Fatty Liver Disease

Foie gras disease: are probiotics useful?

Pre- and probiotic supplementation, along with lifestyle modifications, reduced liver fat infiltration and inflammation in people with nonalcoholic liver steatosis (NAFLD) in a recent study.

Fatty Liver

Photo Gustavo Fring in Pexels

Why is it important

NAFLD (Non-Alcoholic Fatty Liver Disease) is characterized by the accumulation of fat in the liver.

It is a lifestyle disease that develops in people with poor eating habits (too much sugar, too many foods with a high glycemic index).

NAFLD increases with age and is related to insulin resistance, overweight, and diabetes. It affects between 14 and 30% of the population.

There is no specific treatment for this disease, which can progress to a more severe form: nonalcoholic steatohepatitis (NASH) and then cirrhosis. Dietary modifications and regular physical activity can improve the disease.

The intestinal microbiota plays an important role in the development and progression of the disease. Therefore, probiotics could be an interesting strategy in the treatment of NAFLD.

In a new study published in the journal Clinical Nutrition ESPEN, researchers studied the effect of supplementation with Bacillus coagulans, a bacterium that survives the acidic pH of the stomach and then reaches the intestine where it performs its probiotic activities (regulation of the microbiota and the immune system).

The studio

In this randomized controlled trial, all 53 NAFLD participants received either a symbiotic supplement (a mixture of probiotics and prebiotics) containing Bacillus coagulans and inulin or a placebo for 12 weeks.

Participants also made lifestyle changes (diet and physical activity, at least 30 minutes 3 times a week).

All participants had a 1.5 times higher than normal concentration of alanine aminotransferase or ALT, a liver enzyme.

The results show that waist circumference, weight, and body mass index decreased in the symbiotic supplement group while only waist circumference decreased in the placebo group.

The decrease in liver enzymes, particularly ALT, was greater in the coagulating bacilli group than in the placebo group.

Steatosis (infiltration of fat into the liver) also decreased more in the probiotic group.

Finally, supplementation with Bacillus coagulans reduced inflammation in NAFLD patients and insulin levels after 12 weeks of supplementation.

Probiotics act by modifying the intestinal microbiota, reducing the levels of endotoxins – in particular lipopolysaccharides – and inhibiting the production and absorption of intestinal toxins.

Probiotics also decrease intestinal permeability, which prevents endotoxins from entering the bloodstream. All of these parameters allow liver cells to be less exposed to endotoxins and thus improve NAFLD.

In practice

Taking probiotics has increased the benefits of lifestyle changes alone.

In this study, probiotic supplementation was accompanied by prebiotics that provide the necessary food for bacterial growth in the intestine.

Taking care of the intestinal microbiota can be a winning strategy when suffering from NAFLD. Emphasis should be placed on foods that are beneficial to intestinal bacteria.

It is possible to reduce naturally the fats infiltrated in the liver, in particular by eliminating sugary products and those with a high glycemic index and focusing on antioxidants and omega-3s.

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