Resveratrol, a natural polyphenol found in grapes and some berries, and its conjugates (such as glucuronides and sulfates formed in the body or included in supplements) have been investigated for potential benefits in non-alcoholic fatty liver disease (NAFLD). Preclinical studies in animal models consistently demonstrate that resveratrol can reduce liver fat accumulation, improve insulin sensitivity, and decrease oxidative stress and inflammation—key factors in fatty liver disease. These effects appear to be mediated by the activation of SIRT1, AMP-activated protein kinase (AMPK), and modulation of lipid metabolism pathways.

Human studies are more limited and less conclusive. Several small clinical trials have shown that oral resveratrol supplementation (typically 300-500 mg/day for 8-12 weeks) may reduce liver enzymes, hepatic steatosis, and markers of inflammation in NAFLD patients. However, other trials have found minimal or no significant effects, and the bioavailability of resveratrol and its conjugates remains a concern. Systematic reviews and meta-analyses conclude that while preliminary results are promising, larger and longer-term human studies are needed to confirm efficacy, optimal dosing, and safety.

In summary, there is scientific rationale and some early human evidence supporting the use of resveratrol and its conjugates in fatty liver disease, but the overall strength of evidence is moderate (rated 3/5), and further validation is required before widespread clinical adoption.