Effects of Hydro-Ethanolic Extract of Portulaca oleracea (Purslane) on Depression, Anxiety, and Stress Symptoms in Patients With Non-Alcoholic Fatty Liver Disease: A Randomized Double-Blind Controlled Trial.

Abstract

Non-alcoholic fatty liver disease (NAFLD) is a prevalent chronic liver condition globally. Managing anxiety, depression, and stress is crucial in NAFLD care. Preliminary hypotheses suggest that Portulaca oleracea extract may improve mental health by modulating stress-related hormones. The high flavonoid content and antioxidant characteristics may diminish inflammation and oxidative stress, which are principal factors contributing to both neuropsychological disorders and NAFLD-related mental health issues. This study assessed changes in depression, anxiety, and stress levels using the DASS-21 scale in NAFLD patients after 8 weeks of supplementation with Portulaca oleracea extract. In a randomized clinical trial, 70 patients were divided into two groups: an intervention group ( n = 35) and a placebo group ( n = 35). The intervention group was administered 700 mg of P. oleracea extract daily for 8 weeks, whereas the control group received a placebo. Each participant received a calorie-restricted diet and directives for physical activity. Mental well-being was assessed with the Depression, Anxiety, and Stress Scale (DASS-21). Dietary consumption was documented by 3-day recalls both before and following the intervention. The average age of the participants was 44.01 ± 8.6 years, with 34 (48.6%) being women. There were significant differences in weight and waist circumference in the intervention group as opposed to the group that received a placebo ( p < 0.001). Depression and stress scores in the intervention group changed significantly compared to those in the study's placebo group, even after controlling for possible causes ( p = 0.002, 0.05, respectively). However, before and after controlling for variables including weight and physical activity, there were no appreciable variations in the two groups' anxiety scores ( p = 0.1 and 0.12, respectively). Our findings suggest that an 8-week supplementation with Portulaca oleracea can help alleviate depression and stress symptoms in patients with NAFLD. Trial Registration: Clinical trial registration code: IRCT20211116053073N1.