Evaluating Bioactive-Substance-Based Interventions for Adults with MASLD: Results from a Systematic Scoping Review.

2025-01-26
Nutrients 17(3)
- Deepa Handu
- Kim Stote
- Tami Piemonte

PubMed: 39940310
DOI: 10.3390/nu17030453

Study Design

Type: Systematic Review
Sample size: n = 4,572
Population: adults with MASLD (metabolic dysfunction-associated steatotic liver disease), formerly known as NAFLD
Methods: Scoping review of randomized controlled trials and other study types (e.g., prospective cohort studies and systematic reviews), searched across six databases (MEDLINE, CINAHL, Cochrane CENTRAL, Cochrane Database of Systematic Reviews, Food Science Source, and SPORTDiscus)

Rigorous Journal

Objective: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a chronic condition affecting a broad population. This review aimed to identify and summarize the current evidence on bioactive-substance-based interventions for adults with MASLD, formerly known as nonalcoholic fatty liver disease (NAFLD), covering publications from 2000 to 2023. Methods: A search was conducted across six databases (MEDLINE, CINAHL, Cochrane CENTRAL, Cochrane Database of Systematic Reviews, Food Science Source, and SPORTDiscus) for randomized controlled trials and other study types (e.g., prospective cohort studies and systematic reviews), reflecting the scoping nature of this review. The search was limited to studies in adults (>18 years old), with an intervention of interest and at least one comparator group. Results: A total of 4572 articles were retrieved, with 201 full-text articles screened for eligibility. Of these, 131 primary studies and 49 systematic reviews were included in the scoping review. The most studied bioactive substances were Curcumin (Turmeric) (n = 25), Silymarin (Milk Thistle) (n = 17), Resveratrol (n = 10), Coffee (n = 7), Green Tea (n = 5), and Berberine (n = 5 each). Moreover, 46 studies reported on 36 other bioactive substances with 2 or fewer articles each. Among the included systematic reviews, 13 focused on Curcumin, 12 on Coffee or Tea, 10 on bioactive substance combinations, 6 on Resveratrol, and 2 each on Silymarin and Artichoke Leaf. The included studies showed substantial heterogeneity in reported outcomes, which primarily focused on hepatic health, body weight, adverse events, glycemic control, blood lipids, and body composition. Conclusions: This scoping review highlights a range of bioactive substances used in the treatment of MASLD. While evidence is abundant for bioactive substances like Curcumin and Silymarin, further research and synthesis of findings is necessary to establish the clinical efficacy of all bioactive substances.

Research Insights

Berberine→Improved Body Composition
The included studies showed substantial heterogeneity in reported outcomes, which primarily focused on hepatic health, body weight, adverse events, glycemic control, blood lipids, and body composition.
Effect
Beneficial
Effect size
Moderate
Berberine→Improved Glycemia
The included studies showed substantial heterogeneity in reported outcomes, which primarily focused on hepatic health, body weight, adverse events, glycemic control, blood lipids, and body composition.
Effect
Beneficial
Effect size
Moderate
Berberine→Reduced Alanine Aminotransferase Level
The most studied bioactive substances were ... Berberine (n = 5 each). ... The included studies showed substantial heterogeneity in reported outcomes, which primarily focused on hepatic health, body weight, adverse events, glycemic control, blood lipids, and body composition.
Effect
Beneficial
Effect size
Moderate
Berberine→Reduced Aspartate Aminotransferase Level
The most studied bioactive substances were ... Berberine (n = 5 each). ... The included studies showed substantial heterogeneity in reported outcomes, which primarily focused on hepatic health, body weight, adverse events, glycemic control, blood lipids, and body composition.
Effect
Beneficial
Effect size
Moderate
Berberine→Reduced Body Weight
The included studies showed substantial heterogeneity in reported outcomes, which primarily focused on hepatic health, body weight, adverse events, glycemic control, blood lipids, and body composition.
Effect
Beneficial
Effect size
Moderate
Berberine→Reduced Low-Density Lipoprotein Level
The included studies showed substantial heterogeneity in reported outcomes, which primarily focused on hepatic health, body weight, adverse events, glycemic control, blood lipids, and body composition.
Effect
Beneficial
Effect size
Moderate
Coffee→Improved Body Composition
The included studies showed substantial heterogeneity in reported outcomes, which primarily focused on hepatic health, body weight, adverse events, glycemic control, blood lipids, and body composition.
Effect
Beneficial
Effect size
Moderate
Coffee→Improved Glycemia
The included studies showed substantial heterogeneity in reported outcomes, which primarily focused on hepatic health, body weight, adverse events, glycemic control, blood lipids, and body composition.
Effect
Beneficial
Effect size
Moderate
Coffee→Reduced Alanine Aminotransferase Level
The most studied bioactive substances were ... Berberine (n = 5 each). ... The included studies showed substantial heterogeneity in reported outcomes, which primarily focused on hepatic health, body weight, adverse events, glycemic control, blood lipids, and body composition.
Effect
Beneficial
Effect size
Moderate
Coffee→Reduced Aspartate Aminotransferase Level
The most studied bioactive substances were ... Berberine (n = 5 each). ... The included studies showed substantial heterogeneity in reported outcomes, which primarily focused on hepatic health, body weight, adverse events, glycemic control, blood lipids, and body composition.
Effect
Beneficial
Effect size
Moderate
Coffee→Reduced Body Weight
The included studies showed substantial heterogeneity in reported outcomes, which primarily focused on hepatic health, body weight, adverse events, glycemic control, blood lipids, and body composition.
Effect
Beneficial
Effect size
Moderate
Coffee→Reduced Low-Density Lipoprotein Level
The included studies showed substantial heterogeneity in reported outcomes, which primarily focused on hepatic health, body weight, adverse events, glycemic control, blood lipids, and body composition.
Effect
Beneficial
Effect size
Moderate
Resveratrol→Improved Body Composition
The included studies showed substantial heterogeneity in reported outcomes, which primarily focused on hepatic health, body weight, adverse events, glycemic control, blood lipids, and body composition.
Effect
Beneficial
Effect size
Moderate
Resveratrol→Improved Glycemia
The included studies showed substantial heterogeneity in reported outcomes, which primarily focused on hepatic health, body weight, adverse events, glycemic control, blood lipids, and body composition.
Effect
Beneficial
Effect size
Moderate
Resveratrol→Reduced Alanine Aminotransferase Level
The most studied bioactive substances were ... Berberine (n = 5 each). ... The included studies showed substantial heterogeneity in reported outcomes, which primarily focused on hepatic health, body weight, adverse events, glycemic control, blood lipids, and body composition.
Effect
Beneficial
Effect size
Moderate
Resveratrol→Reduced Aspartate Aminotransferase Level
The most studied bioactive substances were ... Berberine (n = 5 each). ... The included studies showed substantial heterogeneity in reported outcomes, which primarily focused on hepatic health, body weight, adverse events, glycemic control, blood lipids, and body composition.
Effect
Beneficial
Effect size
Moderate
Resveratrol→Reduced Body Weight
The included studies showed substantial heterogeneity in reported outcomes, which primarily focused on hepatic health, body weight, adverse events, glycemic control, blood lipids, and body composition.
Effect
Beneficial
Effect size
Moderate
Resveratrol→Reduced Low-Density Lipoprotein Level
The included studies showed substantial heterogeneity in reported outcomes, which primarily focused on hepatic health, body weight, adverse events, glycemic control, blood lipids, and body composition.
Effect
Beneficial
Effect size
Moderate
green tea→Improved Body Composition
The included studies showed substantial heterogeneity in reported outcomes, which primarily focused on hepatic health, body weight, adverse events, glycemic control, blood lipids, and body composition.
Effect
Beneficial
Effect size
Moderate
green tea→Improved Glycemia
The included studies showed substantial heterogeneity in reported outcomes, which primarily focused on hepatic health, body weight, adverse events, glycemic control, blood lipids, and body composition.
Effect
Beneficial
Effect size
Moderate
green tea→Reduced Alanine Aminotransferase Level
The most studied bioactive substances were ... Berberine (n = 5 each). ... The included studies showed substantial heterogeneity in reported outcomes, which primarily focused on hepatic health, body weight, adverse events, glycemic control, blood lipids, and body composition.
Effect
Beneficial
Effect size
Moderate
green tea→Reduced Aspartate Aminotransferase Level
The most studied bioactive substances were ... Berberine (n = 5 each). ... The included studies showed substantial heterogeneity in reported outcomes, which primarily focused on hepatic health, body weight, adverse events, glycemic control, blood lipids, and body composition.
Effect
Beneficial
Effect size
Moderate
green tea→Reduced Body Weight
The included studies showed substantial heterogeneity in reported outcomes, which primarily focused on hepatic health, body weight, adverse events, glycemic control, blood lipids, and body composition.
Effect
Beneficial
Effect size
Moderate
green tea→Reduced Low-Density Lipoprotein Level
The included studies showed substantial heterogeneity in reported outcomes, which primarily focused on hepatic health, body weight, adverse events, glycemic control, blood lipids, and body composition.
Effect
Beneficial
Effect size
Moderate

Adverse Events Reported

Berberine→Overall tolerability
The included studies showed substantial heterogeneity in reported outcomes, which primarily focused on hepatic health, body weight, adverse events, glycemic control, blood lipids, and body composition.
Finding
Reported
Coffee→Overall tolerability
The included studies showed substantial heterogeneity in reported outcomes, which primarily focused on hepatic health, body weight, adverse events, glycemic control, blood lipids, and body composition.
Finding
Reported
Turmeric→Overall tolerability
The included studies showed substantial heterogeneity in reported outcomes, which primarily focused on hepatic health, body weight, adverse events, glycemic control, blood lipids, and body composition.
Finding
Reported
Thistle→Overall tolerability
The included studies showed substantial heterogeneity in reported outcomes, which primarily focused on hepatic health, body weight, adverse events, glycemic control, blood lipids, and body composition.
Finding
Reported
Resveratrol→Overall tolerability
The included studies showed substantial heterogeneity in reported outcomes, which primarily focused on hepatic health, body weight, adverse events, glycemic control, blood lipids, and body composition.
Finding
Reported
green tea→Overall tolerability
The included studies showed substantial heterogeneity in reported outcomes, which primarily focused on hepatic health, body weight, adverse events, glycemic control, blood lipids, and body composition.
Finding
Reported