By Kim Ross, DCN, CNS, LDN, IFMCP⁺

Polyphenols in Practice: Targeted Strategies to Support Liver Health

1. Introduction
2. The Liver-Metabolic Health Connection
3. Polyphenols: Bergamot & Artichoke Extracts in Supporting Liver Health: A Summary of the Evidence
4. Pure Encapsulations Nutrient Solutions
5. Conclusion
6. Resources

Introduction to Liver Health

The liver is a central metabolic hub, responsible for nutrient processing, energy regulation and detoxification processes. With functions such as glycogen storage, lipid metabolism, bile production and clearance of endogenous and exogenous toxins, it plays a critical role in maintaining homeostasis. It also regulates circulating glucose and lipid levels, synthesizes essential proteins and processes hormones and cytokine mediators.¹

Given its pivotal role, changes to hepatic function have systemic consequences. When fat accumulation occurs within hepatocytes, it can lead to altered metabolic health and disrupt normal metabolic processes.²

Prevalence of Altered Metabolic Health and Fat Accumulation in the Liver³

The most vulnerable and at-risk populations include those who carry extra weight, have alterations in glucose and/or insulin regulation and cardiovascular concerns.

The Liver–Metabolic Health Connection

Body Fat Distribution

The liver is a central regulator of energy balance, integrating signals from dietary intake, adipose tissue and peripheral organs to maintain homeostasis. In states of energy excess, these finely tuned pathways become altered, contributing directly to systemic metabolic changes.

Central adiposity, measured via waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR), consists of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT).⁵

Visceral adiposity is of particular concern, since this becomes metabolically active tissue that drives higher levels of adipokines, cytokines produced by adipose tissue (i.e., TNF-α, IL-6) and is associated with increased changes in glucose and insulin regulation.6 Visceral adiposity promotes increased lipolysis, releasing free fatty acids (FFAs) directly into the portal circulation. The liver becomes flooded with FFAs, which are either re-esterified into triglycerides or incompletely oxidized.

Glucose and Insulin Metabolism

The liver stores glucose as glycogen during times of energy abundance and releases it via glycogenolysis during fasting. It also produces glucose through gluconeogenesis from substrates like lactate, glycerol and amino acids to maintain blood glucose levels.

When there is a consistent surplus of calories, the body experiences changes in insulin responses. Over time, this will impact the way the liver responds to insulin to reduce glucose production and continues to release glucose into the bloodstream, even when energy needs are already met.

While insulin fails to suppress gluconeogenesis, it activates pathways in the liver that convert excess carbohydrates into fat through a process called de novo lipogenesis. These newly created fats (triglycerides) are stored in liver cells, contributing to increased fat accumulation.

Lipid Metabolism

The liver plays a central role in regulating lipid balance, acting as the body's main processing center for fats. It packages triglycerides and cholesterol into very-low-density lipoproteins (VLDL) for delivery to other tissues, removes excess cholesterol from the bloodstream and helps break down dietary fats through bile acid production.

When the system becomes overwhelmed by a surplus of calories and circulating fats, the liver begins to store more fat than it can process or export. Over time, this leads to an accumulation of triglycerides within liver cells, reducing its efficiency and altering metabolic pathways.

As fat continues to accumulate, the liver produces more VLDL particles, contributing to an altered lipid profile.⁷ These changes affect not just liver health but also overall cardiometabolic risk, making lipid metabolism a critical link between liver function and systemic health.

Prevalence of Altered Metabolic Health and Fat Accumulation in the Liver³

Excess visceral fat = “Overflowing Delivery Trucks”-too many incoming deliveries (FFAs)

Imagine visceral fat as a fleet of delivery trucks constantly sending shipments of fat (free fatty acids) to the liver.

In excess weight, these trucks are working overtime, sending far more cargo than the liver’s “receiving docks” can handle. With nowhere else to go, the liver starts storing the excess inventory as fat.

Glucose/Insulin = “Mixed Messages from the Control Tower”

The liver is like a shipping control center that coordinates what gets produced and where it goes. Normally, insulin acts like a dispatcher, telling the liver to slow glucose production when supplies are sufficient and direct energy elsewhere.

But in states of energy surplus, the dispatcher’s messages get scrambled. The glucose “production line” keeps running at full speed, adding more cargo to already full warehouses, while the liver simultaneously ramps up fat production from excess carbs. The result? A backlog of stored products and a growing traffic jam in energy management.

Lipid Metabolism = “An Overloaded Shipping Hub” managing excess inventory

The liver functions as the body’s central shipping hub for fats. It receives cargo (free fatty acids from adipose tissue and dietary fats), processes it and packages triglycerides and cholesterol into VLDL particles for delivery throughout the body.

When too much cargo arrives too quickly, the hub becomes overloaded. This excess cargo is stored inside the “warehouse” (liver cells), slowing operations, while an increasing number of overflow packages spill into circulation.

Analogy created with the assistance of AI. Reference: OpenAI. ChatGPT [Large language model]. Version GPT-5. Published September 2025. Accessed September 2, 2025. https://chat.openai.com

Polyphenols: Bergamot & Artichoke Extracts in Supporting Liver Health: A Summary of the Evidence

Polyphenols are bioactive plant-derived compounds with antioxidant and metabolic-regulatory properties. In particular, BergaCynFF^®, a patented blend of bergamot flavonoids and artichoke (Cynara cardunculus) polyphenols, has demonstrated significant benefits for supporting lipid metabolism in the liver with the added benefits of promoting healthy uric acid levels, decreasing oxidative stress and supporting vascular endothelial health.^{8–11‡ 8–11‡}

A 12-week, randomized, placebo-controlled trial (n=102) assessed BergaCynFF^® (300 mg/day) in individuals with altered liver health. Compared to placebo, BergaCynFF^® significantly reduced hepatic fat measured by controlled attenuation parameter (CAP) score (P = .02). Subgroup analysis revealed the most pronounced benefit among participants aged >50 years and those with android adiposity (response rates: 78% vs 44%; P = .007).¹¹

Endothelial Function Improvement

A 12-week RCT of 32 adults with altered liver health and impaired endothelial function found that BergaCynFF^® supplementation significantly improved reactive hyperemia index (RHI) compared to placebo (P = .02). Improved endothelial reactivity supports the potential role of BergaCynFF^® in mitigating the heightened health risk factors.^12‡

Clinical Integration

BergaCynFF^® at 300 mg/day for 6–12 weeks may complement lifestyle interventions for liver health. Clinicians should monitor liver enzymes, CAP score, lipids, glycemic control and vascular markers to assess therapeutic response.^‡

Pure Encapsulations Nutrient Solutions

Lipid Support Complex is for patients seeking support for healthy fat metabolism. Lipid Support Complex supports hepatic fat metabolism with a combination of berberine and clinically studied BergacynFF^®, a patented extract blend of bergamot citrus and Cynara cardunculus. BergacynFF^® supports lipid metabolism in the liver, with the added benefits of promoting healthy uric acid levels, decreasing oxidative stress and supporting vascular endothelial health.^{8–11 ‡}

Suggested Dose: Take 2 capsules daily, with a meal.

Conclusion

The liver serves as a central hub for energy balance, nutrient processing and metabolic regulation. Disruptions in these pathways, driven by factors such as excess visceral fat, altered glucose handling and lipid imbalances, altered liver health.

Emerging evidence highlights the role of targeted nutraceutical strategies in supporting liver health. BergaCynFF^®, a patented combination of bergamot and artichoke polyphenols, demonstrates multi-faceted benefits, improvements in lipid profiles and glycemic control, enhanced antioxidant defenses and improved endothelial function.^‡

For clinicians, integrating BergaCynFF^® alongside foundational lifestyle interventions offers a promising approach to supporting liver function and broader metabolic health.^‡

Resources

For additional resources that include diet and lifestyle recommendations for supporting occasional anxiety, refer to the protocols listed below:

Hepatic Fat Metabolism Protocol: Designed by our scientific and medical advisors to help you deliver the most effective care and support liver health

For more details on the research on the selected nutrient solutions, download the product information sheets: Lipid Support Complex

Drug-Nutrient Interactions Checker: Provides valuable information on potential interactions between your patients' prescriptions, over-the-counter medications and nutritional supplements.

PureInsight^™: Our streamlined platform easily collects patient data and provides valuable recommendations to help achieve their health goals.

Virtual Dispensary: Our Pure Patient Direct program provides account holders FREE access to our virtual dispensary to help simplify patient sales and reduce in-office inventory.

You can also explore Pure Encapsulations^® to find On-Demand Learning, Clinical Protocols and other resources developed with our medical and scientific advisors.

1. Rhyu J, Yu R. World J Hepatol. 2021;13(11). doi:10.4254/wjh.v13.i11.1611
2. Rinella ME, Sookoian S. J Lipid Res. 2024;65(1). doi:10.1016/j.jlr.2023.100485
3. Younossi ZM, Kalligeros M, Henry L. Clin Mol Hepatol. 2025;31(Suppl):S32-S50. doi:10.3350/cmh.2024.0431
4. Chalasani N, Younossi Z, Lavine JE, et al. Hepatology. 2018;67(1). doi:10.1002/hep.29367
5. Nahorna A, Baur H. Obes Sci Pract. 2025;11(3):e70078. doi:10.1002/osp4.70078
6. Schousboe JT, Kats AM, Langsetmo L, et al. J Am Heart Assoc. 2018;7(16). doi:10.1161/JAHA.118.009172
7. Targher G, Byrne CD, Tilg H. Gut. 2020;69(9). doi:10.1136/gutjnl-2020-320622
8. Parafati M, Lascala A, Morittu VM, et al. Journal of Nutritional Biochemistry. 2015;26(9). doi:10.1016/j.jnutbio.2015.03.008
9. Musolino V, Gliozzi M, Bombardelli E, et al. J Tradit Complement Med. 2020;10(3). doi:10.1016/j.jtcme.2020.02.004
10. Ferro Y, Maurotti S, Mazza E, et al. Medicina (B Aires). 2022;58(12):1728. doi:10.3390/medicina58121728
11. Ferro Y, Montalcini T, Mazza E, et al. Front Endocrinol (Lausanne). 2020;11. doi:10.3389/fendo.2020.00494
12. Maurotti S, Pujia R, Ferro Y, et al. Nutrition. 2024;118. doi:10.1016/j.nut.2023.112294

⁺Kim Ross is a paid consultant for Pure Encapsulations.

Think Ahead: Cognitive Wellness Today for Tomorrow

By: Amy Doyle, MS, CNS⁺

1. Introduction
2. Age-Related Changes in the Brain
3. Oxidative Stress and Brain Health
4. Antioxidant Intake and Cognitive Function
5. Nutrient Solutions for Cognitive Function
6. Pure Encapsulations^® Nutrient Solutions for Cognitive Function
7. Summary
8. Resources
9. References

Introduction

As we age, supporting brain health and cognitive function increasingly becomes a focal point of our health. Mild memory deficits and slower cognitive processing are a normal part of aging. It has been estimated that 1 in 9 adults in the US age 65 and older experience memory loss, thinking difficulties and other cognitive changes that could interfere with daily life and activities.¹

By age 45, the risk of these types of cognitive changes is 1 in 5 for women and 1 in 10 for men.¹

Read on to discover how you can proactively target metabolic processes and related pathways to support your patients’ brain health and cognitive function throughout their lifetime.

Age-Related Changes in the Brain

Changes in brain neurons can begin 20 years or more before cognitive symptoms develop, with the prevalence of these changes doubling every five years after age 65.^1,2

Age-related chemical and physical changes in the brain can include:³

• Changes in vascular makeup, reduced blood flow and oxygen
• Decline in production of hormones and neurotransmitters
• Decreased antioxidant defenses

While these underlying brain changes can occur for decades, one factor is emerging as a significant player in the development and occurrence of cognitive changes: oxidative stress.

Oxidative Stress and Brain Health

Oxidative stress occurs when there’s an imbalance between free radicals and antioxidants in the body resulting in greater reactive oxygen species (ROS) production.  Free radicals are a natural byproduct of many physiological processes, but they can also be introduced by external sources like diet, toxins and environmental factors.

While free radicals play essential roles in cellular signaling and immune function, an excess can lead to cellular damage, an immune response and mitochondrial dysfunction that can progress to adverse effects on brain function.⁴ Highly metabolic, the brain is a large consumer of oxygen and is rich in polyunsaturated fatty acids. These characteristics combined with its high production of ROS and low levels of antioxidant enzymes make it particularly vulnerable to oxidative damage.^5,6

When ROS production overwhelms the brain’s antioxidant defenses, oxidative stress damages proteins, DNA and cell membranes, disrupts neuronal cell functions and triggers neuronal cell death.⁴ Regulation of ROS in the brain is critical for memory consolidation and long-term potentiation.⁷

Antioxidant Intake and Cognitive Function

Several prospective studies have found that people who consume an antioxidant rich diet of fruits and vegetables can reduce their risk of cognitive changes.^8,9,10

In a 2023 meta-analysis of cohort studies, researchers sought to investigate the association of antioxidant intake with the risk of cognitive changes.¹¹

The meta-analysis included 17 articles with 98,264 participants. Of the total, 7,425 participants had cognitive changes after 2-3 years of follow up, that interfered with their daily living. Studies included participants from Europe, Asia and North America.  The studies considered antioxidant intake from diet, supplements or both.  The antioxidants studied included vitamin A, vitamin C, vitamin E and flavonoids. Additional subgroup analyses were conducted based on the participants’ kind of nutrition, diet and supplement, geographical region and study quality.

Overall, the researchers determined that a high antioxidant diet or supplement intake significantly decreased the incidence of cognitive changes that interfere with daily living by 16% (RR =.084, 95% CI 077.-091(p_t <0.001).

In subgroup analysis by nutritional type, high dietary and supplement intake of vitamin C or vitamin E alone significantly reduced risk of cognitive changes (RR= 0.81, 95% CI 0.70-0.94, I² = 37.9%, p = 0.097), and (RR=0.77, 95% CI 0.64-0.92, I²=54%, p=0.013), respectively.

Both vitamin A and flavonoid intake were also shown to decrease risk of cognitive changes, however results were not statistically significant.

High dietary and supplement antioxidant intake demonstrated a greater risk reduction with statistical significance in North American populations (RR=.083, 95% CI 0.75-0.93, I²=47.3%, p=0.003), compared to European populations, where although risk was reduced, results were not statistically significant.

The authors concluded that consuming fruits and vegetables rich in antioxidants or antioxidant supplements can have a protective effect on cognitive function and reduce risk of cognitive changes.

Nutrient Solutions for Cognitive Function

It is important to educate patients about modifiable risk factors associated with mild, age-related cognitive decline like an antioxidant-rich diet, physical activity, managing stress, prioritizing sleep and engaging in social and mental stimulation.¹² In addition, the practitioner can support the brain’s resilience against oxidative stress with targeted nutrient solutions.

Magnesium L-threonate Animal research suggests that magnesium-l-threonate may promote synaptic plasticity and density in the regions of the hippocampus correlated with learning and memory.^13‡

Acetyl-L-carnitine supports the availability of acetyl-CoA, an important energy-generating metabolite. In addition, it supports healthy mitochondrial function and cell membrane stability.^14‡

Phosphatidylserine supports cognitive function, emotional well-being and behavioral performance. It has also been shown to support healthy memory.^15,16‡

Resveratrol promotes cardiometabolic, neuronal and cellular health through a variety of effects on cell signaling, mitochondrial function and endogenous antioxidant defenses.^{17,18,19,20‡}

Omega 3 Fatty Acids encourage cardiovascular health by supporting lipid metabolism and healthy blood flow. ^21,22,23 In addition, studies indicate these oils help maintain healthy endothelial function.^24‡

Curcumin supports neuronal stability and function, in part, by promoting healthy cytokine balance and antioxidant defenses.^25‡

Bacopa monnieri has been utilized traditionally for centuries in Ayurvedic medicine to support the nervous system, cognitive capacity and memory. A three-month trial conducted by Australian scientists suggests that bacopa may support learning, moderate stress and support memory.^26‡

Luteolin promotes neuronal health through antioxidant, immunomodulating and mast cell stabilizing actions, helping to moderate the release of immune mediators.^‡

Ginkgo biloba helps sustain the strength and elasticity of blood vessels and capillaries. It may also promote the flow of oxygen and blood to the brain. ^‡

With oxidative stress and related metabolic shifts occurring early in the development of changes in cognitive function, identifying and addressing these processes can be crucial for healthy function.

Pure Encapsulations^® Nutrient Solutions for Cognitive Function

As the most trusted brand and leader in the professional supplement space, Pure Encapsulations^® is committed to helping healthcare professionals understand and apply personalized, evidence-based nutrition to achieve optimal patient outcomes.

The following supplements can support neuronal health, vascular integrity, memory, mental sharpness and overall cognitive function.^‡

Memory Pro promotes neural health, cognitive function and memory. Also supports vascular integrity and promotes relaxation.^‡
Suggested use: As a dietary supplement, take 3 capsules daily, with or between meals.

BenfoMax is a fat-soluble vitamin B₁ (thiamine) derivative that maintains healthy advanced glycation end (AGE) product activity to support vascular, nerve, retinal and kidney cellular health. It also promotes healthy glucose metabolism.^‡
Suggested use: As a dietary supplement, take 1 capsule, 1-3 times daily, with meals.

O.N.E. Omega contains triglyceride form EPA and DHA from fish oil produced through a unique solvent free, supercritical, CO2-based extraction method. Encourages cardiovascular health by supporting lipid metabolism and healthy blood flow.  Also helps maintain healthy endothelial function.^‡
Suggested use: As a dietary supplement, take 1 capsule daily, with a meal.

CurcumaSorb Mind contains Meriva^® bioavailable curcumin phytosome; support for mood, memory and mental sharpness.^‡
Suggested use: As a dietary supplement, take 2 capsules, 1-2 times daily, with meals

CogniMag  promotes cognitive function, learning ability and working memory. Also supports optimal brain magnesium levels.^‡
Suggested use: As a dietary supplement, take 2 capsules, twice daily, with a meal and at bedtime.

Brain Reset promotes concentration, mental clarity and memory with a multi-faceted blend of nutrients and herbal extracts. Promotes neuroimmune health by supporting cellular function, neuroprotection and immune mediator balance.^‡
Suggested use: As a dietary supplement, take 2 capsules daily, between meals.

AntiOxidant Formula  supports the body’s natural defense mechanism against free radicals.^‡ Offers a synergistic, broad spectrum of antioxidants, including essential vitamins and minerals like vitamin A, E and B complex vitamins.
Suggested use: As a dietary supplement, take 1 capsule, 1-2 times daily, with meals.

Ester-C^® & Flavonoids offers a blend of Ester-C^® and flavonoid compounds to provide vitamin C support for healthy immune and cellular function as well as blood vessel integrity.^‡
Suggested use: As a dietary supplement, take 1 capsule, 1-2 times daily, with or between meals.

Summary

In the quest to maintain optimal brain health, understanding and addressing the role of oxidative stress is key to safeguarding your patient’s cognitive function

Resources

Mild Age-Related Cognitive Decline Protocol^‡: Developed in collaboration with our scientific and medical advisors to support cognitive health in older adults^‡

Drug-Nutrient Interactions Checker:  provides valuable information on potential interactions between your patients’ prescriptions, over-the-counter medications and nutritional supplements.

PureInsight^™: Our streamlined platform easily collects patient data and provides valuable recommendations to help achieve their health goals.

Virtual Dispensary: our Pure Patient Direct program provides account holders FREE access to our virtual dispensary to help simplify patient sales and reduce in-office inventory.

You can also explore Pure Encapsulations^® to find On-Demand Learning, Clinical Protocols, and other resources developed with our medical and scientific advisors.

References

1. ALZ.org. Facts and Figures 2024. Accessed May 14, 2024.
2. CDC.gov. Accessed May 14, 2024.
3. NCOA. Accessed May 12, 2024.
4. Song T et al. Ageing Res Rev. 2021;72:101503. doi:10.1016/j.arr.2021.101503
5. Bai R et al.  Ageing Res Rev. 2022;77:101619. doi:10.1016/j.arr.2022.101619.
6. Qin P, Sun Y, Li L.  Int J Mol Med. 2024;53(5):47. doi:10.3892/ijmm.2024.5371.
7. Serrano, F., & Klann, E.  Ageing Research Reviews, 2004. 3(4): 431–43. doi:10.1016/j.arr.2004.05.002.
8. Dai Q, Borenstein AR, Wu Y, Jackson JC, Larson EB. Fruit and vegetable juices and Alzheimer's disease: the Kame Project. Am J Med. 2006;119(9):751-759. doi:10.1016/j.amjmed.2006.03.045
9. Barberger-Gateau P et al. Neurology. 2007. 69(20):1921-30. doi:10.1212/01.wnl.0000278116.37320.52.
10. Hughes TF et al. Am J Geriatr Psychiatry. 2010.18(5):413-20. doi:10.1097/JGP.0b013e3181c65250.
11. Zhao R et al. J Alzheimers Dis. 2024. 99(s1):S35-S50. doi:10.3233/JAD-220909.
12. Livingston G et al. Lancet. 2020. 396(10248):413-46. doi:10.1016/S0140-6736(20)30367-6.
13. Slutsky I, et al. Neuron. 2010 Jan 28;65(2):165- 77.
14. Kerner J, et al. Mech Ageing Dev. 2015 Jan;145:39-50.
15. Maggioni M, et al. Acta Psychiatr Scand. 1990 Mar;81(3):265-70.
16. Hirayama S, et al. J Hum Nutr Diet. 2013 Apr;27 Suppl 2:284-91.
17. Xia N, et al. Br J Pharmacol. 2017 Jun;174(12):1633-1646
18. Brito PM, et al. Atherosclerosis. 2009 Jul;205(1):126-34.
19. Pyo IS, et al. Molecules. 2020 Oct 12;25(20):4649.
20. Ghanim H, et al. J Clin Endocrinol Metab. 2010 Sep;95(9):E1-8.
21. Ottestad I, Hassani S, Borge GI, et al. PLoS One. 2012;7(8):e42550
22. Ebrahimi M, Ghayour-Mobarhan M, Rezaiean S, et al. Acta Cardiol. 2009 Jun;64(3):321-7.
23. Geleijnse JM, Giltay EJ, Grobbee DE, et al. J Hypertens. 2002 Aug;20(8):1493-9.
24. Khan F, Elherik K, Bolton-Smith C, et al. Cardiovasc Res. 2003 Oct 1;59(4):955-62.
25. Braidy N, et al. FEBS J. 2010 Jan;277(2):368-82.
26. Stough C, et al. Psychopharmacology (Berl). 2001 Aug;156(4):481-4.

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Felice L. Gersh, M.D. is an award-winning physician, board-certified in both OB/GYN and Integrative Medicine. She has special expertise in the use of female hormones, the impact of environmental toxicants on metabolic and reproductive functions and on all aspects of lifestyle medicine. She graduated from Princeton University and the University of Southern California School of Medicine. She completed her OB/GYN residency at Kaiser Hospital in Los Angeles and was fellowship-trained in integrative medicine at the University of Arizona School of Medicine.  

⁺Dr. Gersh is a paid advisor for Pure Encapsulations.
1. Santoro N. J Womens Health (Larchmt). 2016 Apr;25(4):332-9.