Probiotics for dietary management of non-alcoholic fatty liver disease

  • Fouad M. F. Elshaghabee
  • Namita Rokana
  • Harsh Panwar
  • Knut J. Heller
  • Jürgen SchrezenmeirEmail author


Non-alcoholic fatty liver disease (NAFLD) is characterized by an increase in fat content of liver cells, which is independent from alcohol intake. Here, we review the impact of microbiota and diet on the pathogenesis of NAFLD and the present knowledge on the effect of probiotics for dietary management of NAFLD. The major points are the following: (1) dietary preference of a high fructose and/or high fat diet seems to be associated with NAFLD. (2) Different microbial metabolites, including short chain fatty acids and ethanol, are associated with increased levels of lipogenesis. (3) Ethanol is metabolized to acetaldehyde resulting in increased oxidative stress and consecutively in liver injury. (4) Ethanol may also impair gut barrier function, which may enable translocation of lipopolysaccharides from Gram-negative bacteria and, hence, further promote low grade inflammation in liver tissue. (5) Beneficial gut microbiota may counteract the pathogenesis of NAFLD through displacement of NAFLD promoting microbes, reduction of overall microbial ethanol production, promotion of gut barrier function and suppression of inflammatory cascades. Therefore, selective probiotic strains with proven efficacy for NAFLD management and validated safety can be considered as a promising approach for NAFLD management.


NAFLD High fat diet Metabolic syndrome Gut microbiota Probiotics 



Funding was provided by DAAD (Grant No. Alumni grant).

Compliance with ethical standards

Conflict of interest

Jürgen Schrezenmeir is a member of the Scientific Advisory Board of Actial (marketing VSL#3) and served as scientific expert in a hearing on VSL#3. JS co-authored studies sponsored by Christian Hansen and by Yakult.

Information from authors

This article is a corrected and actualized version of the book chapter published by Elshaghabee et al. (2019) [Probiotics as a dietary intervention for reducing the risk of Nonalcoholic fatty liver disease] in the series Environmental Chemistry for a Sustainable World ( The submitted version of the book chapter was not provided to co-authors Heller KJ and Schrezenmeir J for final correction.


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Authors and Affiliations

  1. 1.Department of Dairy Science, Faculty of AgricultureCairo UniversityGizaEgypt
  2. 2.Department of Dairy Microbiology, College of Dairy Science and TechnologyGuru Angad Dev Veterinary and Animal Sciences University (GADVASU)LudhianaIndia
  3. 3.Department of Microbiology and BiotechnologyMax Rubner-Institut (Federal Research Institute of Nutrition and Food)KielGermany
  4. 4.Medical ClinicJohannes Gutenberg UniversityMainzGermany
  5. 5.Clinical Research CenterKiel Innovation and Technology Center KielKielGermany

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