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12.09.2024

The effect of synbiotics on a fatty liver

Synbiotics are supplements that contain dietary fibers such as inulin and benign bacteria such as Streptococcus thermophilus. If you give such a synbiotic supplement to someone with a fatty liver, he will become healthier. The concentration of liver enzymes and LDL will decrease, sensitivity to insulin will increase and the concentration of TNF-alpha will decrease.

Study
Indonesian nutrition scientists from Diponegoro University collected 11 previously published trials in which people with fatty liver - more precisely: non-alcoholic fatty liver disease or NAFLD - received supplements with both prebiotics and probiotics for several months in a row. They combined the results of the trials and reanalyzed them.

Prebiotics are fibers such as inulin, FOS and GOS that bacteria can use as a breeding ground. If you combine them in a supplement with probiotics, you have a synbiotic.

To give you an idea of what a synbiotic supplement may contain, in one of the selected trials the subjects were given 200 million copies daily of a combination of Lactobacillus casei, Lactobacillus rhamnosus, Streptococcus thermophilus, Bifidobacterium breve, Lactobacillus acidophilus, Bifidobacterium longum and Lactobacillus bulgaricus - plus 125 milligrams of fructooligosaccharide.

Results
Supplementation with synbiotics reduced the concentration of the liver enzymes AST [first figure below] and ALT [second figure] in the blood of the test subjects.

A high level of these enzymes is an indication that the liver is no longer functioning optimally. A reduction in AST and ALT indicates that the synbiotics reduce the physiological stress of a fatty liver.

Click on the figures below for a larger version.

Administration of synbiotics caused the LDL level to drop. You can see this above.

Supplementation with synbiotics reduced glucose and insulin levels [the first and second figures below, respectively]. The HOMA-IR, a marker for insulin resistance, also dropped [third figure]. This means that administration of synbiotics increased sensitivity to insulin.

Finally, synbiotics also reduced the concentration of the inflammatory factor TNF-alpha.

Mechanism
The researchers suspect that synbiotics cause the intestines to produce more short chain fatty acids such as acetate, propionate and butyrate. These reduce appetite via receptors GPR41 and GPR43. Short chain fatty acids increase sensitivity to insulin via yet another receptor, ANGPTL4.

Conclusion
"Synbiotic therapy emerges as a promising approach for enhancing liver function and metabolic profiles in NAFLD patients, as supported by the findings of this review," the researchers summarize.

Source:
Clinical Nutrition Open Science. 2024;56:128e151.

More:
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Supplement with vitamin E supports the non-alcoholic fatty liver 28.11.2023
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Obese with a fatty liver? This dose of myo-inositol makes you healthier 27.02.2023

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