From the Guidelines
Resveratrol is not recommended for the treatment of NAFL/NASH due to lack of efficacy and potential adverse effects, as evidenced by a strong consensus of 100% in the ESPEN practical guideline: clinical nutrition in liver disease 1. Resveratrol is a polyphenol found in various plants, including the skin of red grapes, red wine, peanuts, and some berries. It has been studied for its potential health benefits, including antioxidant and anti-inflammatory properties. However, according to the ESPEN practical guideline: clinical nutrition in liver disease 1, oral resveratrol (3000 mg) for eight weeks had no effect on insulin resistance, steatosis, abdominal fat distribution, and plasma lipids or antioxidant activity, and even increased ALT and AST levels significantly. Some studies have reported conflicting results, with one trial showing improvement in AST, ALT, LDL, and total cholesterol, HOMA-IR, and inflammation mediators with 150 mg of resveratrol per day for three months 1, and another study finding that 500 mg of resveratrol together with lifestyle intervention was more effective than lifestyle intervention alone in improving ALT, inflammatory cytokines, and hepatic steatosis in overweight patients 1. However, the most recent and highest-quality study, as per the ESPEN guideline 1, does not support the use of resveratrol for NAFL/NASH treatment. Key points to consider:
- Resveratrol has been studied for its potential health benefits, but its efficacy in treating NAFL/NASH is lacking
- The ESPEN practical guideline: clinical nutrition in liver disease 1 recommends against the use of resveratrol for NAFL/NASH treatment due to lack of efficacy and potential adverse effects
- Conflicting results have been reported in various studies, but the most recent and highest-quality study does not support the use of resveratrol for NAFL/NASH treatment 1
From the FDA Drug Label
Uses • Helps prevent sunburn. Warnings For external use only. Do not use on damaged or broken skin. Keep out of eyes. If contact occurs, rinse with water. If rash or irritation develops, discontinue use and consult your physician.
Resveratrol is a drug that helps prevent sunburn when used externally 2. It is for external use only and should not be used on damaged or broken skin 2.
From the Research
Definition and Properties of Resveratrol
- Resveratrol is a natural polyphenolic, non-flavonoid antioxidant, and a phytoalexin found in many plants including grapes, nuts, and berries 3, 4, 5, 6.
- It is a stilbene polyphenolic compound with two phenol rings linked to each other by an ethylene bridge 6.
- Resveratrol has been detected in more than 70 plant species, especially in grapes' skin and seeds, and is found in discrete amounts in red wines and various human foods 6.
Health Benefits of Resveratrol
- Resveratrol has various health benefits, such as cardiovascular and cancer preventive properties 3, 7, 5.
- It has anti-inflammatory, anticarcinogenic, cardioprotective, vasorelaxant, phytoestrogenic, and neuroprotective effects 4, 5, 6.
- Resveratrol has been shown to inhibit all carcinogenesis stages (e.g., initiation, promotion, and progression) 6.
- It also has antioxidant, anti-cancer, cardioprotective, neuroprotective, anti-inflammatory, anti-microbial, immunomodulatory, and radioprotective properties 5.
Mechanisms of Action
- Resveratrol's mechanisms of action include downregulation of the inflammatory response through inhibition of synthesis and release of pro-inflammatory mediators, modification of eicosanoid synthesis, inhibition of activated immune cells, or inhibiting enzymes such as cyclooxygenase-1 (COX-1) or cyclooxygenase-2 (COX-2) 3, 4.
- It also has inhibitory effects on nuclear factor kappaB (NFkappaB) or activator protein-1 (AP-1) 3, 4.
- Resveratrol can improve endothelial function by upregulating endothelial NO synthase (eNOS) and decreasing endothelial dysfunction 7.