Network Meta-Analysis: Most Plant Extracts Show No Proven Benefit in Fatty Liver Disease
A network meta-analysis of 32 randomized trials with 2,053 adults compared 28 plant extracts in fatty liver disease (MASLD), which affects about 38% of the global population. Most extracts did not significantly improve liver enzymes or liver fat compared with placebo. A curcumin preparation, cinnamon, fenugreek and purslane ranked highest for individual measures, but the authors do not regard this as evidence of a clinically meaningful advantage.
1. What the Research Says
The work pools randomized controlled trials in adults with MASLD up to November 2025 and compares liver enzymes (ALT, AST), liver fat and liver stiffness. The authors point to limited evidence, considerable differences between studies and uncertain comparative estimates; the data do not support plant extracts as a standalone treatment without lifestyle changes.
2. How It Fits Earlier Research
Earlier meta-analyses of single extracts such as curcumin and silymarin (milk thistle) found lower liver enzymes, and a 2024 review found an added benefit of herbal medicines on top of lifestyle changes. The new network meta-analysis does not contradict this but is more cautious: a curcumin preparation ranks first for ALT, while overall the advantage over placebo remains uncertain for most extracts. The effects of curcumin supplementation on liver function, metabolic profile and body composition in… (2020) · The therapeutic effect of silymarin in the treatment of nonalcoholic fatty disease: A meta-analysis (PRISMA)… (2017) · The additive effect of herbal medicines on lifestyle modification in the treatment of non-alcoholic fatty… (2024)
3. Source
Every statement on this page carries its evidence tier — proven, plausible or hypothesis — and leads to the original work. The decision in the individual case rests with the practitioner; we provide the connections.