Researchers tested whether a natural compound called ellagic acid could help people with fatty liver disease. Sixty patients took either ellagic acid supplements or a placebo while following a reduced-calorie diet for 8 weeks. The group taking ellagic acid showed significant improvements in liver fat content, liver function tests, blood sugar levels, and cholesterol. This suggests that ellagic acid, combined with healthy eating, may be a helpful addition to current fatty liver disease treatments, though more research is needed to confirm these results.

The Quick Take

  • What they studied: Whether taking ellagic acid (a natural compound found in berries and pomegranates) could help reduce fat buildup in the liver and improve overall health markers in people with fatty liver disease.
  • Who participated: 60 adults diagnosed with metabolic dysfunction-associated steatotic liver disease (a condition where too much fat builds up in the liver). Participants were randomly split into two groups: one received ellagic acid supplements and the other received a placebo (fake pill).
  • Key finding: After 8 weeks, people taking ellagic acid had significantly more reduction in liver fat compared to the placebo group. They also showed improvements in liver function tests, blood sugar control, cholesterol levels, and markers of inflammation in their bodies.
  • What it means for you: Ellagic acid appears to be a promising natural supplement that, when combined with eating fewer calories, may help improve fatty liver disease. However, this is one study with a small group, so talk to your doctor before starting any new supplement. More research is needed to confirm these findings work for everyone.

The Research Details

This was a randomized controlled trial, which is considered one of the strongest types of medical research. Researchers divided 60 people with fatty liver disease into two equal groups. One group received 200 mg of ellagic acid daily, while the other group received a placebo (a pill with no active ingredient). Neither the participants nor the researchers knew who was getting the real supplement—this is called “double-blind” and helps prevent bias. All participants also followed a reduced-calorie diet for 8 weeks. The researchers measured various health markers at the beginning and end of the study to see if ellagic acid made a difference.

Ellagic acid is a natural polyphenol, which is a type of plant compound with antioxidant and anti-inflammatory properties. These properties may help reduce damage and swelling in the liver. The researchers chose this compound because fatty liver disease involves multiple problems in the body—including inflammation, oxidative stress, and metabolic dysfunction—and ellagic acid may address several of these issues at once.

The study measured several important outcomes: the amount of fat in the liver, liver stiffness (which indicates liver damage), liver enzyme levels, blood sugar, cholesterol levels, inflammation markers, and body measurements like weight and waist circumference.

The randomized, double-blind design is important because it reduces the chance that results are influenced by expectations or bias. By having participants follow a reduced-calorie diet in both groups, researchers could see whether ellagic acid provided additional benefits beyond just eating less. This helps determine if the supplement itself is truly helpful. The 8-week timeframe is long enough to see meaningful changes in liver health but short enough to maintain good study compliance.

Strengths of this study include its randomized, double-blind design and the use of multiple health measurements to assess outcomes. The study was registered in a clinical trial database, which increases transparency. However, the sample size of 60 people is relatively small, and the study lasted only 8 weeks. The results are statistically significant (meaning unlikely to be due to chance), but we don’t know how long the benefits last or whether they work for different populations. The study doesn’t mention potential side effects or safety concerns with long-term use.

What the Results Show

The main finding was that ellagic acid significantly reduced liver fat content compared to placebo. Participants taking ellagic acid showed a mean reduction of 0.23 units in their hepatic fat index, which was statistically significant (P < 0.001, meaning there’s less than a 0.1% chance this happened by random chance).

Beyond liver fat, the ellagic acid group showed improvements in liver stiffness, which decreased by 0.47 kPa. This is important because liver stiffness indicates scarring and damage—less stiffness suggests the liver is healthier. Liver enzyme levels (alanine transaminase and aspartate transaminase) also decreased significantly, indicating less liver inflammation and damage.

Metabolic improvements were also notable. Fasting blood sugar dropped by 6.78 mg/dL in the ellagic acid group compared to placebo. Triglycerides (a type of fat in the blood) decreased by 42.65 mg/dL, and LDL cholesterol (the “bad” cholesterol) decreased by 14.63 mg/dL. Interestingly, HDL cholesterol (the “good” cholesterol) increased by 3.38 mg/dL.

Inflammation markers also improved significantly. High-sensitivity C-reactive protein, which measures inflammation throughout the body, decreased by 0.81 mg/L in the ellagic acid group. By week 8, participants also showed improvements in body measurements like weight and waist circumference.

All secondary outcomes showed improvements in the ellagic acid group compared to placebo. The consistency of improvements across multiple health markers—liver function, blood sugar control, cholesterol levels, inflammation, and body composition—suggests that ellagic acid may work through multiple beneficial pathways in the body. This multi-system improvement is particularly encouraging because fatty liver disease involves problems in several body systems simultaneously.

Fatty liver disease is a growing health problem with limited effective treatments. Most current approaches focus on lifestyle changes like diet and exercise, with few medications specifically approved for this condition. This study adds to emerging research on natural compounds that may help. Previous studies have shown that polyphenols (the class of compounds ellagic acid belongs to) have antioxidant and anti-inflammatory effects, but this is one of the first studies specifically testing ellagic acid in fatty liver disease patients. The results align with the theoretical understanding of how ellagic acid should work, making the findings more credible.

Several important limitations should be considered. First, the study included only 60 people, which is a relatively small sample size. Results from small studies may not apply to larger, more diverse populations. Second, the study lasted only 8 weeks, so we don’t know if benefits continue, decrease, or disappear over longer periods. Third, the study doesn’t provide information about potential side effects or safety concerns with long-term use. Fourth, we don’t know if results would be similar for people with different ages, body types, or severity of liver disease. Finally, all participants also followed a reduced-calorie diet, so we can’t determine how much benefit comes from ellagic acid alone versus the diet. The study also doesn’t compare ellagic acid to other treatments currently used for fatty liver disease.

The Bottom Line

Based on this study, ellagic acid combined with a reduced-calorie diet appears to be a promising addition to fatty liver disease treatment (moderate confidence level). However, this is one study with a small group and short duration. Before starting ellagic acid supplements, consult with your doctor, especially if you take medications or have other health conditions. If your doctor approves, ellagic acid may be worth trying as part of a comprehensive approach that includes healthy eating and regular physical activity. Don’t rely on supplements alone—lifestyle changes remain the foundation of fatty liver disease management.

People diagnosed with fatty liver disease (MASLD) who are looking for additional treatment options should pay attention to this research. This is particularly relevant for people who haven’t responded well to diet and exercise alone. However, this study was conducted in adults, so it’s unclear if results apply to children or teenagers. People with severe liver disease, pregnant women, and those taking blood thinners or other medications should definitely consult their doctor before trying ellagic acid. If you have fatty liver disease, discuss this research with your healthcare provider to determine if it’s appropriate for your situation.

In this study, improvements appeared within 8 weeks. However, this doesn’t mean everyone will see results this quickly. Some people may need 8-12 weeks to notice changes in how they feel or in their lab results. It’s important to have realistic expectations—supplements work gradually and are most effective when combined with healthy eating and regular exercise. You should plan to give any new supplement at least 8-12 weeks before deciding whether it’s working for you.

Want to Apply This Research?

  • Track daily ellagic acid supplementation (yes/no) alongside weekly measurements of waist circumference and monthly liver function test results if available. This creates a clear record of supplement adherence and correlates it with measurable health improvements.
  • Users can set a daily reminder to take ellagic acid at the same time each day (for example, with breakfast) and log it in the app. Simultaneously, they can track their reduced-calorie diet by logging meals and monitoring portion sizes. The app can show how supplement adherence correlates with progress in weight, energy levels, and other health markers.
  • Establish a baseline by recording current weight, waist circumference, and any available liver function test results. Then track these measurements weekly or monthly. Create a simple dashboard showing progress over 8-12 weeks. Include reminders to schedule follow-up doctor visits and lab work to monitor liver function tests (ALT, AST) and other metabolic markers. This long-term tracking helps determine if ellagic acid is providing sustained benefits for your individual situation.

This research summary is for educational purposes only and should not replace professional medical advice. Fatty liver disease is a serious condition that requires medical supervision. Before starting ellagic acid supplements or making any changes to your treatment plan, consult with your doctor or hepatologist. This is especially important if you take medications, have other health conditions, are pregnant or breastfeeding, or have severe liver disease. While this study shows promising results, it is one trial with a small group and short duration. Individual results may vary, and more research is needed to confirm these findings. Your healthcare provider can help determine if ellagic acid is appropriate for your specific situation and can monitor your progress with appropriate lab tests.