Does Flavonoid Supplementation Alleviate Non‐Alcoholic Fatty Liver Disease? A Systematic Review and Meta‐Analysis of Randomized Controlled Trials

Scope Higher flavonoid intake is associated with reduced risk of non‐alcoholic fatty liver disease (NAFLD). However, there is a large discrepancy in the effects of flavonoid supplementation on NAFLD. To fill such knowledge gap, we systematically reviewed randomized clinical trials (RCTs) to critically assess flavonoid supplementation effect on liver function, lipid profile, inflammation, and insulin resistance in adults with NAFLD. Methods and results A systematic search was conducted from 4 databases from inception until May 2023. Twelve RCTs were included in the final analysis demonstrating beneficial effects of flavonoids on ALT (SMD = −3.59, p = 0.034), AST (SMD = −4.47, p = 0.001), GGT (SMD = −8.70, p = 0.000), CK‐18M30 (SMD = −0.35, p = 0.042), TG (SMD = −0.37, p = 0.001), LDL‐C (SMD = −0.38, p = 0.039), TC (MD = −0.25 mmol/l, p = 0.017), steatosis score (MD = −18.97, p = 0.30), TNF‐α (MD = −0.88, p = 0.000), and NF‐κB (MD = −1.62, p = 0.001). Conclusion This meta‐analysis suggests that flavonoid alleviates NAFLD through exerting favourable effects on liver function, lipid profile, and inflammation, indicating flavonoid supplementation presents a promising drug regimen for the management of NAFLD and its associated complications.