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.