Abstract
Nonalcoholic fatty liver disease (NAFLD), which is associated with obesity, is the most common reason for chronic hepatitis in developed countries. Its therapy includes a low-energy diet, physical activity and also various antioxidative compounds, such as milk thistle (Silybum Marianum) seeds, which are a natural source of silymarin. The aim of the study was to assess the influence of 3 months of therapy including dietary and physical activity recommendations combined with a daily milk thistle supply on the biochemical parameters of NAFLD patients. The study was conducted on a group of 20 patients (11 females, 9 males) with NAFLD and excessive body mass diagnosed. For 3 months, participants received daily doses of 7.1 g of milk thistle as a source of silymarin (210 mg a day). They also received dietary and physical activity recommendations and were monitored every 2 weeks. Their diet, body composition and biochemical parameters were assessed. It was observed that the studied patients did not follow their dietary recommendations, as when comparing the baseline diet and the diet after 3 months, there were no differences (for the vast majority of nutrients; p < 0.05). Patients also did not follow their physical activity recommendations, as when comparing baseline results with those after 3 months, there were no differences (for the vast majority of parameters; p < 0.05). However, when comparing baseline biochemical parameters and those after 3 months, it was indicated that blood triglyceride levels (140.36 ± 14.92 vs. 110.04 ± 37.23 mg/dL; p = 0.0017) and gamma-glutamyltransferase (GGT) activity decreased (23.03 ± 12.87 vs. 12.77 ± 5.24 U/L; p = 0.0008). As the diet and physical activity of the studied patients were not changed within the studied period, it may be supposed that the beneficial decrease in blood triglyceride levels and GGT activity were obtained due to the milk thistle supply as a source of silymarin. It may be indicated that including milk thistle in an everyday diet may be an additional recommendation for NAFLD patients, as it allows one to obtain beneficial effects, even if the other recommendations are not followed.
Highlights
Liver diseases are a serious global health problem contributing worldwide to about 2 million deaths per year [1]
nonalcoholic fatty liver disease (NAFLD) is associated with lipid accumulation in the liver, as it is defined as steatosis in over 5% of hepatocytes observed in individuals neither consuming excessive amounts of alcohol nor diagnosed with concurrent liver diseases [3], and it may develop into nonalcoholic steatohepatitis (NASH), progressing to liver cirrhosis [4,5]
It was observed that all the parameters were comparable before and after intervention, and no statistically significant differences were observed for female participants (p > 0.05)
Summary
Liver diseases are a serious global health problem contributing worldwide to about 2 million deaths per year [1]. The most common reason for chronic hepatitis is nonalcoholic fatty liver disease (NAFLD), as in various countries its frequency is attributed to 12–32% [2]. NAFLD is associated with lipid accumulation in the liver, as it is defined as steatosis in over 5% of hepatocytes observed in individuals neither consuming excessive amounts of alcohol nor diagnosed with concurrent liver diseases [3], and it may develop into nonalcoholic steatohepatitis (NASH), progressing to liver cirrhosis [4,5]. NAFLD is indicated as one of the most important factors contributing to gastrointestinal cancers, including especially hepatocellular carcinoma, which is the most common type of liver cancer [6]. Taking into consideration that the majority of indicated conditions are included as elements of metabolic syndrome, it is suggested that NAFLD may be a liver manifestation of a metabolic syndrome [11]
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