From the Guidelines
Resveratrol cannot be recommended to treat NAFL/NASH due to a lack of sufficient evidence regarding its efficacy, as stated in the ESPEN practical guideline: clinical nutrition in liver disease 1. The use of resveratrol in the treatment of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) has been explored in several studies, but the results are inconsistent and limited by small sample sizes and variable dosing regimens.
- A study found that oral resveratrol (3000 mg) for eight weeks had no effect on insulin resistance, steatosis, abdominal fat distribution, and plasma lipids or antioxidant activity, and actually increased ALT and AST levels 1.
- Another trial found that 150 mg of resveratrol per day for three months improved AST, ALT, LDL, and total cholesterol, as well as inflammation mediators 1.
- A study using 500 mg of resveratrol per day in combination with lifestyle intervention found improvements in ALT, inflammatory cytokines, and hepatic steatosis in overweight patients 1. However, the ESPEN guideline concludes that until further data regarding the efficacy of antioxidants like resveratrol are available, they cannot be recommended to treat NAFL/NASH, citing a strong consensus of 100% 1. In the context of real-life clinical medicine, prioritizing morbidity, mortality, and quality of life as outcomes, it is essential to exercise caution when considering the use of resveratrol for NAFLD/NASH treatment, given the current lack of robust evidence supporting its effectiveness.
- Instead, focusing on established treatments and lifestyle interventions that have demonstrated benefits in improving liver function and reducing the risk of progression to more severe liver disease is recommended.
- Further research is needed to fully understand the potential benefits and risks of resveratrol in the treatment of NAFLD/NASH, and patients should be advised to consult with their healthcare provider before initiating any supplement regimen.
From the Research
Resveratrol Overview
- Resveratrol is a nutraceutical with several therapeutic effects, including anti-inflammatory and anti-oxidative effects 2
- It has been shown to mimic effects of caloric restriction and affect the initiation and progression of many diseases through several mechanisms 2
Health Benefits
- Resveratrol may play an important role in managing or preventing a variety of diseases, including cardiovascular disease, obesity, diabetes, Alzheimer disease, and cancer 3
- It has been found to be safe and reasonably well tolerated in humans, with mild to moderate gastrointestinal side effects 3
- Resveratrol has antioxidant, anti-inflammatory, immunomodulatory, glucose and lipid regulatory, neuroprotective, and cardiovascular protective effects 4
Clinical Trials
- Most of the clinical trials of resveratrol have focused on cancer, neurological disorders, cardiovascular diseases, diabetes, non-alcoholic fatty liver disease (NAFLD), and obesity 2
- The current clinical trials show that resveratrol was well tolerated and beneficially influenced disease biomarkers for neurological disorders, cardiovascular diseases, and diabetes 2
- However, resveratrol had ambiguous and sometimes even detrimental effects in certain types of cancers and in NAFLD 2
Limitations and Future Research
- The major obstacle presented in most of the clinical trials was resveratrol's poor bioavailability 2
- Extensive future studies on the long-term effects, as well as the in vivo adverse effects, of resveratrol supplementation in humans are needed 5
- New delivery methods are being employed to overcome the low bioavailability of resveratrol 5