Project results: the role of bile acids and dietary fibre in non-alcoholic fatty liver disease

Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease, with a global overall prevalence of 25-30%. Currently, there is no specific treatment for NAFLD. Therefore, efforts are being made by many researchers to develop a successful treatment. One of these efforts focuses on understanding the liver–gut axis and especially the role of bile acids in the progression of NAFLD. Soluble fibres like oat β-glucans bind bile acids and have been proposed to alter intestinal microbiota composition, thereby affecting metabolic parameters and liver health.

In the past 4 years (2018-2022), the Dietary modulation of intestinal microbiota as trigger of liver health: role of bile acids (Di-Mi-Liv) project investigated whether certain dietary fibres from oats have a positive effect on the functional role of the intestinal microbiome in bile acid metabolism. Researchers from Austria, Germany and Sweden were involved in the project. Two additional collaborators from Germany participated with their own resources. Together, the partners formed a multidisciplinary team combining the expertise of leading hepatologists, bile acid experts and nutritionists. The project was cofunded by the European Commission within the HDHL-INTIMIC cofunded call.


The Di-Mi-Liv project aimed to determine whether the interaction of bile acids and intestinal microbiota is critical for the initiating and progressing stages of NAFLD. In addition, through a combination of research in humans and mice, the project aimed to understand how fibres, particularly those found in oats, can affect the development and treatment of NAFLD.


The study found that people with NAFLD typically do not consume enough fibre. Additionally, the research suggests that a type of fibre called ‘oat β-glucans’ may have protective effects against metabolic diseases. However, for people who already have NAFLD, it appears that other fibres like spelt bran may be more beneficial. In general, the researchers suggest that fibre-rich flake mixes may be a suitable addition to the human diet to increase overall dietary fibre intake, which has multiple health benefits. Furthermore, results of the study also suggest that different fibres may impact human health differently and that the effects may be related to the overall health status of the individual. More research is needed to understand how different fibres and sources of fibre affect health in people with NAFLD and healthy individuals.

Although the project results may not directly impact NAFLD treatment, the findings can be used to prevent metabolic diseases and improve treatments for NAFLD in the future. All in all, the project expanded knowledge on NAFLD, bile acids and intestinal microbiota with oat β-glucans, and provided more evidence for health claims on oat β-glucans and products containing these fibres.

In total, 11 projects were funded within the HDHL-INTIMIC cofunded call. In the coming weeks, the results of these projects will be shared on our website. Stay tuned!

More information