Zahra Yari1, Makan Cheraghpour2, Seyed Moayed Alavian3, Mehdi Hedayati4, Hassan Eini-Zinab5, Azita Hekmatdoost6. 1. Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2. Cancer Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Bio_makan@yahoo.com. 3. Middle East Liver Diseases (MELD) Center, Tehran, Iran. 4. Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 5. Department of Community Nutrition, National Nutrition and Food Technology Research Institute; and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 6. Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran. a_hekmat2000@yahoo.com.
Abstract
BACKGROUND/ OBJECTIVES:Non-alcoholic fatty liver disease (NAFLD) is growing in prevalence globally and no definitive evidence for any approved pharmacological approaches for patients with NAFLD has been found yet. This study was aimed to assess the clinical effects of flaxseed and hesperidin in patients with NAFLD. SUBJECTS/ METHODS: In this randomized, controlled, clinical trial, one hundred eligible patients with NAFLD were enrolled and randomly assigned to four dietary intervention groups including lifestyle modification program (control), lifestyle modification program with 30 g whole flaxseed powder, lifestyle modification program with 1 g hesperidin supplementation, and lifestyle modification program with combination of 30 g flaxseed and 1 g hesperidin (flax-hes) for 12 weeks. The changes in anthropometric parameters, metabolic profiles of glucose and lipids, inflammatory biomarkers and hepatic steatosis and fibrosis were evaluated. RESULTS: After the 12-week dietary interventions, significant reductions in body mass index, glucose hemostasis parameters and hepatic steatosis were observed in all groups. Repeated measures analysis of variance revealed a significant effect for time relative to almost all paraclinical parameters. Post hoc analysis with Bonferroni correction revealed that the three intervention groups experienced significant decreases in plasma levels of alanine aminotransferase, indices of insulin resistance and insulin sensitivity, fasting glucose and fatty liver index compared to control (p < 0.008). CONCLUSIONS: In conclusion, our study confirmed that hesperidin and flaxseed supplementation improved glucose and lipid metabolism, while reduced inflammation and hepatic steatosis (controlled attenuation parameter) in NAFLD patients. The synergistic effects of their combination were observed on plasma glucose concentration and HOMA-IR.
RCT Entities:
BACKGROUND/ OBJECTIVES:Non-alcoholic fatty liver disease (NAFLD) is growing in prevalence globally and no definitive evidence for any approved pharmacological approaches for patients with NAFLD has been found yet. This study was aimed to assess the clinical effects of flaxseed and hesperidin in patients with NAFLD. SUBJECTS/ METHODS: In this randomized, controlled, clinical trial, one hundred eligible patients with NAFLD were enrolled and randomly assigned to four dietary intervention groups including lifestyle modification program (control), lifestyle modification program with 30 g whole flaxseed powder, lifestyle modification program with 1 g hesperidin supplementation, and lifestyle modification program with combination of 30 g flaxseed and 1 g hesperidin (flax-hes) for 12 weeks. The changes in anthropometric parameters, metabolic profiles of glucose and lipids, inflammatory biomarkers and hepatic steatosis and fibrosis were evaluated. RESULTS: After the 12-week dietary interventions, significant reductions in body mass index, glucose hemostasis parameters and hepatic steatosis were observed in all groups. Repeated measures analysis of variance revealed a significant effect for time relative to almost all paraclinical parameters. Post hoc analysis with Bonferroni correction revealed that the three intervention groups experienced significant decreases in plasma levels of alanine aminotransferase, indices of insulin resistance and insulin sensitivity, fasting glucose and fatty liver index compared to control (p < 0.008). CONCLUSIONS: In conclusion, our study confirmed that hesperidin and flaxseed supplementation improved glucose and lipid metabolism, while reduced inflammation and hepatic steatosis (controlled attenuation parameter) in NAFLD patients. The synergistic effects of their combination were observed on plasma glucose concentration and HOMA-IR.
Authors: Zobair M Younossi; Vlad Ratziu; Rohit Loomba; Mary Rinella; Quentin M Anstee; Zachary Goodman; Pierre Bedossa; Andreas Geier; Susanne Beckebaum; Philip N Newsome; David Sheridan; Muhammad Y Sheikh; James Trotter; Whitfield Knapple; Eric Lawitz; Manal F Abdelmalek; Kris V Kowdley; Aldo J Montano-Loza; Jerome Boursier; Philippe Mathurin; Elisabetta Bugianesi; Giuseppe Mazzella; Antonio Olveira; Helena Cortez-Pinto; Isabel Graupera; David Orr; Lise Lotte Gluud; Jean-Francois Dufour; David Shapiro; Jason Campagna; Luna Zaru; Leigh MacConell; Reshma Shringarpure; Stephen Harrison; Arun J Sanyal Journal: Lancet Date: 2019-12-05 Impact factor: 79.321
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Authors: Oluyemi Komolafe; Elena Buzzetti; Audrey Linden; Lawrence Mj Best; Angela M Madden; Danielle Roberts; Thomas Jg Chase; Dominic Fritche; Suzanne C Freeman; Nicola J Cooper; Alex J Sutton; Elisabeth Jane Milne; Kathy Wright; Chavdar S Pavlov; Brian R Davidson; Emmanuel Tsochatzis; Kurinchi Selvan Gurusamy Journal: Cochrane Database Syst Rev Date: 2021-07-19