The efficacy of flaxseed and hesperidin on non-alcoholic fatty liver disease: an open-labeled randomized controlled trial

• Published in: European journal of clinical nutrition Vol. 75; no. 1; pp. 99 - 111
• Main Authors: Yari, Zahra, Cheraghpour, Makan, Alavian, Seyed Moayed, Hedayati, Mehdi, Eini-Zinab, Hassan, Hekmatdoost, Azita
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01-01-2021; Nature Publishing Group
• Subjects: 692/699/1503/1607/2750; 692/700/2814; Alanine; Alanine transaminase; Analysis; Attenuation; Biomarkers; Body mass index; Body size; Clinical Nutrition; Dietary supplements; Disease control; Epidemiology; Fatty liver; Fibrosis; Flax; Flaxseed; Glucose; Glucose metabolism; Hemostasis; Hemostatics; Hesperidin; Inflammation; Insulin; Insulin resistance; Internal Medicine; Lifestyles; Lipid metabolism; Lipids; Liver; Liver diseases; Medicine; Medicine & Public Health; Metabolic Diseases; Parameters; Plasma levels; Public Health; Steatosis; Synergistic effect; Variance analysis; Iran
• ISSN: 0954-3007; 1476-5640
• DOI: 10.1038/s41430-020-0679-3

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.