Probiotics are the most effective, evidence-based supplement available for fatty liver disease.
This is because the human digestive tract is strongly connected to most, if not all, of our major organs.
Look no further than the fact that you’ll likely have heard terms such as the gut-brain axis and the gut-skin axis, but did you know there is a gut-liver axis too?
Indeed there is!
And it has generated significant scientific interest as a target for intervention in the management of fatty liver disease.
The Gut-Liver Axis
Essentially, the liver is closely connected to the digestive system both in proximity and through physiological systems (known as the portal system, which connects them) such that proposed imbalances in the GI tract (imbalances between good vs bad bacteria, etc) can ultimately damage the liver in part through the release of inflammatory compounds that occur in this sub-optimal state.
It’s for this reason that the concept of enhancing gut balance through the use probiotics (healthy bacteria) and prebiotics ( special types of fibre, which acts as “food” for good bacteria) could potentially lead to positive effects on the liver.
When taken together, a combination pre+probiotic supplement is generally referred to as a synbiotic, the term I will be using going forward in today’s article and the subject matter of the content ahead.
Let’s get to the good stuff.
Synbiotics For Fatty Liver Disease
The 2020 ESPEN Clinical Nutrition Guidelines For Fatty Liver Disease have this to say about the use of probiotics & synbiotics in the management of NAFLD:
“Nutritional supplements containing selected probiotics or
synbiotics can be used to improve liver enzymes in NAFL/NASH patients.”
These conclusions were drawn based on the results of a number of promising randomized controlled trials looking at liver health outcomes following a synbiotic intervention.
One such trial, a 2014 study out of the American Journal Of Clinical Nutrition, looked at the results of a 28-week supplementation cycle with a synbiotic in people living with NAFLD.
The study found that, in addition to decreased liver enzyme levels, there were decreases noted in a number of biological inflammatory markers such as C-reactive protein and TNF.
The amount of scarring on the liver, known as fibrosis, was also less in the group who took the synbiotic vs the placebo.
In this particular study the synbiotic supplement contained a 7 strain blend of various types of Lactobacillus and Bifidobacteriuma type probiotics and used FOS (fructooligosaccharide) as the prebiotic fibre.
Natural food sources of FOS include onions, garlic, asparagus and bananas – foods which may be reasonably recommended to be considered for those living with NAFLD.
While I’m in no way endorsing or promoting this particular product, I did a quick search on Amazon to identify an synbiotic that shared these characteristics and this particular product appears to share some of the characteristics of what was noted in this study.
Another randomized controlled trial out of Digestive Diseases & Sciences found that , over a 24-week period, the FOS prebiotic combined with a single strain probiotic (Bifidobacterium longum) yielded similar positive results and may have contributed in some capacity to improving insulin resistance and reducing liver fat storage.
Recently published meta-analysis data, study linked via the image above, has confirmed the potential benefit of multi-strain probiotics on individuals living with NAFLD.
I Can Help You Conquer Fatty Liver
Multi-strain probiotics, including in combination with prebiotic fibre, are the most evidence-based supplements available to improve liver health in those with fatty liver disease.
Their benefits are inevitably less than those provided by physical activity and fully optimizing one’s diet, but they are still significant.
If you are looking for further support in utilizing the best available nutrition science to curate a strategy to help you improve your liver health and reverse fatty liver disease, I’m the dietitian for the job.
Reach out to discuss working together 1-on-1 or call directly at 647 886 2197.
Until next time,
Andy De Santis RD MPH