Vaccinium spp. Berries in the Prevention and Treatment of Non-Alcoholic Fatty Liver Disease: A Comprehensive Update of Preclinical and Clinical Research

Abstract

Non-alcoholic fatty liver disease (NAFLD) is a common chronic liver disorder marked by the buildup of triacylglycerols (TGs) in the liver. It includes a range of conditions, from simple steatosis to more severe forms like non-alcoholic steatohepatitis (NASH), which can advance to fibrosis, cirrhosis, and hepatocellular carcinoma. NAFLD's prevalence is rising globally, estimated between 10% and 50%. The disease is linked to comorbidities such as obesity, type 2 diabetes, insulin resistance, and cardiovascular diseases and currently lacks effective treatment options. Therefore, researchers are focusing on evaluating the impact of adjunctive herbal therapies in individuals with NAFLD. One herbal therapy showing positive results in animal models and clinical studies is fruits from the Vaccinium spp. genus. This review presents an overview of the association between consuming fruits, juices, and extracts from Vaccinium spp. and NAFLD. The search used the following keywords: ((Vaccinium OR blueberry OR bilberry OR cranberry) AND ("non-alcoholic fatty liver disease" OR "non-alcoholic steatohepatitis")). Exclusion criteria included reviews, research notes, book chapters, case studies, and grants. The review included 20 studies: 2 clinical trials and 18 studies on animals and cell lines. The findings indicate that juices and extracts from Vaccinium fruits and leaves have significant potential in addressing NAFLD by improving lipid and glucose metabolism and boosting antioxidant and anti-inflammatory responses. In conclusion, blueberries appear to have the potential to alleviate NAFLD, but more clinical trials are needed to confirm these benefits.

Keywords: NAFLD; NASH; PRISMA; Vaccinium spp.; animal model; bilberry; blueberry; cell line; extract; fruits; juices; liver steatosis; non-alcoholic fatty liver disease; supplement.

Figure 1

Flow diagram of the study selection process.

Figure 2

Systemic anti-inflammatory and antioxidant effects of dietary polyphenols.

Figure 3

General overview of the impact of Vaccinium spp. on transcription factors. ACC—acetyl-coenzyme A carboxylas; ACOX1—acyl-CoA oxidase1; ADP—adenosine-5′-diphosphate; AMPK—AMP-activated protein kinase; CPTIα—carnitine palmitoyltransferase-I-alpha; PPAR—peroxisome proliferator-activated receptor; SREBP—sterol regulatory element-binding protein; ↑—increase; ↓—decrease;.