Review

. 2023 Mar:189:106679.

doi: 10.1016/j.phrs.2023.106679. Epub 2023 Feb 8.

Nutraceutical approaches to non-alcoholic fatty liver disease (NAFLD): A position paper from the International Lipid Expert Panel (ILEP)

Manfredi Rizzo¹, Alessandro Colletti², Peter E Penson^{3

4}, Niki Katsiki^{5

6}, Dimitri P Mikhailidis⁷, Peter P Toth⁸, Ioanna Gouni-Berthold⁹, John Mancini¹⁰, David Marais¹¹, Patrick Moriarty¹², Massimiliano Ruscica¹³, Amirhossein Sahebkar¹⁴, Dragos Vinereanu¹⁵, Arrigo Francesco Giuseppe Cicero^{16

17}, Maciej Banach^{18

19

20}; International Lipid Expert Panel (ILEP)

Collaborators, Affiliations

Collaborators

International Lipid Expert Panel (ILEP):
Julio Acosta²⁰, Mutaz Al-Khnifsawi¹⁷, Fahad Alnouri¹⁸, Fahma Amar¹⁹, Atanas G Atanasov²⁰, Gani Bajraktari²¹, Maciej Banach²², Ioanna Gouni-Berthold²³, Sonu Bhaskar²⁴, Agata Bielecka-Dąbrowa²⁵, Bojko Bjelakovic²⁶, Eric Bruckert²⁷, Ibadete Bytyçi²⁸, Alberto Cafferata²⁹, Richard Ceska³⁰, Arrigo F G Cicero³¹, Krzysztof Chlebus³², Xavier Collet³³, Magdalena Daccord³⁴, Olivier Descamps³⁵, Dragan Djuric³⁶, Ronen Durst³⁷, Marat V Ezhov³⁸, Zlatko Fras³⁹, Dan Gaita⁴⁰, Ioanna Gouni-Berthold⁷, Adrian V Hernandez⁴¹, Steven R Jones⁴², Jacek Jozwiak⁴³, Nona Kakauridze⁴⁴, Amani Kallel⁴⁵, Niki Katsiki⁴⁶, Amit Khera⁴⁷, Karam Kostner⁴⁸, Raimondas Kubilius⁴⁹, Gustavs Latkovskis⁵⁰, G B John Mancini⁸, A David Marais⁹, Seth S Martin⁵¹, Julio Acosta Martinez⁵², Mohsen Mazidi⁵³, Dimitri P Mikhailidis⁵⁴, Erkin Mirrakhimov⁵⁵, Andre R Miserez⁵⁶, Olena Mitchenko⁵⁷, Natalya P Mitkovskaya⁵⁸, Patrick M Moriarty¹⁰, Seyed Mohammad Nabavi⁵⁹, Devaki Nair⁶⁰, Demosthenes B Panagiotakos⁶¹, György Paragh⁶², Daniel Pella⁶³, Peter E Penson⁶⁴, Zaneta Petrulioniene⁶⁵, Matteo Pirro⁶⁶, Arman Postadzhiyan⁶⁷, Raman Puri⁶⁸, Ashraf Reda⁶⁹, Željko Reiner⁷⁰, Dina Radenkovic⁷¹, Michał Rakowski⁷², Jemaa Riadh⁷³, Dimitri Richter⁷⁴, Manfredi Rizzo⁷⁵, Massimiliano Ruscica¹¹, Amirhossein Sahebkar¹², Maria-Corina Serban⁷⁶, Abdullah M A Shehab⁷⁷, Aleksandr B Shek⁷⁸, Cesare R Sirtori⁷⁹, Claudia Stefanutti⁸⁰, Tomasz Tomasik⁸¹, Peter P Toth⁴², Margus Viigimaa⁸², Pedro Valdivielso⁸³, Dragos Vinereanu¹³, Branislav Vohnout⁸⁴, Stephan von Haehling⁸⁵, Michal Vrablik⁸⁶, Nathan D Wong⁸⁷, Hung-I Yeh⁸⁸, Jiang Zhisheng⁸⁹, Andreas Zirlik⁹⁰

Affiliations

¹ Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (Promise), University of Palermo, Via del Vespro 141, 90127 Palermo, Italy.
² Department of Science and Drug Technology, University of Turin, Turin, Italy.
³ School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, UK;
⁴ Liverpool Centre for Cardiovascular Science, Liverpool, UK.
⁵ Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece.
⁶ School of Medicine, European University Cyprus, Nicosia, Cyprus.
⁷ Department of Clinical Biochemistry, Royal Free Campus, Medical School, University College London (UCL), London, UK
⁸ The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA; Preventive Cardiology, CGH Medical Center, Sterling, IL, USA
⁹ Department of Endocrinology, Diabetes and Preventive Medicine, University of Cologne, Germany
¹⁰ Department of Medicine, Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada
¹¹ Chemical Pathology Division of the Department of Pathology, University of Cape Town Health Science Faculty, Cape Town, South Africa
¹² Division of Clinical Pharmacology, Division of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA
¹³ Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
¹⁴ Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
¹⁵ Cardiology Department, University and Emergency Hospital, Bucharest, Romania, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
¹⁶ Hypertension and Cardiovascular disease risk research center, Medical and Surgical Sciences Department, University of Bologna, Bologna, Italy
¹⁷ IRCCS Policlinico S. Orsola-Malpighi, Bologna, Italy
¹⁸ Department of Preventive Cardiology and Lipidology, Medical University of Lodz (MUL), Poland
¹⁹ Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
²⁰ Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland
²¹ Institute of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden; Clinic of Cardiology, University Clinical Centre of Kosovo, Prishtina, Kosovo, Medical Faculty, University of Prishtina, Prishtina, Kosovo.
²² Department of Preventive Cardiology and Lipidology, Medical University of Lodz (MUL), Poland; Cardiovascular Research Centre, University of Zielona-Gora, Zielona-Gora, Poland.
²³ Polyclinic for Endocrinology, Diabetes and Preventive Medicine, University of Cologne, Germany.
²⁴ Department of Neurology & Neurophysiology, Liverpool Hospital and South Western Sydney Local Health District, Sydney, NSW, Australia.
²⁵ Department of Cardiology and Congenital Diseases of Adults, Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland.
²⁶ Clinic of Pediatrics, Clinical Center, Nis, Faculty of Medicine, University of Nis, Serbia.
²⁷ Pitié-Salpetrière Hospital and Sorbonne University, Cardio metabolic Institute, Paris, France.
²⁸ Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden & Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Kosovo.
²⁹ Council of Epidemiology and Cardiovascular Prevention "Dr. Mario Ciruzzi", Argentine Society of Cardiology, Buenos Aires, Argentina.
³⁰ Third Department of Medicine - Department of Endocrinology and Metabolism of the First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic.
³¹ IRCCS Policlinico S.Orsola-Malpighi, University of Bologna, Italy.
³² 1st Department of Cardiology, Medical University of Gdansk, Gdańsk, Poland.
³³ Institute of Metabolic and Cardiovascular Diseases, Inserm, Toulouse, France.
³⁴ FH Europe, France.
³⁵ Department of Internal Medicine, Centres Hospitaliers Jolimont, Haine Saint-Paul, Belgium; Department of Cardiology, Cliniques Universitaires Saint-Luc, Bruxells, Belgium.
³⁶ Institute of Medical Physiology "Richard Burian" Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
³⁷ Cardiology Department, Hadassah Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel.
³⁸ National Medical Research Center of Cardiology, Moscow, Russia.
³⁹ Preventive Cardiology Unit, Department of Vascular Medicine, Division of Medicine, University Medical Centre Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
⁴⁰ Institutul de Boli Cardiovasculare, Universitatea de Medicina si Farmacie Victor Babes din Timisoara, Romania.
⁴¹ Health Outcomes, Policy, and Evidence Synthesis (HOPES) Group, University of Connecticut School of Pharmacy, Storrs, CT, USA; Vicerrectorado de Investigación, Universidad San Ignacio de Loyola (USIL), Lima, Peru.
⁴² The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA.
⁴³ Department of Family Medicine and Public Health Faculty of Medicine University of Opole, Opole, Poland.
⁴⁴ Department of Internal Medicine, Faculty of Medicine, Tbilisi State Medical University, Tbilisi, Georgia.
⁴⁵ University of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, Tunisia.
⁴⁶ Diabetes Center, Division of Endocrinology and Metabolism, First Department of Internal Medicine, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
⁴⁷ Department of Cardiology, UT Southwestern Medical Center, Dallas, TX, USA.
⁴⁸ Mater Hospital, University of Queensland, St Lucia, QLD, Australia.
⁴⁹ Department of Rehabilitation, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
⁵⁰ Institute of Cardiology and Regenerative Medicine, Faculty of Medicine, University of Latvia, Riga, Latvia; Pauls Stradins Clinical University Hospital, Riga, Latvia.
⁵¹ Ciccarone Center for Prevention of Heart Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
⁵² Medico Cardiologo de la Policlinica Metropolitana, Carcass, Venezuela.
⁵³ Department of Twin Research and Genetic Epidemiology, King's College London, St Thomas' Hospital, Strand, London, UK.
⁵⁴ Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London (UCL), London, UK.
⁵⁵ Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan.
⁵⁶ diagene Research Institute, Reinach, Switzerland; University of Basel, Basel, Switzerland.
⁵⁷ Dyslipidaemia Department, Institute of Cardiology AMS of Ukraine, Ukraine.
⁵⁸ Belarusian State Medical Univer- sity, Minsk, Republic of Belarus.
⁵⁹ Applied Biotechnology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
⁶⁰ Department of Clinical Biochemistry, the Royal Free London NHS Foundation Trust, Pond Street, London, UK.
⁶¹ School of Health Science and Education, Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece.
⁶² Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
⁶³ 1st Department of Internal Medicine, Faculty of Medicine, Pavol Jozef Safarik University, Košice, Slovakia.
⁶⁴ School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, UK.
⁶⁵ Vilnius University Faculty of Medicine, Vilnius, Lithuania; Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.
⁶⁶ Department of Medicine, University of Perugia, Perugia, Italy.
⁶⁷ Bulgarian Society of Cardiology, Medical University of Sofia, Sofia, Bulgaria.
⁶⁸ I P Apollo Hospital, New Delhi, India.
⁶⁹ Menoufia University, President of EAVA, Egypt.
⁷⁰ University Hospital Center Zagreb, Department of Internal Medicine, School of Medicine, University of Zagreb, Zagreb, Croatia.
⁷¹ Health Longevity Performance Optimisation Institute, Cambridge, UK.
⁷² International Lipid Expert Panel, Poland; The Bio-Med-Chem Doctoral School of the University of Lodz and Lodz Institutes of the Polish Academy of Sciences / University of Lodz, Faculty of Biology and Environmental Protection, Department of Molecular Biophysics, University of Lodz, Lodz, Poland.
⁷³ Laboratory of Biochemistry, Faculty of Medicine of Tunis, Rabta Hospital, University of Tunis El Manar, Tunis, Tunisia.
⁷⁴ Cardiac Department, Euroclinic, Athens, Greece.
⁷⁵ Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy.
⁷⁶ Department of Functional Sciences, Discipline of Pathophysiology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania.
⁷⁷ Medical Education Department, United Arab Emirates University, Al Ain, United Arab Emirates.
⁷⁸ Department of Ischemic Heart Disease and Atherosclerosis, Republican Specialised Center of Cardiology, Tashkent, Uzbekistan.
⁷⁹ Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano Centro Dislipidemie, Grande Ospedale Metropolitano, Niguarda Ca'Granda President, Fondazione Carlo Sirtori, Italy.
⁸⁰ Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy.
⁸¹ Department of Family Medicine, Jagiellonian University Medical College, Krakow, Poland.
⁸² Tallinn University of Technology, North Estonia Medical Centre, Tallinn, Estonia.
⁸³ Catedrático de Medicina, Departamento de Medicina y Dermatología, Universidad de Málaga, España.
⁸⁴ Institute of Nutrition, Faculty of Nursing and Health Professional Studies and Coordination Centre for Familial Hyperlipoproteinemias, Slovak Medical University in Bratislava, Bratislava, Slovakia; Institute of Epidemiology, School of Medicine, Comenius University, Bratislava, Slovakia.
⁸⁵ Department of Cardiology and Pneumology, Heart Center Göttingen, University of Göttingen Medical Center, Georg-August-University, Göttingen, Germany.
⁸⁶ 1st Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic.
⁸⁷ Department of Medicine, School of Medicine University of California, Irvine, CA, USA; Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, CA, USA.
⁸⁸ Department of Medicine, Mackay Medical College, Taipei, Taiwan; Cardiovascular Division, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan.
⁸⁹ Institute of Cardiovascular Disease, University of South China, Hengyang, Hunan, China.
⁹⁰ University Heart Centre Freiburg University, Department of Cardiology and Angiology I, Faculty of Medicine, University of Freiburg, Freiburg, Germany.

PMID: 36764041
DOI: 10.1016/j.phrs.2023.106679

Free article

Review

Nutraceutical approaches to non-alcoholic fatty liver disease (NAFLD): A position paper from the International Lipid Expert Panel (ILEP)

Manfredi Rizzo et al. Pharmacol Res. 2023 Mar.

Free article

. 2023 Mar:189:106679.

doi: 10.1016/j.phrs.2023.106679. Epub 2023 Feb 8.

Authors

Collaborators

International Lipid Expert Panel (ILEP):
Julio Acosta²⁰, Mutaz Al-Khnifsawi¹⁷, Fahad Alnouri¹⁸, Fahma Amar¹⁹, Atanas G Atanasov²⁰, Gani Bajraktari²¹, Maciej Banach²², Ioanna Gouni-Berthold²³, Sonu Bhaskar²⁴, Agata Bielecka-Dąbrowa²⁵, Bojko Bjelakovic²⁶, Eric Bruckert²⁷, Ibadete Bytyçi²⁸, Alberto Cafferata²⁹, Richard Ceska³⁰, Arrigo F G Cicero³¹, Krzysztof Chlebus³², Xavier Collet³³, Magdalena Daccord³⁴, Olivier Descamps³⁵, Dragan Djuric³⁶, Ronen Durst³⁷, Marat V Ezhov³⁸, Zlatko Fras³⁹, Dan Gaita⁴⁰, Ioanna Gouni-Berthold⁷, Adrian V Hernandez⁴¹, Steven R Jones⁴², Jacek Jozwiak⁴³, Nona Kakauridze⁴⁴, Amani Kallel⁴⁵, Niki Katsiki⁴⁶, Amit Khera⁴⁷, Karam Kostner⁴⁸, Raimondas Kubilius⁴⁹, Gustavs Latkovskis⁵⁰, G B John Mancini⁸, A David Marais⁹, Seth S Martin⁵¹, Julio Acosta Martinez⁵², Mohsen Mazidi⁵³, Dimitri P Mikhailidis⁵⁴, Erkin Mirrakhimov⁵⁵, Andre R Miserez⁵⁶, Olena Mitchenko⁵⁷, Natalya P Mitkovskaya⁵⁸, Patrick M Moriarty¹⁰, Seyed Mohammad Nabavi⁵⁹, Devaki Nair⁶⁰, Demosthenes B Panagiotakos⁶¹, György Paragh⁶², Daniel Pella⁶³, Peter E Penson⁶⁴, Zaneta Petrulioniene⁶⁵, Matteo Pirro⁶⁶, Arman Postadzhiyan⁶⁷, Raman Puri⁶⁸, Ashraf Reda⁶⁹, Željko Reiner⁷⁰, Dina Radenkovic⁷¹, Michał Rakowski⁷², Jemaa Riadh⁷³, Dimitri Richter⁷⁴, Manfredi Rizzo⁷⁵, Massimiliano Ruscica¹¹, Amirhossein Sahebkar¹², Maria-Corina Serban⁷⁶, Abdullah M A Shehab⁷⁷, Aleksandr B Shek⁷⁸, Cesare R Sirtori⁷⁹, Claudia Stefanutti⁸⁰, Tomasz Tomasik⁸¹, Peter P Toth⁴², Margus Viigimaa⁸², Pedro Valdivielso⁸³, Dragos Vinereanu¹³, Branislav Vohnout⁸⁴, Stephan von Haehling⁸⁵, Michal Vrablik⁸⁶, Nathan D Wong⁸⁷, Hung-I Yeh⁸⁸, Jiang Zhisheng⁸⁹, Andreas Zirlik⁹⁰

Affiliations

¹ Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (Promise), University of Palermo, Via del Vespro 141, 90127 Palermo, Italy.
² Department of Science and Drug Technology, University of Turin, Turin, Italy.
³ School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, UK;
⁴ Liverpool Centre for Cardiovascular Science, Liverpool, UK.
⁵ Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece.
⁶ School of Medicine, European University Cyprus, Nicosia, Cyprus.
⁷ Department of Clinical Biochemistry, Royal Free Campus, Medical School, University College London (UCL), London, UK
⁸ The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA; Preventive Cardiology, CGH Medical Center, Sterling, IL, USA
⁹ Department of Endocrinology, Diabetes and Preventive Medicine, University of Cologne, Germany
¹⁰ Department of Medicine, Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada
¹¹ Chemical Pathology Division of the Department of Pathology, University of Cape Town Health Science Faculty, Cape Town, South Africa
¹² Division of Clinical Pharmacology, Division of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA
¹³ Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
¹⁴ Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
¹⁵ Cardiology Department, University and Emergency Hospital, Bucharest, Romania, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
¹⁶ Hypertension and Cardiovascular disease risk research center, Medical and Surgical Sciences Department, University of Bologna, Bologna, Italy
¹⁷ IRCCS Policlinico S. Orsola-Malpighi, Bologna, Italy
¹⁸ Department of Preventive Cardiology and Lipidology, Medical University of Lodz (MUL), Poland
¹⁹ Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
²⁰ Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland
²¹ Institute of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden; Clinic of Cardiology, University Clinical Centre of Kosovo, Prishtina, Kosovo, Medical Faculty, University of Prishtina, Prishtina, Kosovo.
²² Department of Preventive Cardiology and Lipidology, Medical University of Lodz (MUL), Poland; Cardiovascular Research Centre, University of Zielona-Gora, Zielona-Gora, Poland.
²³ Polyclinic for Endocrinology, Diabetes and Preventive Medicine, University of Cologne, Germany.
²⁴ Department of Neurology & Neurophysiology, Liverpool Hospital and South Western Sydney Local Health District, Sydney, NSW, Australia.
²⁵ Department of Cardiology and Congenital Diseases of Adults, Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland.
²⁶ Clinic of Pediatrics, Clinical Center, Nis, Faculty of Medicine, University of Nis, Serbia.
²⁷ Pitié-Salpetrière Hospital and Sorbonne University, Cardio metabolic Institute, Paris, France.
²⁸ Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden & Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Kosovo.
²⁹ Council of Epidemiology and Cardiovascular Prevention "Dr. Mario Ciruzzi", Argentine Society of Cardiology, Buenos Aires, Argentina.
³⁰ Third Department of Medicine - Department of Endocrinology and Metabolism of the First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic.
³¹ IRCCS Policlinico S.Orsola-Malpighi, University of Bologna, Italy.
³² 1st Department of Cardiology, Medical University of Gdansk, Gdańsk, Poland.
³³ Institute of Metabolic and Cardiovascular Diseases, Inserm, Toulouse, France.
³⁴ FH Europe, France.
³⁵ Department of Internal Medicine, Centres Hospitaliers Jolimont, Haine Saint-Paul, Belgium; Department of Cardiology, Cliniques Universitaires Saint-Luc, Bruxells, Belgium.
³⁶ Institute of Medical Physiology "Richard Burian" Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
³⁷ Cardiology Department, Hadassah Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel.
³⁸ National Medical Research Center of Cardiology, Moscow, Russia.
³⁹ Preventive Cardiology Unit, Department of Vascular Medicine, Division of Medicine, University Medical Centre Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
⁴⁰ Institutul de Boli Cardiovasculare, Universitatea de Medicina si Farmacie Victor Babes din Timisoara, Romania.
⁴¹ Health Outcomes, Policy, and Evidence Synthesis (HOPES) Group, University of Connecticut School of Pharmacy, Storrs, CT, USA; Vicerrectorado de Investigación, Universidad San Ignacio de Loyola (USIL), Lima, Peru.
⁴² The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA.
⁴³ Department of Family Medicine and Public Health Faculty of Medicine University of Opole, Opole, Poland.
⁴⁴ Department of Internal Medicine, Faculty of Medicine, Tbilisi State Medical University, Tbilisi, Georgia.
⁴⁵ University of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, Tunisia.
⁴⁶ Diabetes Center, Division of Endocrinology and Metabolism, First Department of Internal Medicine, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
⁴⁷ Department of Cardiology, UT Southwestern Medical Center, Dallas, TX, USA.
⁴⁸ Mater Hospital, University of Queensland, St Lucia, QLD, Australia.
⁴⁹ Department of Rehabilitation, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
⁵⁰ Institute of Cardiology and Regenerative Medicine, Faculty of Medicine, University of Latvia, Riga, Latvia; Pauls Stradins Clinical University Hospital, Riga, Latvia.
⁵¹ Ciccarone Center for Prevention of Heart Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
⁵² Medico Cardiologo de la Policlinica Metropolitana, Carcass, Venezuela.
⁵³ Department of Twin Research and Genetic Epidemiology, King's College London, St Thomas' Hospital, Strand, London, UK.
⁵⁴ Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London (UCL), London, UK.
⁵⁵ Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan.
⁵⁶ diagene Research Institute, Reinach, Switzerland; University of Basel, Basel, Switzerland.
⁵⁷ Dyslipidaemia Department, Institute of Cardiology AMS of Ukraine, Ukraine.
⁵⁸ Belarusian State Medical Univer- sity, Minsk, Republic of Belarus.
⁵⁹ Applied Biotechnology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
⁶⁰ Department of Clinical Biochemistry, the Royal Free London NHS Foundation Trust, Pond Street, London, UK.
⁶¹ School of Health Science and Education, Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece.
⁶² Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
⁶³ 1st Department of Internal Medicine, Faculty of Medicine, Pavol Jozef Safarik University, Košice, Slovakia.
⁶⁴ School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, UK.
⁶⁵ Vilnius University Faculty of Medicine, Vilnius, Lithuania; Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.
⁶⁶ Department of Medicine, University of Perugia, Perugia, Italy.
⁶⁷ Bulgarian Society of Cardiology, Medical University of Sofia, Sofia, Bulgaria.
⁶⁸ I P Apollo Hospital, New Delhi, India.
⁶⁹ Menoufia University, President of EAVA, Egypt.
⁷⁰ University Hospital Center Zagreb, Department of Internal Medicine, School of Medicine, University of Zagreb, Zagreb, Croatia.
⁷¹ Health Longevity Performance Optimisation Institute, Cambridge, UK.
⁷² International Lipid Expert Panel, Poland; The Bio-Med-Chem Doctoral School of the University of Lodz and Lodz Institutes of the Polish Academy of Sciences / University of Lodz, Faculty of Biology and Environmental Protection, Department of Molecular Biophysics, University of Lodz, Lodz, Poland.
⁷³ Laboratory of Biochemistry, Faculty of Medicine of Tunis, Rabta Hospital, University of Tunis El Manar, Tunis, Tunisia.
⁷⁴ Cardiac Department, Euroclinic, Athens, Greece.
⁷⁵ Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy.
⁷⁶ Department of Functional Sciences, Discipline of Pathophysiology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania.
⁷⁷ Medical Education Department, United Arab Emirates University, Al Ain, United Arab Emirates.
⁷⁸ Department of Ischemic Heart Disease and Atherosclerosis, Republican Specialised Center of Cardiology, Tashkent, Uzbekistan.
⁷⁹ Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano Centro Dislipidemie, Grande Ospedale Metropolitano, Niguarda Ca'Granda President, Fondazione Carlo Sirtori, Italy.
⁸⁰ Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy.
⁸¹ Department of Family Medicine, Jagiellonian University Medical College, Krakow, Poland.
⁸² Tallinn University of Technology, North Estonia Medical Centre, Tallinn, Estonia.
⁸³ Catedrático de Medicina, Departamento de Medicina y Dermatología, Universidad de Málaga, España.
⁸⁴ Institute of Nutrition, Faculty of Nursing and Health Professional Studies and Coordination Centre for Familial Hyperlipoproteinemias, Slovak Medical University in Bratislava, Bratislava, Slovakia; Institute of Epidemiology, School of Medicine, Comenius University, Bratislava, Slovakia.
⁸⁵ Department of Cardiology and Pneumology, Heart Center Göttingen, University of Göttingen Medical Center, Georg-August-University, Göttingen, Germany.
⁸⁶ 1st Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic.
⁸⁷ Department of Medicine, School of Medicine University of California, Irvine, CA, USA; Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, CA, USA.
⁸⁸ Department of Medicine, Mackay Medical College, Taipei, Taiwan; Cardiovascular Division, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan.
⁸⁹ Institute of Cardiovascular Disease, University of South China, Hengyang, Hunan, China.
⁹⁰ University Heart Centre Freiburg University, Department of Cardiology and Angiology I, Faculty of Medicine, University of Freiburg, Freiburg, Germany.

PMID: 36764041
DOI: 10.1016/j.phrs.2023.106679

Abstract

Non-Alcoholic Fatty Liver Disease (NAFLD) is a common condition affecting around 10-25% of the general adult population, 15% of children, and even > 50% of individuals who have type 2 diabetes mellitus. It is a major cause of liver-related morbidity, and cardiovascular (CV) mortality is a common cause of death. In addition to being the initial step of irreversible alterations of the liver parenchyma causing cirrhosis, about 1/6 of those who develop NASH are at risk also developing CV disease (CVD). More recently the acronym MAFLD (Metabolic Associated Fatty Liver Disease) has been preferred by many European and US specialists, providing a clearer message on the metabolic etiology of the disease. The suggestions for the management of NAFLD are like those recommended by guidelines for CVD prevention. In this context, the general approach is to prescribe physical activity and dietary changes the effect weight loss. Lifestyle change in the NAFLD patient has been supplemented in some by the use of nutraceuticals, but the evidence based for these remains uncertain. The aim of this Position Paper was to summarize the clinical evidence relating to the effect of nutraceuticals on NAFLD-related parameters. Our reading of the data is that whilst many nutraceuticals have been studied in relation to NAFLD, none have sufficient evidence to recommend their routine use; robust trials are required to appropriately address efficacy and safety.

Keywords: Dietary supplements; Liver steatosis; NAFLD; Nutraceuticals; Position paper.

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Declaration of Competing Interest Manfredi Rizzo: speakers bureau: Amgen, Astra Zeneca, Boehringer Ingelheim, Eli Lilly, Meda, Mylan, Merck Sharp & Dohme, Novo Nordisk, Roche Diagnostics, Sanofi, and Servier; consultant to Amgen, Astra Zeneca, Boehringer Ingelheim, Eli Lilly, Meda, Mylan, Merck Sharp & Dohme, Novo Nordisk, Roche Diagnostics, Sanofi, and Servier; Medical and Scientific Advisor, Europe East and South at Novo Nordisk; Peter E. Penson has received honoraria and/or travel reimbursement for events sponsored by AKCEA, Amgen, AMRYT, Link Medical, Mylan, Napp, Sanofi; Niki Katsiki; Dimitri P. Mikhailidis has given talks, acted as a consultant or attended conferences sponsored by Amgen and Novo Nordisk; Peter P. Toth: speakers bureau: Amgen, Esperion, Kowa, Merck, Novo-Nordisk; consultant to Amarin, bio89, Kowa, Merck, Resverlogix, Theravance; Maciej Banach: speakers bureau: Amgen, Herbapol, Kogen, KRKA, Polpharma, Mylan/Viatris, Novartis, Novo-Nordisk, Sanofi-Aventis, Teva, Zentiva; consultant to Amgen, Daichii Sankyo, Esperion, Freia Pharmaceuticals, Novartis, Novo-Nordisk, Polfarmex, Sanofi-Aventis; Grants from Amgen, Mylan/Viatris, Sanofi and Valeant; CMO at Nomi Biotech Corporation Ltd.; all other authors have no conflict of interest.

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Nutraceutical approaches to non-alcoholic fatty liver disease (NAFLD): A position paper from the International Lipid Expert Panel (ILEP)

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Nutraceutical approaches to non-alcoholic fatty liver disease (NAFLD): A position paper from the International Lipid Expert Panel (ILEP)

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