Aliment Pharmacol Ther31, 679–692


Background  Non-alcoholic fatty liver disease affects 10–35% of the adult population worldwide; there is no consensus on its treatment. Omega-3 fatty acids have proven benefits for hyperlipidaemia and cardiovascular disease, and have recently been suggested as a treatment for non-alcoholic fatty liver disease.

Aims  To review the evidence base for omega-3 fatty acids in non-alcoholic fatty liver disease and critically appraise the literature relating to human trials.

Methods  A Medline and PubMed search was performed to identify relevant literature using search terms ‘omega-3’, ‘N-3 PUFA’, ‘eicosapentaenoic acid’, ‘docosahexaenoic acid’, ‘non-alcoholic fatty liver disease’ and ‘NAFLD’.

Results  Omega-3 fatty acids are important regulators of hepatic gene transcription. Animal studies demonstrate that they reduce hepatic steatosis, improve insulin sensitivity and reduce markers of inflammation. Clinical trials in human subjects generally confirm these findings, but have significant design inadequacies.

Conclusions  Omega-3 fatty acids are a promising treatment for non-alcoholic fatty liver disease which require to be tested in randomized placebo-controlled trials.