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      Impact of silymarin‐supplemented cookies on liver enzyme and inflammatory markers in non‐alcoholic fatty liver disease patients

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          Abstract

          Nonalcoholic fatty liver disease (NAFLD) is a growing public health concern characterized by fat accumulation and severe disorders like nonalcoholic steatohepatitis (NASH), which are influenced by obesity, inflammatory processes, and metabolic pathways. This research investigates the potential of silymarin‐supplemented cookies in managing NAFLD by evaluating their impact on liver enzyme activity, inflammatory markers, and lipid profiles. A clinical trial in Lahore, Pakistan, involved 64 NAFLD patients. Participants were divided into placebo and three treatment groups, with the latter receiving silymarin‐supplemented cookies for 3 months. The study assessed liver enzyme levels and inflammatory markers, at baseline and after the intervention, utilizing statistical analyses to evaluate differences. The lipid profile and renal function test (RFT) were also measured at baseline and after 3 months in each group for safety assessment. After 3 months, the treatment groups indicated more significant decreases in liver enzymes compared to the placebo group ( p ≤ .05). Treatment 3 showed significant reductions in alanine aminotransferase (ALT) (64.39–49.38 U/L) and aspartate aminotransferase (AST) (61.53–45.38 U/L). Treatment 3 also showed improvements in alkaline phosphatase (ALP) levels and the AST/ALT ratio. Additionally, the treatment group demonstrated a significant reduction in inflammatory markers. Treatment 3 showed a significant decrease in C‐reactive protein (CRP) (6.32–3.39 mg/L) and erythrocyte sedimentation rate (ESR) (38.72–23.86 mm/h), indicating that individuals with NAFLD may benefit from the intervention's potential benefits in lowering inflammation. The study revealed that an intervention significantly improved the inflammatory markers, liver enzymes, and lipid profiles of NAFLD participants, suggesting potential benefits for liver health.

          Abstract

          The study investigates the potential of silymarin‐supplemented cookies in managing nonalcoholic fatty liver disease (NAFLD), a growing public health concern characterized by fat accumulation and severe disorders like nonalcoholic steatohepatitis (NASH). A clinical trial in Lahore, Pakistan, involved 64 NAFLD patients divided into placebo and three treatment groups. After 3 months, the treatment groups showed significant decreases in liver enzymes, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, alkaline phosphatase (ALP) levels, and AST/ALT ratio. Additionally, the treatment group showed a significant reduction in inflammatory markers, C‐reactive protein (CRP) and erythrocyte sedimentation rate (ESR). The study concluded that the intervention significantly improved the inflammatory markers, liver enzymes, and lipid profiles of NAFLD participants, suggesting potential benefits for liver health.

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          Most cited references41

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          Role of oxidative stress in the pathogenesis of nonalcoholic fatty liver disease

          Nonalcoholic fatty liver disease (NAFLD) has emerged as the most common chronic liver disease worldwide and is strongly associated with the presence of oxidative stress. Disturbances in lipid metabolism lead to hepatic lipid accumulation, which affects different reactive oxygen species (ROS) generators, including mitochondria, endoplasmic reticulum, and NADPH oxidase. Mitochondrial function adapts to NAFLD mainly through the downregulation of the electron transport chain (ETC) and the preserved or enhanced capacity of mitochondrial fatty acid oxidation, which stimulates ROS overproduction within different ETC components upstream of cytochrome c oxidase. However, non-ETC sources of ROS, in particular, fatty acid β-oxidation, appear to produce more ROS in hepatic metabolic diseases. Endoplasmic reticulum stress and NADPH oxidase alterations are also associated with NAFLD, but the degree of their contribution to oxidative stress in NAFLD remains unclear. Increased ROS generation induces changes in insulin sensitivity and in the expression and activity of key enzymes involved in lipid metabolism. Moreover, the interaction between redox signaling and innate immune signaling forms a complex network that regulates inflammatory responses. Based on the mechanistic view described above, this review summarizes the mechanisms that may account for the excessive production of ROS, the potential mechanistic roles of ROS that drive NAFLD progression, and therapeutic interventions that are related to oxidative stress.
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            Advancing the global public health agenda for NAFLD: a consensus statement

            Non-alcoholic fatty liver disease (NAFLD) is a potentially serious liver disease that affects approximately one-quarter of the global adult population, causing a substantial burden of ill health with wide-ranging social and economic implications. It is a multisystem disease and is considered the hepatic component of metabolic syndrome. Unlike other highly prevalent conditions, NAFLD has received little attention from the global public health community. Health system and public health responses to NAFLD have been weak and fragmented, and, despite its pervasiveness, NAFLD is largely unknown outside hepatology and gastroenterology. There is only a nascent global public health movement addressing NAFLD, and the disease is absent from nearly all national and international strategies and policies for non-communicable diseases, including obesity. In this global Delphi study, a multidisciplinary group of experts developed consensus statements and recommendations, which a larger group of collaborators reviewed over three rounds until consensus was achieved. The resulting consensus statements and recommendations address a broad range of topics - from epidemiology, awareness, care and treatment to public health policies and leadership - that have general relevance for policy-makers, health-care practitioners, civil society groups, research institutions and affected populations. These recommendations should provide a strong foundation for a comprehensive public health response to NAFLD.
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              AGA Clinical Practice Update on Lifestyle Modification Using Diet and Exercise to Achieve Weight Loss in the Management of Nonalcoholic Fatty Liver Disease: Expert Review

              Nonalcoholic fatty liver disease (NAFLD) is a leading cause of chronic liver disease, with global public health impact affecting more than 25% of the global population. NAFLD is associated with significant morbidity and mortality from cirrhosis, hepatocellular carcinoma, solid organ malignancies, diabetes mellitus, cardiovascular disease, and obstructive sleep apnea, resulting in significant health care resource use and decreased health-related quality of life. NAFLD cirrhosis is a leading indication for liver transplantation in the United States. Lifestyle modification to achieve weight loss remains a first-line intervention in patients with NAFLD. We summarize evidence-based interventions for lifestyle modification in the treatment of NAFLD and provided best practice advice statements to address key issues in clinical management.
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                Author and article information

                Contributors
                tabarak.malik@ju.edu.et
                Journal
                Food Sci Nutr
                Food Sci Nutr
                10.1002/(ISSN)2048-7177
                FSN3
                Food Science & Nutrition
                John Wiley and Sons Inc. (Hoboken )
                2048-7177
                17 July 2024
                October 2024
                : 12
                : 10 ( doiID: 10.1002/fsn3.v12.10 )
                : 7273-7286
                Affiliations
                [ 1 ] Faculty of Allied Health Sciences University Institute of Diet & Nutritional Sciences, University of Lahore Lahore Pakistan
                [ 2 ] School of Food and Biological Engineering Jiangsu University Zhenjiang China
                [ 3 ] Allied Health Sciences The University of Lahore Lahore Pakistan
                [ 4 ] Department of Biomedical Sciences Jimma University Jimma Ethiopia
                [ 5 ]Present address: Division of Research & Development Lovely Professional University Phagwara Punjab 144001 India
                Author notes
                [*] [* ] Correspondence

                Tabarak Malik, Department of Biomedical Sciences, Jimma University, Jimma, Ethiopia.

                Email: tabarak.malik@ 123456ju.edu.et

                Author information
                https://orcid.org/0000-0002-7632-5261
                https://orcid.org/0000-0002-8332-7927
                Article
                FSN34348 FSN3-2024-03-0869.R1
                10.1002/fsn3.4348
                11521666
                39479680
                3b482917-bce4-451e-a49c-5ba7d6736059
                © 2024 The Author(s). Food Science & Nutrition published by Wiley Periodicals LLC.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 01 July 2024
                : 30 March 2024
                : 04 July 2024
                Page count
                Figures: 7, Tables: 7, Pages: 14, Words: 7200
                Categories
                Original Article
                Original Article
                Custom metadata
                2.0
                October 2024
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.4.9 mode:remove_FC converted:29.10.2024

                cookies,inflammatory markers,lipid profiles,liver enzymes,nafld,silymarin

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