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Non-alcoholic Fatty Liver Disease (NAFLD)

Treatment in Phytochemicals Perspective

By Kyle J. Norton

Nonalcoholic fatty liver disease (NAFLD) is a chronic condition caused by fat

accumulated in the liver over time, in the absence of excessive alcohol use. The
disease can be classified into the types of non-inflammatory fatty liver (NAFl)
and inflammatory nonalcoholic steatohepatitis (NASH)(1).

Nonalcoholic fatty liver disease (NAFLD) is one of the major causes of

cirrhosis and liver cancer.

According to world statistics, nonalcoholic fatty liver disease (NAFLD) is

normally known as a disease of the Western world(2). However, due to the
economic prosperity of Southeast Asian(3), the disease also was found in a
large number of population in the cities, causing concerns of many scientists in
the region(4)(6).

According to the joint assessment of the prevalence of non-alcoholic fatty liver

disease and risk factors for advanced fibrosis and mortality in the US, led by
the Stanford University School of Medicine, "The prevalence of NAFLD in the
United States (U.S.) has risen from 18% in 1988–1991 to 31% in 2011–2012.
Estimates of NAFLD prevalence for adults in Western countries is 20–30%,
with much higher prevalence in adults with obesity (80–90%), diabetes (30–
50%), and hyperlipidemia (90%)"(5).

Among the more affluent regions of China, the prevalence rate of non-alcoholic
fatty liver disease (NAFLD) is approximately 15%(6). The number may
decrease substantially if the poor rural populations where obesity is non-
existence are also taking into account(7).

The exact causes of NAFLD aren't well understood. Some researchers

suggested that certain risk factors such as long-term use of certain
medications(8), genetic preposition(8), insulin resistance(8), high cholesterol(8)
and triglycerides(8) in the blood, polycystic ovary syndrome(8), metabolic
syndrome(8), obesity(8), and type 2 diabetes(8) are associated with the onset of
the disease.
Recent studies also found that people with obstructive sleep apnea(11),
underactive thyroid (hypothyroidism(10) and underactive pituitary gland
(hypopituitarism) (9) also at an increased risk of the NALFD.

Some researchers suggested that unhealthy diet such as high-fat diet may also
have a strong implication on NAFLD(12)(13).

Dr. Jensen VS, the lead scientist in the study high-fat diet-induced non-
alcoholic fatty liver disease, wrote, "In humans and animal models, excessive
intake of dietary fat, fructose, and cholesterol has been linked to the
development of non-alcoholic fatty liver disease (NAFLD)"(13).

And, " Only HFr-fed rats developed dyslipidemia as characterized by higher

levels of plasma triglycerides compared to all other groups (p < 0.0001).
Hepatic dysfunction and inflammation was confirmed in HFD-fed rats by
elevated levels of hepatic MCP-1 (p < 0.0001), TNF-alpha (p < 0.001) and
plasma β-hydroxybutyrate (p < 0.0001), and in NASH-fed rats by elevated
levels of hepatic MCP-1 (p < 0.01), increased hepatic macrophage infiltration
(p < 0.001), and higher plasma levels of alanine aminotransferase (p < 0.0001)
aspartate aminotransferase (p < 0.05), haptoglobin (p < 0.001) and TIMP-1 (p <
0.01) compared to Control"(13).

According to the statistics, in the US, over 100 million people have non-
alcoholic fatty liver disease and the condition is more double over the past 20
years(14). The disease also is the most prevalent liver disease in children(14).

The prevalence rate of NAFLD is varied among different ethnic groups in the
US. Dr. Rich NE, the lead scientist in the investigation of the ethnicity and
NAFLD, wrote, "NAFLD prevalence was highest in Hispanics, intermediate in
Whites, and lowest in Blacks, although differences between groups were
smaller in high-risk cohorts (range 47.6%-55.5%) than population-based
cohorts (range, 13.0%-22.9%)(15)".

And, "Among patients with NAFLD, the risk of NASH was higher in Hispanics
(relative risk, 1.09; 95% CI, 0.98-1.21) and lower in Blacks (relative risk, 0.72;
95% CI, 0.60-0.87) than Whites"(15).

The progression of NAFLD and NASH led to cirrhosis, the late stage of liver
scarring are well defined, as the liver tries to heal itself by halting
inflammation(16), leading to symptoms of ascites(16)(18), swell esophageal
varices(16)(19), hepatic encephalopathy(16)(17) and complications of liver
cancer(16)(17) and liver failure(16)(17).

Most people at the early stage NAFLD are asymptomatic, however, as the
disease progression into the later stage, most patients experience symptoms of
right upper abdominal discomfort(20), fatigue(20), and/or malaise(20), and
jaundice(20) with yellowing of the skin and eyes(20).

Most patients with NAFLD have elevated levels of liver enzymes gamma-
glutamyl transferase (GGT)(21) and/or Aspartate Aminotransferase (AST)(21)
to platelet ratio index (APRI) score(21), and/or Alanine Aminotransferase
(ALT) (21) which are the markers used to predict the severity of liver disease
including the fatty liver. A blood test is required if you suspected to have
developing nonfatty liver disease.

Conventionally, as of today, there is no effective treatment of NAFLD(22)(23).

Weight loss for overweight and obese patients(22) has been recommended
through our the industry accompanied by the change of lifestyles(22) such as
moderate exercise and reduced intake of alcohol, depending on individuals.

Patients who are hepatitis virus B and C carriers are also recommended to be

Given the nature of the nonalcoholic fatty liver disease, the search for effective
treatment for NAFLD from the natural sources used over thousands of years in
traditional medicine for the treatment of liver disease has been intensified(23).
Many secondary metabolites, whole foods, and herbal medicine have been
found to be effective in vivo, vitro and small human trials(24). However, most
of them were stopped due to a simple reason. Who will spend billions to prove
the thing which has no commercial values? Secondary metabolites, whole
foods, and herbal medicine cannot be patented.

A. Phytochemicals
Phytochemicals, the natural chemical constituent, protect the plants against
diseases and form their outer's color.
Phytochemicals may be the next potential sources of a new medicine for
treatment of diseases with little or no side effects(32), including
* Secondary metabolites
Secondary metabolites produced by plants have been used as medicines,
flavorings, pigments, and recreational drugs over thousands of year in human
* Bioactive compounds isolated from plant include vegetables, fruits, and nut.

1. Triterpenoid
Triterpenoid is a various unsaturated hydrocarbon, found in essential oils and
oleoresins of plants, including Ilex, hainanensis Merr(25).

In the study to test the effect of Triterpenoid-rich fraction (TP) from Ilex
hainanensis Merr. on NAFLD with Male Sprague-Dawley (SD) fed with a
normal diet (control) or high fat diet (NAFLD model), after 4 weeks, then
orally administrated TF (250 mg/kg) for another two weeks(26), researchers
showed that TP not only improves the symptoms of the subjects but also
decreases the levels of triglyceride(26), total cholesterol(26), low-density
lipoprotein cholesterol(26), abnormality of lipid accumulation(26), levels of
inflammation(26) and infection(26) and apoptosis response(26) in the liver.

Of these results, TF is effective in protecting the liver against NAFLD by

regulating lipids metabolism(26) and alleviating insulin resistance(26),
inflammation(26) and oxidative stress(26).

2. Curcumin
Turmeric is a perennial plant in the genus Curcuma, belonging to the family
Zingiberaceae, native to tropical South Asia(27)., used in traditional medicine
as anti-oxidant, hypoglycemic, colorant, antiseptic, wound healing agent, and to
treat flatulence, bloating, and appetite loss, ulcers, eczema, inflammations,
etc(27)(28). Curcumin is one of the natural phenols in the plant(28).

Curcumin, as an antihyperlipidemic agent, has been found to lower the “bad

cholesterol” low-density lipoprotein (LDL) and increase high-density
lipoprotein (HDL)(29), thus reducing the risk of fat accumulated in the tissues
in the liver(29).

In the support of the above, the water-soluble curcumin derivative was tested
for its efficacy against steatohepatitis which is an inflammation of the liver(30)
(31) with concurrent fat accumulation in the liver(30)(31), researchers found
that the derivative not only significantly alleviates fibrosis(30)(31) but also
decreases the grade of liver steatosis(30)(31).
3. Piperine
Piperine is a phytochemical alkaloid in the class of organosulfur compound,
found abundantly in white and black pepper, long pepper, etc.

Administration of piperine appeared to reverse hepatic steatosis (33) and

insulin resistance(33) in mice fed with high fat, probably inactivation of
adiponectin-AMPK signaling(33) associated with stimulated fatty acid
oxidation and enhance insulin sensitivity.

In other words, piperine not only inhibited hepatic steatosis and insulin
resistance by reducing the expressions of lipogenic target genes(33) associated
with insulin resistance (33) but also increased the expression of carnitine
palmitoyltransferase 1 (CPT1) gene(33) involved in fatty acid oxidation.

4. Resveratrol
Resveratrol, a phytochemical in the class of Stilbenoids found abundantly in
many vegetables and fruits as well as herbs and herbal formulas(34) including
found abundantly in skins and seed of grape wine, nuts, peanuts, etc.

According to studies, the formulas of berberine and resveratrol not only

improved a biochemical and histological change in nonalcoholic fatty liver
disease(35)(36), but also inhibited lipid accumulation(36) by up-regulating
low-density lipoprotein receptor (LDLR) expression(36), alleviating lipid
peroxidation(36), and reducing the production of inflammatory cytokines(36).

5. Carotenoids
Carotenoids are class of phytochemicals that give yellow, orange, or red fat-
soluble pigments, including lycopene and carotene, found in ripe tomatoes and
autumn leaves(38).

According to studies, in the examination of a total of 2687 in middle-aged and

elderly Chinese adults. who completed both NAFLD tests were classified into
stable, improved and progressed groups, serum carotenoids(37) are inversely
associated with non-alcoholic fatty liver disease (NAFLD)(37) by reducing
serum RBP4 and HOMA-IR(37), associated with insulin resistance(37),
triglycerides(37), and body max index (BMI)(37).

More precisely, higher levels of α-carotene, β-carotene, lutein + zeaxanthin(39),

and total carotenoids(39) have a strong impact on a significant decrease in the
severity of NAFLD(39).
6. Quercetin
Quercetin is a type of flavonoid antioxidant found in leafy greens, tomatoes,
berries, and broccoli(40). Recent studies have shown that the beneficial effects
of quercetin include the activation of mitochondrial biogenesis(41).

In Male Sprague-Dawley rats fed high-fat diet (HFD) induced alcoholic fatty
liver disease (NAFLD), quercetin intake decreased hepatic TG content by 39%,
(42) with a 1.5-fold increase in very low-density lipoproteins (VLDL)(42)
which transport hepatic lipids to peripheral tissue acquired apoC-II and apoE
from high-density lipoprotein (HDL) and exhibited the function of a protein
involved in stress response(42) compared with the HFD group.

Injection of quercetin also is found to increase the protein complex expression

of lipid transfer with a function to promote the very low-density lipoproteins
(VLDL)(42) secreted by the liver.

In other words, these findings suggested that quercetin inhibits the expression
NAFLD by increasing hepatic VLDL assembly and autophagy in hepatic lipid

Additonally, quercetin exhibited hepatoprotective activity in 30-day HFD-

induced NAFLD rats by regulating fatty acid related metabolites(43) (adrenic
acid, etc.) including the inflammation-related metabolites (arachidonic acid,
etc.), oxidative stress-related metabolites(43) (2-hydroxybutyric acid) and other
differential metabolites(43) (citric acid, etc.).

8. Anthocyanin
Anthocyanins are water-soluble pigments of colored berries, fruits, and
vegetables (44). They can protect hepatocytes against injury caused by high
glucose-induced oxidative damage(45), by improving the antioxidant status and
inhibiting the mitochondria pathways of apoptosis(45).

In male C57BL/6 J mice fed with a high fat high cholesterol (HFC) diet with or
without 200 mg/kg B.W Cy-3-G for 8 weeks, injection of cyanidin-3-O-β-
glucoside (Cy-3-G) regulated the activation of brown adipose tissue (BAT)(46)
and the expression of adipokines in BAT disrupted by HFC diet associated with
the induction of fatty liver(46).

In other words, Cy-3-G exerted the liver protective effect of on hepatic lipid
accumulation(46) via regulating the secretion of adipokines from BAT(46).
9. Epigallocatechin gallate
Epigallocatechin gallate is the ester of epigallocatechin and gallic acid,
belonging to the chemical class of flavan-3-ols (catechins) found most
abundant in green tea (Camellia sinensis L.), accounting for about 50% of its
total polyphenols(47).

In the examination of gene expression profiles with non-alcoholic fatty liver

disease (NAFLD) and associated advanced liver diseases(48), application of
Epigallocatechin-3-gallate (EGCG) inhibited the fibrosis-related genes
(48)Col1a1, Col1a2, Col3a1, and Col6a3) that have a strong impact on the
onset of NAFLD found in an independent mouse dataset (48).

In other words, EGCG protects the liver against genes related to liver

Furthermore, EGCG also exhibits multi-pronged preventive and therapeutic

activities(49), including promoted lipid(49) and glucose metabolism(49), anti-
lipid peroxidation(49) and anti-inflammation activities(49), anti-fibrosis(49),
and anti-NAFLD related tumor(49), thus contributing to the mitigation of
NAFLD occurrence and progression(49).

10. Astaxanthin
Astaxanthin is a phytochemical in the class of Xanthophylls, belonging to the
group of Carotenoids (tetraterpenoids), found abundantly in yeast, krill, shrimp,
salmon, lobsters, and green microalga(50). Astaxanthin showed to exhibit
antifibrotic effects in the liver(51).

On the steatotic liver model by giving mice a methionine and choline-deficient

high fat (MCDHF) diet, pretreatment of astaxanthin reduced levels of lipid
peroxidation(52) and reduced number of liver cells apoptosis(52) by inhibiting
the expression of inflammatory cytokines(2) and gene(52) involved oxidative
stress in the liver(32)

11. Fucoxanthin
Fucoxanthin is one of the most abundant marine carotenoids, accounting for
more than 10% of the estimated total carotenoids in nature(53).
Fucoxanthin protected the liver induced by obesity(54) by improving insulin
resistance(54) and decreasing blood glucose levels (54) through the regulation
of cytokine secretions(54).

On body weight, body fat, liver lipids, and blood biochemistry in obese, non-
diabetic female volunteers with non-alcoholic fatty liver disease (NAFLD) and
normal liver fat (NLF) content, Xanthigen (brown marine algae fucoxanthin +
pomegranate seed oil (PSO)) promoted weight loss(55), reduced body(55) and
liver fat content)(55), and improved liver function tests in obese non-diabetic

Xanthigen may be considered a promising food supplement in the management

of obesity(55).

12. Glucoraphanin (4-methyl sulfinyl butyl glucosinolate)

Glucoraphanin (4-methyl sulfinyl butyl glucosinolate), the major glucosinolate
is the precursor of sulforaphane found abundantly in broccoli Brussels sprouts
and cabbages(56).

Obesity-induced insulin resistance and nonalcoholic fatty liver disease

(NAFLD), glucoraphanin, a precursor of the Nrf2 activator sulforaphane,
ameliorated obesity by enhancing energy expenditure(57) and browning of
white adipose tissue(57), and attenuated obesity-related inflammation(57) and
insulin resistance(57) and reduced metabolic endotoxemia(57).

Where nuclear factor erythroid 2-related factor 2 (Nrf2) is a key regulator of

antioxidant signaling that serves as a primary cellular defense against the
cytotoxic effects.

In chronic inflammation, insulin resistance, and NAFLD in high-fat diet

(HFD)-fed mice, Glucoraphanin supplementation attenuated weight gain(58),
decreased hepatic steatosis(58), and improved glucose tolerance(58) and insulin

Furthermore, glucoraphanin attenuated hepatic lipogenic gene expression(58),

lipid peroxidation(58), classically activated M1-like macrophage
accumulation(58), and inflammatory signaling pathways(58).

In other words, by promoting fat browning, limiting metabolic endotoxemia-

related chronic inflammation, and modulating redox stress, glucoraphanin may
have a therapeutic effect for the treatment of obesity(58), insulin resistance(58),
and NAFLD(58).

13. Sinigrin
Sinigrin is a major component of commonly consumed cruciferous vegetables,
such as horseradish and wasabi(59).

Sinigrin found in glucosinolates, a class of antioxidants has been found to

reverse of fatty liver (60) probably through indirect interaction with
mitochondrial metabolism(60) which encompasses a range of conditions caused
by lipid deposition within liver cells.

In other words, by targeting the mitochondrial metabolism, sinigrin modulates

antioxidant molecules for a potential treatment for hepatic steatosis(60).

Taken altogether, phytochemicals, herbal medicines, healthy foods found in the
research paper may be considered remedies for the prevention and treatment of
non-alcoholic fatty liver disease, pending to large sample size and
multicenter human study.

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Author Biography
Kyle J. Norton (Scholar, Master of Nutrition, All right reserved)
Health article writer and researcher; Over 10.000 articles and research papers
have been written and published online, including worldwide health, ezine
articles, article base, health blogs, self-growth, best before it's news, the karate
GB daily, etc.,.
by Named 50 of the best health Tweeters Canada - Huffington
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as
international journal Pharma and Bioscience, ISSN 0975-6299.

(1) Histopathology of Nonalcoholic Fatty Liver Disease and Nonalcoholic
Steatohepatitis by G. Thomas Brown, M.D., Ph.D., and David E. Kleiner, M.D.,
Ph.D. (PMC)
(2) Non-alcoholic fatty liver disease in 2015 by Monjur Ahmed. (PMC)
(3) The Global Pattern of Urbanization and Economic Growth: Evidence from
the Last Three Decades by Mingxing Chen, Hua Zhang, 2 Weidong Liu, 1 and
Wenzhong Zhang. (PMC)
(4) Non-alcoholic Fatty Liver Disease in South Asians: A Review of the
Literature by Sital Singh,1 Gabriela N. Kuftinec,2 and Souvik Sarkar. (PMC)
(5) Prevalence of non-alcoholic fatty liver disease and risk factors for advanced
fibrosis and mortality in the United States by Michael H. Le,1 Pardha Devaki,2
Nghiem B. Ha,3,4 Dae Won Jun,5 Helen S. Te,6Ramsey C. Cheung,4,7 and
Mindie H. Nguyen. (PMC)
(6) Epidemiology of non-alcoholic fatty liver disease in China by Fan JG1,
Farrell GC. (PubMed)
(7) Modeling the epidemic of nonalcoholic fatty liver disease demonstrates an
exponential increase in the burden of disease by Chris Estes, 1 Homie Razavi,
1 Rohit Loomba, 2 Zobair Younossi, 3 and Arun J. Sanyal. (PMC)
(8) Symptoms & Causes of NAFLD & NASH by NIH
(9) Nonalcoholic fatty liver disease in adult hypopituitary patients with GH
deficiency and the impact of GH replacement therapy. by Nishizawa H1, Iguchi
G, Murawaki A, Fukuoka H, Hayashi Y, Kaji H, Yamamoto M, Suda K,
Takahashi M, Seo Y, Yano Y, Kitazawa R, Kitazawa S, Koga M, Okimura Y,
Chihara K, Takahashi Y. (PubMed)
(10) Non-alcoholic fatty liver disease and thyroid dysfunction: A systematic
review by Ahad Eshraghian and Alireza Hamidian Jahromi. (PMC)
(11) Obstructive sleep apnea syndrome and fatty liver: Association or causal
link? by Mohamed H Ahmed and Christopher D Byrne, (PMC)
(12) Diets and nonalcoholic fatty liver disease: The good and the bad by
Mohamed Asrih, François R. Jornayvaz. (El Sevier)
(13) Dietary fat stimulates the development of NAFLD more potently than
dietary fructose in Sprague-Dawley rats by Jensen VS1,2, Hvid H2, Damgaard
J2, Nygaard H2, Ingvorsen C3, Wulff EM4, Lykkesfeldt J1, Fledelius C.
(14) Non-Alcoholic Fatty Liver Disease by NICK G. (The American Liver
(15) Racial and Ethnic Disparities in Nonalcoholic Fatty Liver Disease
Prevalence, Severity, and Outcomes in the United States: A Systematic Review
and Meta-analysis by Rich NE1, Oji S1, Mufti AR1, Browning JD1, Parikh
ND2, Odewole M1, Mayo H3, Singal AG. (PubMed)
(16) Emerging Trends Conference: EMERGING TRENDS IN NON-
(17) Hepatic Encephalopathy by the Canadian Liver Foundation
(18) LIVER DISEASE AND ASCITES by Sequana Medical
(19) Nonalcoholic fatty liver disease manifesting esophageal variceal bleeding
by Tang CP1, Huang YS, Tsay SH, Chang FY, Lee SD. (PubMed)
(20) Non-alcoholic fatty liver disease by Genetic Home Reference. (NIH)
(21) Systematic review: the diagnosis and staging of non-alcoholic fatty liver
disease and non-alcoholic steatohepatitis by J K Dowman,*† J W Tomlinson,‡
and P N Newsome. (PMC)
(22) Current treatment options for nonalcoholic fatty liver disease and
nonalcoholic steatohepatitis by Melanie D Beaton, MD FRCPC. (PMC)
(23) Herbal medicines and nonalcoholic fatty liver disease by Hong Yao, Yu-Jie
Qiao, Ya-Li Zhao, Xu-Feng Tao, Li-Na Xu, Lian-Hong Yin, Yan Qi, and Jin-
Yong Peng. (PMC)
(24) An Overview of Herbal Products and Secondary Metabolites Used for
Management of Type Two Diabetes by Ajda Ota and Nataša P. Ulrich.
(25) Triterpenoids are compounds with a carbon skeleton based on six isoprene
units which are derived biosynthetically from the acyclic C30 hydrocarbon,
squalene From Pharmacognosy, 2017. (Science Direct)
(26) The triterpenoid-rich fraction from Ilex hainanensis Merr. attenuates non-
alcoholic fatty liver disease induced by high-fat diet in rats by Cui WX, Yang J,
Chen XQ, Mao Q, Wei XL, Wen XD, Wang Q.(PubMed)
(27) Turmeric, the Golden Spice. From Traditional Medicine to Modern
Medicine by Sahdeo Prasad and Bharat B. Aggarwal. (NCBI)
(28) Popular #Herbs - Turmeric (Curcuma longa) by Kyle J. Norton
(29) Effect of curcumin on serum and liver cholesterol levels in the rat by Rao
DS, Sekhara NC, Satyanarayana MN, Srinivasan M. (PubMed)
(30) [Recent advances in curcumin and its derivatives for the treatment of liver
diseases].[Article in Chinese] by Sun Y, Peng ML. (PubMed)
(31) [The effects of curcumin derivative on experimental steatohepatitis].
[Article in Chinese] by Zeng CH, Zeng P, Deng YH, Shen N, Peng ML, Liu Q,
Ren H.(PubMed)
(32) Phytochemical Piperine and antimicrobial activity by Kyle J. Norton
(33) Piperine reverses high fat diet-induced hepatic steatosis and insulin
resistance in mice by Choi S1, Choi Y, Choi Y, Kim S, Jang J, Park T.
(34). Phytochemicals in Foods - 15 Health Benefits of Resveratrol by Kyle J.
(35) Nutraceutical Approach to Non-Alcoholic Fatty Liver Disease (NAFLD):
The Available Clinical Evidence by Arrigo F. G. Cicero,1,* Alessandro
Colletti,1 and Stefano Bellentani. (PMC)
(36) Natural products berberine and curcumin exhibited better ameliorative
effects on rats with non-alcohol fatty liver disease than lovastatin by Feng
WW1, Kuang SY2, Tu C3, Ma ZJ3, Pang JY3, Wang YH3, Zang QC3, Liu
TS4, Zhao YL3, Xiao XH3, Wang JB. (PubMed)
(37) Higher serum carotenoids associated with improvement of non-alcoholic
fatty liver disease in adults: a prospective study by Xiao ML1, Chen GD1,
Zeng FF1,2, Qiu R1, Shi WQ3, Lin JS1, Cao Y1, Li HB1, Ling WH1, Chen
YM. (PubMed)
(38) Carotenoids Found in Tomatoes by SF Gate
(39) Greater serum carotenoid levels associated with lower prevalence of
nonalcoholic fatty liver disease in Chinese adults by Cao Y1, Wang C2, Liu J2,
Liu ZM3, Ling WH2, Chen YM. (PubMed)
(41) Quercetin Induces Mitochondrial Biogenesis through Activation of HO-1
in HepG2 Cells by Nabin Rayamajhi, Seul-Ki Kim, 1 Hiroe Go, 3 Yeonsoo Joe,
1 Zak Callaway, 1Jae-Gu Kang, 4 Stefan W. Ryter, 5 and Hun Taeg Chung.
(42) Quercetin ameliorates HFD-induced NAFLD by promoting hepatic VLDL
assembly and lipophagy via the IRE1a/XBP1s pathway by Zhu X1, Xiong T1,
Liu P1, Guo X1, Xiao L1, Zhou F1, Tang Y2, Yao P. (PMC)
(43) Metabolomics Characterizes the Effects and Mechanisms of Quercetin in
Nonalcoholic Fatty Liver Disease Development by Xu Y1, Han J2, Dong J3,
Fan X4, Cai Y5, Li J6, Wang T7,8, Zhou J9, Shang J. (PubMed)
(44) The Health Benefits of Anthocyanin by Cathy Wong. (VeryWell Health)
(45) Anthocyanins inhibit high glucose-induced renal tubular cell apoptosis
caused by oxidative stress in db/db mice by Jinying Wei,#1,2,* Haijiang
Wu,#1,2,* Haiqiang Zhang,3 Fang Li,1,2 Shurui Chen,1,2Baohua Hou,1,2
Yonghong Shi, #1,2,* Lijuan Zhao,4 and Huijun Duan. (the International
Journal od Modular Medicine)
(46) Cyanidin-3-O-β-glucoside regulates the activation and the secretion of
adipokines from brown adipose tissue and alleviates diet-induced fatty liver
by Pei L1, Wan T1, Wang S1, Ye M1, Qiu Y1, Jiang R1, Pang N1, Huang Y1,
Zhou Y1, Jiang X1, Ling W2, Zhang Z3, Yang L. (PubMed)
(47) Phytochemicals in foods - 12 Health Benefits of Epigallocatechin gallate
(EGCG) by Kyle J. Norton
(48) (-)-Epigallocatechin-3-gallate and atorvastatin treatment down-regulates
liver fibrosis-related genes in non-alcoholic fatty liver disease by Ying L1,2,3,
Yan F2,3, Zhao Y1, Gao H2,3, Williams BR2,3, Hu Y4, Li X5, Tian R6, Xu P1,
Wang Y. (PubMed)
(49) Potential Biological Effects of (-)-Epigallocatechin-3-gallate on the
Treatment of Nonalcoholic Fatty Liver Disease by Chen C1, Liu Q1, Liu L1,
Hu YY1,2,3, Feng Q. (PubMed)
(50) Phytochemicals in Foods - 16 Health Benefits of Astaxanthin by Kyle J.
(51) Food components with antifibrotic activity and implications in the
prevention of liver disease.
Bae M1, Park YK1, Lee JY. (PubMed)
(52) Astaxanthin prevents ischemia-reperfusion injury of the steatotic liver in
mice by Li S1,2,3,4, Takahara T5, Fujino M1,6, Fukuhara Y7, Sugiyama T5, Li
XK1, Takahara S. (PubMed)
(53) Astaxanthin by Tetsuo Satoh, in Nutraceuticals, 2016. (Science Direct)
(54) The anti-obesity activity of the marine carotenoid fucoxanthin(PubMed)
(55) The effects of Xanthigen in the weight management of obese
premenopausal women with the non-alcoholic fatty liver disease and normal
liver fat by Abidov M1, Ramazanov Z, Seifulla R, Grachev S.marine
carotenoid fucoxanthin.Gammon MA1, D'Orazio N. (PubMed)
(56) Glucoraphanin by Science Direct
(57) Glucoraphanin: a broccoli sprout extract that ameliorates obesity-induced
inflammation and insulin resistance by Xu L1, Nagata N1, Ota T. (PubMed)
(58) Glucoraphanin Ameliorates Obesity and Insulin Resistance Through
Adipose Tissue Browning and Reduction of Metabolic Endotoxemia in Mice by
Nagata N1, Xu L1, Kohno S2, Ushida Y3, Aoki Y3, Umeda R3, Fuke N3,
Zhuge F1, Ni Y1, Nagashimada M1, Takahashi C2, Suganuma H3, Kaneko S4,
Ota T. (PubMed)
(59) Phytochemicals in Foods - 10 Health Benefits of Sinigrin by Kyle J.
(60) The antioxidant dietary approach in the treatment of fatty liver: New
insights and updates by Alessandra Ferramosca, Mariangela Di Giacomo, and
Vincenzo Zara. (PMC)