Duseja A, Acharya SK, Mehta M, Chhabra S, Rana S, Das A, Dattagupta S, Dhiman RK, Chawla YK. High potency multistrain probiotic improves liver histology in non-alcoholic fatty liver disease (NAFLD): a randomised, double-blind, proof of concept study. BMJ open Gastroenterol. 2019;6:e000315.

Article  PubMed  PubMed Central  Google Scholar 

Meroni M, Longo M, Dongiovanni P. The role of probiotics in nonalcoholic fatty liver disease: a new insight into therapeutic strategies. Nutrients. 2019;11:2642.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Araújo AR, Rosso N, Bedogni G, Tiribelli C, Bellentani S. Global epidemiology of non-alcoholic fatty liver disease/non‐alcoholic steatohepatitis: what we need in the future. Liver Int. 2018;38:47–51.

Article  PubMed  Google Scholar 

Moghaddasifar I, Lankarani K, Moosazadeh M, Afshari M, Ghaemi A, Aliramezany M, Gharebagh RA, Malary M. Prevalence of non-alcoholic fatty liver disease and its related factors in Iran. Int J Organ Transplantation Med. 2016;7:149.

CAS  Google Scholar 

Amini-Salehi E, Hassanipour S, Joukar F, Daryagasht AA, Khosousi M-J, Aleali MS, Ansar MM, Heidarzad F, Abdzadeh E, Vakilpour A. Risk factors of non-alcoholic fatty liver disease in the Iranian adult population: a systematic review and meta-analysis. Hepat Monthly 2023, 23.

Sohrabi M, Amirkalali B, Gholami A, Hajjar M, Sohrabi M, NasiriToosi M, Keyvani H, Zamani F, Doustmohammadian A. The association of food insecurity with non-alcoholic fatty liver disease (NAFLD) in a sample of Iranian adults: a path analysis of a cross-sectional survey. BMC Res Notes. 2024;17:272.

Article  PubMed  PubMed Central  Google Scholar 

Cotter TG, Rinella M. Nonalcoholic fatty liver disease 2020: the state of the disease. Gastroenterology. 2020;158:1851–64.

Article  CAS  PubMed  Google Scholar 

Shen F, Zheng R-D, Sun X-Q, Ding W-J, Wang X-Y, Fan J-G. Gut microbiota dysbiosis in patients with non-alcoholic fatty liver disease. Hepatobiliary Pancreat Dis Int. 2017;16:375–81.

Article  CAS  PubMed  Google Scholar 

Buss C, Valle-Tovo C, Miozzo S, de Mattos AA. Probiotics and synbiotics may improve liver aminotransferases levels in non-alcoholic fatty liver disease patients. Ann Hepatol. 2014;13:482–8.

Article  PubMed  Google Scholar 

Nabavi S, Rafraf M, Somi M, Homayouni-Rad A, Asghari-Jafarabadi M. Effects of probiotic yogurt consumption on metabolic factors in individuals with nonalcoholic fatty liver disease. J Dairy Sci. 2014;97:7386–93.

Article  CAS  PubMed  Google Scholar 

Famouri F, Shariat Z, Hashemipour M, Keikha M, Kelishadi R. Effects of probiotics on nonalcoholic fatty liver disease in obese children and adolescents. J Pediatr Gastroenterol Nutr. 2017;64:413–7.

Article  CAS  PubMed  Google Scholar 

Javadi L, Khoshbaten M, Safaiyan A, Ghavami M, Abbasi MM, Gargari BP. Pro-and prebiotic effects on oxidative stress and inflammatory markers in non-alcoholic fatty liver disease. Asia Pac J Clin Nutr. 2018;27:1031–9.

CAS  PubMed  Google Scholar 

Chen H, Tsai T, Tsai Y, Liao J, Yen C, Chen C. Kefir peptides prevent high-fructose corn syrup-induced non-alcoholic fatty liver disease in a murine model by modulation of inflammation and the JAK2 signaling pathway. Nutr Diabetes. 2016;6:e237–237.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Chen H, Tung Y, Tsai C, Lai C, Lai Z, Tsai H, Lin Y, Wang C-H, Chen C. Kefir improves fatty liver syndrome by inhibiting the lipogenesis pathway in leptin-deficient ob/ob knockout mice. Int J Obes. 2014;38:1172–9.

Article  CAS  Google Scholar 

Witthuhn R, Schoeman T, Britz T. Characterisation of the microbial population at different stages of kefir production and kefir grain mass cultivation. Int Dairy J. 2005;15:383–9.

Article  CAS  Google Scholar 

Arslan S. A review: chemical, microbiological and nutritional characteristics of kefir. CyTA-Journal Food. 2015;13:340–5.

Article  CAS  Google Scholar 

Mohsenpour MA, Mohammadi F, Razmjooei N, Eftekhari MH, Hejazi N. Milk kefir drink may not reduce depression in patients with non-alcoholic fatty liver disease: secondary outcome analysis of a randomized, single-blinded, controlled clinical trial. BMC Nutr. 2023;9:1–9.

Article  Google Scholar 

Kim DH, Jeong D, Kang IB, Kim H, Song KY, Seo KH. Dual function of Lactobacillus kefiri DH5 in preventing high-fat‐diet‐induced obesity: direct reduction of cholesterol and upregulation of PPAR‐α in adipose tissue. Mol Nutr Food Res. 2017;61:1700252.

Article  Google Scholar 

Özcan H, Oskay Ü, Bodur AF. Effects of kefir on quality of life and sleep disturbances in postmenopausal women. Holist Nurs Pract. 2019;33:207–13.

Article  PubMed  Google Scholar 

Sadrzadeh-Yeganeh H, Elmadfa I, Djazayery A, Jalali M, Heshmat R, Chamary M. The effects of probiotic and conventional yoghurt on lipid profile in women. Br J Nutr. 2010;103:1778–83.

Article  CAS  PubMed  Google Scholar 

Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972;18:499–502.

Article  CAS  PubMed  Google Scholar 

Zal F, Mostafavi-Pour Z, Vessal M. Comparison of the effects of vitamin e and/or quercetin in attenuating chronic cyclosporine a‐induced nephrotoxicity in male rats. Clin Exp Pharmacol Physiol. 2007;34:720–4.

Article  CAS  PubMed  Google Scholar 

Reaven G. What do we learn from measurements of HOMA-IR? Diabetologia. 2013;56:1867–8.

AL-Shemmari IGM, Hassan AH. Evaluation of antidiabetic and antihyperlipidimic activity of Kefir in alloxan induced diabetes mellitus rat. Sci J Med Res. 2018;2:83–6.

Google Scholar 

Abd-Alwahab WI, Al-Dulaimi FK. Effects of kefir as a probiotic on total lipid profile and activity of aspartate amino transferase and alanine amino transferase in serum of human. Biochem Cell Arch. 2018;18:411–4.

Google Scholar 

Kim D-H, Kim H, Jeong D, Kang I-B, Chon J-W, Kim H-S, Song K-Y, Seo K-H. Kefir alleviates obesity and hepatic steatosis in high-fat diet-fed mice by modulation of gut microbiota and mycobiota: targeted and untargeted community analysis with correlation of biomarkers. J Nutr Biochem. 2017;44:35–43.

Article  CAS  PubMed  Google Scholar 

da Silva Ghizi AC, de Almeida Silva M, de Andrade Moraes FS, da Silva CL, Endringer DC, Scherer R, Lenz D, de Lima EM, Brasil GA, Maia JF. Kefir improves blood parameters and reduces cardiovascular risks in patients with metabolic syndrome. PharmaNutrition. 2021;16:100266.

Article  Google Scholar 

Bellikci-Koyu E, Sarer-Yurekli BP, Akyon Y, Aydin-Kose F, Karagozlu C, Ozgen AG, Brinkmann A, Nitsche A, Ergunay K, Yilmaz E. Effects of regular kefir consumption on gut microbiota in patients with metabolic syndrome: a parallel-group, randomized, controlled study. Nutrients. 2019;11:2089.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Kersten S. Integrated physiology and systems biology of PPARα. Mol Metabolism. 2014;3:354–71.

Article  CAS  Google Scholar 

Park HS, Park JY, Yu R. Relationship of obesity and visceral adiposity with serum concentrations of CRP, TNF-α and IL-6. Diabetes Res Clin Pract. 2005;69:29–35.

Article  CAS  PubMed  Google Scholar 

Younce C, Kolattukudy P. MCP-1 induced protein promotes adipogenesis via oxidative stress, endoplasmic reticulum stress and autophagy. Cell Physiol Biochem. 2012;30:307–20.

Article  CAS  PubMed  Google Scholar 

Kiessling G, Schneider J, Jahreis G. Long-term consumption of fermented dairy products over 6 months increases HDL cholesterol. Eur J Clin Nutr. 2002;56:843–9.

Article  CAS  PubMed  Google Scholar 

Vesper H, Schmelz E-M, Nikolova-Karakashian MN, Dillehay DL, Lynch DV, Merrill AH Jr. Sphingolipids in food and the emerging importance of sphingolipids to nutrition. J Nutr. 1999;129:1239–50.

Article  CAS  PubMed  Google Scholar 

Mensink RP, Zock PL, Kester AD, Katan MB. Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: a meta-analysis of 60 controlled trials. Am J Clin Nutr. 2003;77:1146–55.

Article  CAS  PubMed  Google Scholar 

Temme E, Mensink RP, Hornstra G. Comparison of the effects of diets enriched in lauric, palmitic, or oleic acids on serum lipids and lipoproteins in healthy women and men. Am J Clin Nutr. 1996;63:897–903.