Abstract
Metabolism dysfunction-associated steatotic liver disease affects approximately 30% of the world’s population, yet there is only one approved treatment option applicable to more advanced disease. Many individuals consume natural health products for general health and a variety of medical conditions but none are recommended for metabolism dysfunction-associated steatotic liver disease in current European or American guidelines. Nevertheless, human trials indicate that some of these products may be efficacious for treatment of metabolism dysfunction-associated steatotic liver disease and these are supported by mechanistic studies using animal models. This narrative review aims to highlight recent research in human and animal trials on selected natural health products. So far, neither probiotics nor omega-3 polyunsaturated fatty acids have produced convincing, consistent benefits in human randomized controlled trials although studies in mouse models suggest that they have actions can lead to reduction of hepatic steatosis or other markers, such as liver enzymes. Two of the many polyphenols that have been studied were also reviewed here. Trials with resveratrol in humans have not yielded significant results whereas curcumin, the active ingredient in turmeric, appeared to consistently lower steatosis or liver enzymes. Both compounds reduced steatosis in rodent models of MASLD, involving a variety of mechanisms including anti-oxidant, anti-inflammatory and metabolic effects. More, better-designed and powered human trials are required to provide convincing evidence of efficacy of most natural health products.