Mart\u00ednez-Fern\u00e1ndez, L., Gonz\u00e1lez-Muniesa, P., P\u00e9rez-Ch\u00e1vez, A., Mart\u00ednez, J.A., and Moreno-Aliaga, M.J. (2019). Oxidative Stress and Non-Alcoholic Fatty Liver Disease: Effects of Omega-3 Fatty Acid Supplementation. Nutrients, 11.","DOI":"10.3390\/nu11040872"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1093\/nutrit\/nuy022","article-title":"Systematic review and meta-analysis of controlled intervention studies on the effectiveness of long-chain omega-3 fatty acids in patients with nonalcoholic fatty liver disease","volume":"76","author":"Venditti","year":"2018","journal-title":"Nutr. Rev."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1336","DOI":"10.1002\/hep4.1906","article-title":"Effect of Omega-3 Polyunsaturated Fatty Acids on Lipid Metabolism in Patients With Metabolic Syndrome and NAFLD","volume":"6","author":"Kosek","year":"2022","journal-title":"Hepatol. Commun."},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Vallianou, N., Christodoulatos, G.S., Karampela, I., Tsilingiris, D., Magkos, F., Stratigou, T., Kounatidis, D., and Dalamaga, M. (2021). Understanding the Role of the Gut Microbiome and Microbial Metabolites in Non-Alcoholic Fatty Liver Disease: Current Evidence and Perspectives. Biomolecules, 12.","DOI":"10.3390\/biom12010056"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"G42","DOI":"10.1152\/ajpgi.00017.2023","article-title":"Probiotics, prebiotics, and synbiotics in nonalcoholic fatty liver disease and alcohol-associated liver disease","volume":"325","author":"Kaufmann","year":"2023","journal-title":"Am. J. Physiol. Gastrointest. Liver Physiol."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Li, S., Liu, J., Wang, Z., Duan, F., Jia, Z., Chen, X., and Li, S. (2022). The promising role of probiotics\/prebiotics\/synbiotics in energy metabolism biomarkers in patients with NAFLD: A systematic review and meta-analysis. Front. Public Health, 10.","DOI":"10.3389\/fpubh.2022.862266"},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Kanchanasurakit, S., Kositamongkol, C., Lanoi, K., Nunta, M., Saetuan, T., Chaiyakunapruk, N., Saokaew, S., and Phisalprapa, P. (2022). Effects of Synbiotics, Probiotics, and Prebiotics on Liver Enzymes of Patients With Non-alcoholic Fatty Liver Disease: A Systematic Review and Network Meta-Analysis. Front. Nutr., 9.","DOI":"10.3389\/fnut.2022.880014"},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Pan, Y., Yang, Y., Wu, J., Zhou, H., and Yang, C. (2024). Efficacy of probiotics, prebiotics, and synbiotics on liver enzymes, lipid profiles, and inflammation in patients with non-alcoholic fatty liver disease: A systematic review and meta-analysis of randomized controlled trials. BMC Gastroenterol., 24.","DOI":"10.1186\/s12876-024-03356-y"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1186\/s13643-023-02299-x","article-title":"Effects of gut microbial therapy on lipid profile in individuals with non-alcoholic fatty liver disease: An umbrella meta-analysis study","volume":"12","author":"Naghipour","year":"2023","journal-title":"Syst. Rev."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"2209335","DOI":"10.1080\/07853890.2023.2209335","article-title":"Relevance of vitamin D on NAFLD and liver fibrosis detected by vibration controlled transient elastography in US adults: A cross-sectional analysis of NHANES 2017\u20132018","volume":"55","author":"Ji","year":"2023","journal-title":"Ann. Med."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/S2213-8587(24)00318-8","article-title":"Metabolic dysfunction-associated steatotic liver disease: Heterogeneous pathomechanisms and effectiveness of metabolism-based treatment","volume":"13","author":"Stefan","year":"2025","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Al Hashmi, K., Giglio, R.V., Pantea Stoian, A., Patti, A.M., Al Waili, K., Al Rasadi, K., Ciaccio, M., and Rizzo, M. (2024). Metabolic dysfunction-associated fatty liver disease: Current therapeutic strategies. Front. Nutr., 11.","DOI":"10.3389\/fnut.2024.1355732"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"101270","DOI":"10.1016\/j.molmet.2021.101270","article-title":"Exercise of high intensity ameliorates hepatic inflammation and the progression of NASH","volume":"53","author":"Fredrickson","year":"2021","journal-title":"Mol. Metab."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"106679","DOI":"10.1016\/j.phrs.2023.106679","article-title":"Nutraceutical approaches to non-alcoholic fatty liver disease (NAFLD): A position paper from the International Lipid Expert Panel (ILEP)","volume":"189","author":"Rizzo","year":"2023","journal-title":"Pharmacol. Res."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1111\/bph.14778","article-title":"Mediterranean diet and health status: Active ingredients and pharmacological mechanisms","volume":"177","author":"Schwingshackl","year":"2020","journal-title":"Br. J. Pharmacol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"389","DOI":"10.5937\/scriptamed54-46932","article-title":"The Impact of Antioxidant Diets, Nutraceuticals and Physical Activity Interventions in the Prevention of Cardiometabolic Diseases: An Overview","volume":"54","author":"Parekh","year":"2023","journal-title":"Scr. Medica"},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"Cium\u0103rnean, L., S\u00e2rb, O.F., Dr\u0103ghici, N.C., S\u0103l\u0103gean, O., Milaciu, M.V., Or\u0103\u0219an, O.H., Vlad, C.V., Vlad, I.M., Alexescu, T., and Para, I. (2024). Obesity Control and Supplementary Nutraceuticals as Cofactors of Brain Plasticity in Multiple Sclerosis Populations. Int. J. Mol. Sci., 25.","DOI":"10.20944\/preprints202407.1943.v2"},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"AlAli, M., Alqubaisy, M., Aljaafari, M.N., AlAli, A.O., Baqais, L., Molouki, A., Abushelaibi, A., Lai, K.S., and Lim, S.H.E. (2021). Nutraceuticals: Transformation of Conventional Foods into Health Promoters\/Disease Preventers and Safety Considerations. Molecules, 26.","DOI":"10.3390\/molecules26092540"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1002\/hep.28813","article-title":"Liver injury from herbal and dietary supplements","volume":"65","author":"Navarro","year":"2017","journal-title":"Hepatology"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"2219","DOI":"10.1111\/jgs.18305","article-title":"Dietary supplement and complementary and alternative medicine use among older adults in Australia and the United States","volume":"71","author":"Fravel","year":"2023","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Dwyer, J.T., Coates, P.M., and Smith, M.J. (2018). Dietary Supplements: Regulatory Challenges and Research Resources. Nutrients, 10.","DOI":"10.3390\/nu10010041"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1080\/10408398.2018.1524364","article-title":"Current regulatory guidelines and resources to support research of dietary supplements in the United States","volume":"60","author":"Bailey","year":"2020","journal-title":"Crit. Rev. Food Sci. Nutr."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"1620","DOI":"10.5551\/jat.64896","article-title":"Comparison of Efficacy between Pemafibrate and Omega-3-Acid Ethyl Ester in the Liver: The PORTRAIT Study","volume":"31","author":"Sumida","year":"2024","journal-title":"J. Atheroscler. Thromb."},{"key":"ref_78","doi-asserted-by":"crossref","unstructured":"Yanai, H., Adachi, H., Hakoshima, M., Iida, S., and Katsuyama, H. (2023). Metabolic-Dysfunction-Associated Steatotic Liver Disease-Its Pathophysiology, Association with Atherosclerosis and Cardiovascular Disease, and Treatments. Int. J. Mol. Sci., 24.","DOI":"10.20944\/preprints202309.1062.v1"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/j.metabol.2018.11.014","article-title":"Obesity and nonalcoholic fatty liver disease: From pathophysiology to therapeutics","volume":"92","author":"Polyzos","year":"2019","journal-title":"Metabolism"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"2212","DOI":"10.1016\/S0140-6736(20)32511-3","article-title":"Non-alcoholic fatty liver disease","volume":"397","author":"Powell","year":"2021","journal-title":"Lancet"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.5114\/aoms\/152921","article-title":"Metabolic syndrome\u2014A new definition and management guidelines: A joint position paper by the Polish Society of Hypertension, Polish Society for the Treatment of Obesity, Polish Lipid Association, Polish Association for Study of Liver, Polish Society of Family Medicine, Polish Society of Lifestyle Medicine, Division of Prevention and Epidemiology Polish Cardiac Society, \u201cClub 30\u201d Polish Cardiac Society, and Division of Metabolic and Bariatric Surgery Society of Polish Surgeons","volume":"18","author":"Dobrowolski","year":"2022","journal-title":"Arch. Med. Sci."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1038\/s41591-018-0104-9","article-title":"Mechanisms of NAFLD development and therapeutic strategies","volume":"24","author":"Friedman","year":"2018","journal-title":"Nat. Med."},{"key":"ref_83","doi-asserted-by":"crossref","unstructured":"Dongiovanni, P., and Valenti, L. (2017). A Nutrigenomic Approach to Non-Alcoholic Fatty Liver Disease. Int. J. Mol. Sci., 18.","DOI":"10.3390\/ijms18071534"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/10\/1657\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:31:50Z","timestamp":1760031110000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/10\/1657"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,13]]},"references-count":83,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,5]]}},"alternative-id":["nu17101657"],"URL":"https:\/\/doi.org\/10.3390\/nu17101657","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,13]]}}}