Non-alcoholic fatty liver disease (NAFLD) has become an increasing epidemic. It is the most common cause of elevated liver enzymes and is associated with diabetes and obesity with advanced liver disease.

There are few guidelines for diagnostic and follow up methods and limited proven treatment options. Previous research of pharmacological agents to treat nonalcoholic fatty liver disease were performed with poor results.

According to a study just published this week in Nutrients, researchers investigated the effects of long-term fish oil supplementation in patients with nonalcoholic fatty liver disease (NAFLD).

This study was a randomized, double-blinded, placebo-controlled trial conducted between January 2018 and February 2020 including 24 patients over the age of 19 with ultrasound proven fatty liver disease. The patients were randomized to receive either fish oil supplementation (1,509 mg of DHA; 306 mg of EPA) or placebo (2,250 mg of oleic acid) over a six-month period. Assessments included circulating miR-122 expression, liver fibrosis (FibroScan®), RBC fatty acid profile, ALT, AST, alkaline phosphatase (ALP), GGT, fasting glucose, HA1c, and lipid profile were performed at baseline and after intervention.

As a result, there was a significant increase in the omega-3 index in the fish oil supplementation group. In addition, there was a significant decrease in ALP levels and liver fibrosis. ALP is commonly used as a marker of liver and bone pathology and is an independent risk factor for NAFLD. Also, increased levels of ALP have been shown in NAFLD patients in stages 1 and 2 of liver fibrosis. There was no difference in omega-3 index levels in the placebo group.

This study demonstrated that the fish oil supplementation was incorporated in the red blood cells after six months of supplementation and fish oil supplementation was effective in reducing liver fibrosis and ALP levels.

These individuals are in a chronic disease state and have increased demands then what could be obtained from the diet alone and therefore, dietary supplements should be considered to help prevent the progression as well as improve liver function. Other nutrients to consider include tocotrienols, phosphatidylcholine, fiber or resistant starch, n-acetylcysteine, and probiotics.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Cansancao K, Citelli M, et al. Impact of Long-Term Supplementation with Fish Oil

in Individuals with Non-Alcoholic Fatty Liver Disease: A Double Blind Randomized Placebo Controlled Clinical Trial. Nutrients 2 November 2020, 12(11), 3372.

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