Hepatoprotective Effects of Betalain Supplementation among Patients with Non-Alcoholic Fatty Liver Disease

Hepatoprotective Effects of Betalain Supplementation


  • Misbah Arshad University Institute of Diet and Nutritional Sciences, The University of Lahore, Lahore, Pakistan
  • Muntaha Jaffar University Institute of Diet and Nutritional Sciences, The University of Lahore, Lahore, Pakistan
  • Shahrukh Khan University of Veterinary and Animal Sciences, Lahore, Pakistan
  • Iqra Akram Faculty of Food Science and Nutrition, Bahauddin Zakariya University, Multan, Pakistan
  • Najm Us Sabah Quaid-E-Azam University, Islamabad, Pakistan
  • Sania Saher University Institute of Diet and Nutritional Sciences, The University of Lahore, Lahore, Pakistan
  • Huzaefa Sheikh Hamdard University, Islamabad, Pakistan/Riphah International University, Al-Meezan Campus, Rawalpindi, Pakistan




Beetroot, Betalain, LDL, C-Reactive Protein, TNF Alpha, NAFLD


Pakistan has the lowest rate (13.5%) of “Non-alcoholic fatty liver disease” NAFLD meanwhile prevalence of NAFLD is 47% nationwide in Pakistan. However, betaine plays a considerable positive role in alleviating hepatic cell lipid accumulation by pacing the oxidation of fatty acid, the TCA cycle, and glycolytic processes in the liver. Objectives: To evaluate the comparative effect of conventional treatment with beetroot supplementation on inflammatory markers and the efficacy of betalain supplementation among patients with NAFLD. Methods: A total participant of 34 patients with NAFLD grade 1 older than 18 years were enrolled for the 12 weeks of the study, and participants were allocated into two groups, 17 each. In this study total of 45.6% of participants were male, and 54.4% were female. The groups G0 was considered as a control group with no supplementation, and group G1 where conventional treatment and supplementation were advised to participants. The 5g beetroot powder supplements in tablet form were given to the participants daily for 12 weeks. Results: The mean age group of NAFLD patients enrolled in the study was 43.042±3.79 years in G0, and in G1, it was 43.7±5.211. The mean BMI was 25.95 and 26 kg/m2 in both groups. There was a substantial (P<0.05) fall in cholesterol and low-density lipoprotein (LDL) levels. High-density lipoprotein levels were also improved. On the other hand, C-reactive protein and TNF alpha levels were also. Conclusions: The current study concluded that beetroot supplementation could improve NAFLD patients' inflammation and lipid profile.   


Wong SW and Chan WK. Epidemiology of non-alcoholic fatty liver disease in Asia. Indian Journal of Gastroenterology. 2020 Feb; 39: 1-8. doi: 10.1007/s12664-020-01018-x. DOI: https://doi.org/10.1007/s12664-020-01018-x

Mundi MS, Velapati S, Patel J, Kellogg TA, Abu Dayyeh BK, Hurt RT. Evolution of NAFLD and its management. Nutrition in Clinical Practice. 2020 Feb; 35(1): 72-84. doi: 10.1002/ncp.10449. DOI: https://doi.org/10.1002/ncp.10449

Mantovani A and Dalbeni A. Treatments for NAFLD: state of art. International Journal of Molecular Sciences. 2021 Feb; 22(5): 2350. doi: 10.3390/ijms22052350. DOI: https://doi.org/10.3390/ijms22052350

Palladini G, Di Pasqua LG, Berardo C, Siciliano V, Richelmi P, Perlini S, et al. Animal models of steatosis (NAFLD) and steatohepatitis (NASH) exhibit hepatic lobe-specific gelatinases activity and oxidative stress. Canadian Journal of Gastroenterology and Hepatology. 2019 Feb; 3(4); 201-9. doi: 10.1155/2019/5413461. DOI: https://doi.org/10.1155/2019/5413461

Ghevariya V, Sandar N, Patel K, Ghevariya N, Shah R, Aron J, et al. Knowing what’s out there: awareness of non-alcoholic fatty liver disease. Frontiers in Medicine. 2014 Mar; 24: 1. doi: 10.3389/fmed.2014.00004. DOI: https://doi.org/10.3389/fmed.2014.00004

Xu L, Huang D, Hu Q, Wu J, Wang Y, Feng J. Betaine alleviates hepatic lipid accumulation via enhancing hepatic lipid export and fatty acid oxidation in rats fed with a high-fat diet. British Journal of Nutrition. 2015 Jun; 113(12): 1835-43. doi: 10.1017/S0007114515001130. DOI: https://doi.org/10.1017/S0007114515001130

Parkash O and Hamid S. Are we ready for a new epidemic of under recognized liver disease in South Asia especially in Pakistan? Non alcoholic fatty liver disease. Journal of Pakistan Medical Association. 2013 Feb; 63(1): 95.

Shah AS, Khan S, Rahim H, Chishti KA, Khan AG. Prevalence of non alcoholic fatty liver and Nonalcoholic Steatohepatitis in Peshawar Cantonment, Khyber Pakhtunkhwa, Pakistan. Pakistan Journal of Pharmaceutical Sciences. 2018 Jan; 31(1): 193-9.

Hadipour E, Taleghani A, Tayarani‐Najaran N, Tayarani‐Najaran Z. Biological effects of red beetroot and betalains: A review. Phytotherapy Research. 2020 Aug; 34(8): 1847-67. doi: 10.1002/ptr.6653. DOI: https://doi.org/10.1002/ptr.6653

Fu Y, Shi J, Xie SY, Zhang TY, Soladoye OP, Aluko RE. Red beetroot betalains: Perspectives on extraction, processing, and potential health benefits. Journal of Agricultural and Food Chemistry. 2020 Oct; 68(42): 11595-611. doi: 10.1021/acs.jafc.0c04241. DOI: https://doi.org/10.1021/acs.jafc.0c04241

Huang T, Yu J, Luo Z, Yu L, Liu S, Wang P, et al. Translatome analysis reveals the regulatory role of betaine in high fat diet (HFD)-induced hepatic steatosis. Biochemical and Biophysical Research Communications. 2021 Oct; 57(5): 20-7. doi: 10.1016/j.bbrc.2021.08.058. DOI: https://doi.org/10.1016/j.bbrc.2021.08.058

Fan C, Hu H, Huang X, Su D, Huang F, Zhuo Z, et al. Betaine Supplementation Causes an Increase in Fatty Acid Oxidation and Carbohydrate Metabolism in Livers of Mice Fed a High-Fat Diet: A Proteomic Analysis of Foods. 2022 Mar; 11(6): 881. doi: 10.3390/foods11060881. DOI: https://doi.org/10.3390/foods11060881

Butt MS, Randhawa MA, Shahid M. Hepatoprotective effects of red beetroot‐based beverages against CCl4‐induced hepatic stress in Sprague Dawley rats. Journal of Food Biochemistry. 2019 Dec; 43(12): 13-57. doi: 10.1111/jfbc.13057. DOI: https://doi.org/10.1111/jfbc.13057

Chen W, Xu M, Xu M, Wang Y, Zou Q, Xie S, et al. Effects of betaine on non-alcoholic liver disease. Nutrition Research Reviews. 2022 Jun; 35(1): 28-38. doi: 10.1017/S0954422421000056. DOI: https://doi.org/10.1017/S0954422421000056

Martinez RM, Longhi-Balbinot DT, Zarpelon AC, Staurengo-Ferrari L, Baracat MM, Georgetti SR, et al. Anti-inflammatory activity of betalain-rich dye of Beta vulgaris: effect on edema, leukocyte recruitment, superoxide anion and cytokine production. Archives of Pharmacal Research. 2015 Apr; 38: 494-504. doi: 10.1007/s12272-014-0473-7. DOI: https://doi.org/10.1007/s12272-014-0473-7

Krajka-Kuźniak V, Szaefer H, Ignatowicz E, Adamska T, Baer-Dubowska W. Beetroot juice protects against N-nitrosodiethylamine-induced liver injury in rats. Food and Chemical Toxicology. 2012 Jun; 50(6): 2027-33. doi: 10.1016/j.fct.2012.03.062. DOI: https://doi.org/10.1016/j.fct.2012.03.062

Kawakami S, Han KH, Nakamura Y, Shimada KI, Kitano T, Aritsuka T, et al. Effects of dietary supplementation with betaine on a nonalcoholic steatohepatitis (NASH) mouse model. Journal of Nutritional Science and Vitaminology. 2012 May; 58(5): 371-5. doi: 10.3177/jnsv.58.371. DOI: https://doi.org/10.3177/jnsv.58.371

Srivastava S, Siddiqi Z, Singh T, Bala L. Beetroot supplementation on non-alcoholic fatty liver disease patients. Current Research in Nutrition and Food Science Journal. 2019 Apr; 7(1): 96-101. doi: 10.12944/CRNFSJ.7.1.10. DOI: https://doi.org/10.12944/CRNFSJ.7.1.10

Afzali N, Ebadi SS, Afzali H, Sharif MR, Vazirian M, Ebadi SA, et al. Effect of beta vulgaris extract on liver enzymes in patients with non-alcoholic fatty liver disease: a randomized clinical trial. Hepatitis Monthly. 2020 Jul; 20(7): 102125. doi: 10.5812/hepatmon.102125. DOI: https://doi.org/10.5812/hepatmon.102125

Vulić JJ, Ćebović TN, Čanadanović-Brunet JM, Ćetković GS, Čanadanović VM, Djilas SM, et al. In vivo and in vitro antioxidant effects of beetroot pomace extracts. Journal of Functional Foods. 2014 Jan; 6: 168-75. doi: 10.1016/j.jff.2013.10.003. DOI: https://doi.org/10.1016/j.jff.2013.10.003

Darabi Z, Darand M, Yari Z, Agah S. Effects of betalain on Non-alcoholic Fatty Liver Disease: A Randomized-controlled Clinical Trial. Iranian Journal of Nutrition Sciences & Food Technology. 2019 Apr; 14(3): 1-9.



DOI: 10.54393/df.v4i02.99
Published: 2023-09-30

How to Cite

Arshad, M., Jaffar, M., Khan, S., Akram, I., Us Sabah, N., Saher, S., & Sheikh, H. (2023). Hepatoprotective Effects of Betalain Supplementation among Patients with Non-Alcoholic Fatty Liver Disease : Hepatoprotective Effects of Betalain Supplementation. DIET FACTOR (Journal of Nutritional and Food Sciences), 4(02), 34–39. https://doi.org/10.54393/df.v4i02.99


Most read articles by the same author(s)