Non‐alcoholic fatty liver disease (NAFLD) is an accumulation of fat in the liver of people who have no history of significant alcohol consumption, use of medicines, disease such as hepatitis C virus infection, or other conditions such as starvation that can damage the liver. It takes follow‐up of 8 to 28 years to detect differences in mortality between people with NAFLD and the general population.

Therefore, it is unlikely that differences in clinical outcomes can be noted in trials with less than 5 to 10 years of follow‐up. Participants were given different treatments including various vitamins and other nutritional supplements. In the presence of inconsistency (model fit better with inconsistency models than consistency model, 95% CrI of 'between‐design' variance did not overlap 0, and 95% confidence intervals of inconsistency factor did not overlap 0), we planned to assess whether inconsistency was due to clinical or methodological heterogeneity by performing separate analyses for each of the different subgroups mentioned in the subgroup analysis and in the investigation of heterogeneity section or by performing limited network meta‐analysis of a more compatible subset of trials when possible. With this systematic review and network meta‐analysis, we aim to provide the best level of evidence for benefits and harms of nutritional supplementation for people with NAFLD. For illustration of absolute measures, we used weighted median control group proportion or mean ( Edgeworth 1887).This is because of multi‐arm trials and trials not involving 'no active intervention' as the control group. If the data were likely to be normally distributed, we used the median for meta‐analysis when the mean was not available; otherwise, we planned to simply provide a median and an interquartile range of the difference in medians. We used a normal distribution with large variance (10,000) for treatment effect priors (vague or flat priors) centred at no effect. Risk of hepatocellular carcinoma (HCC) is increased in people with NASH cirrhosis compared to people with NAFLD without cirrhosis and compared to the general population: approximately 2% to 13% of people with NASH cirrhosis develop HCC in three to seven years ( White 2012).

It is a combination that includes choline bitartrate, inositol, sodium sulfate, artichoke extract, taurine, apple extract and L-methionine. Green colour indicates that intervention A is better than B, and red colour indicates that intervention A is worse than B.HepaGuard Forte is a specialist combination including Choline Bitartrate, Inositol, Sodium Sulphate, Artichoke Extract, L-Taurine, Apple Extract and L-Methionine. HepaGuard Forte is a specialist combination product designed to provide nutritional support to the liver.

During this follow‐up period, clinical events related to NAFLD such as mortality, liver cirrhosis, liver decompensation, liver transplantation, hepatocellular carcinoma, and liver‐related mortality were sparse. To find out if any form of nutritional supplementation decreases effects of non‐alcohol‐related fatty liver disease on lifespan, health‐related quality of life, chronic liver disease, and its complications, and whether nutritional supplementation causes any harm. gov (n = 393), World Health Organization (WHO) Trials register (n = 19), FDA (n = 137), and EMA (n = 131). If there were post‐randomisation dropouts, we re‐analysed the results using best‐worst case scenario and worst‐best case scenario analyses as sensitivity analyses whenever possible.A total of 52 trials (3372 participants) reported mortality at maximal follow‐up of 2 to 28 months ( Wang 2008; Gomez 2009; Sanyal 2010; Vajro 2011; Malaguarnera 2012; Illnait 2013; Magosso 2013; Nobili 2013; Shavakhi 2013; Wong 2013a; Chachay 2014; Foroughi 2014; Sanyal 2014; Scorletti 2014; Somi 2014; Aller 2015; Bae 2015; Chen 2015a; Dasarathy 2015; Zhang 2015; Ferolla 2016; Heeboll 2016; Li 2016; Nabavi 2016; Yari 2016; Chan 2017; Famouri 2017a; Hussain 2017; Manzhalii 2017; Sakpal 2017; Schattenberg 2017; Shahmohammadi 2017; Bakhshimoghaddam 2018; Eriksson 2018; Kobyliak 2018; Lewis 2018; Oscarsson 2018; Taghvaei 2018; Zamani 2018; Bril 2019; Cheraghpour 2019; Duseja 2019; Jazayeri‐Tehrani 2019; Abhari 2020; Afzali 2020; Boonyagard 2020; Mansour 2020; Poparn 2020; Scorletti 2020; Yari 2020; Soleimani 2021; EUCTR 2008‐008275‐34‐GB). Nutritional supplementation has the potential to result in resolution or decreased progression of fatty liver disease.