A randomized, controlled study revealed that red palm oil (RPO, enriched with high levels of tocotrienols, tocopherols and carotenoids) supplementation decreased lipid peroxidation and endotoxemia (the presence of heat stable toxin derived from certain gram negative bacteria in the blood), production of inflammatory cytokines, and monocyte tissue factor (TF) in chronic liver disease patients.

The study, “Beneficial effect of refined red palm oil on lipid peroxidation and monocyte tissue factor in HCV-related liver disease: a randomized controlled study," was published in Hepatobiliary & Pancreatic Diseases International. Sixty patients with mean age of 62 years old with Child A/B genotype 1 HCV-related cirrhosis with no history of alcoholic beverages consumption were recruited. The patients were randomly assigned to receive either 300 mg vitamin E (alpha-tocopherol acetate) or 15 g RPO supplementation for 8 weeks. Blood parameters such as circulating endotoxin, plasma endotoxin-inhibiting capacity, macrophage-colony stimulating factor (M-CSF), urinary isoprostane-F2α-III, and monocyte TF activity, erythrocyte malondialdehyde (MDA) were examined after the 2nd, 4th and 8th weeks. Liver ultrasound imaging was carried out to examine liver steatosis.

Both RPO and vitamin E tocopherol-supplemented groups did not demonstrate any change in level of endotoxin and plasma endotoxin-inhibiting capacity, but they led to significant reduction in erythrocyte malondialdehyde and urinary isoprostane- F2α-III when compared to baseline.

When comparing to vitamin E tocopherol-supplementation, the RPO-supplemented group showed significant improvement in oxidative stress via decrease in M-CSF level and monocyte TF activity following the 4th and 8th week of supplementation, respectively. Additionally, the RPO-supplemented group showed a tendency toward lowering erythrocyte the MDA level more significantly than the vitamin E tocopherol-supplemented group.

No changes were observed in liver ultrasound images for both the RPO and vitamin E groups.

“Oxidative stress plays a key role in the progression of chronic liver diseases," explained CheeYen Lau, nutritionist at ExcelVite. Serum M-CSF is mostly secreted inflammatory cytokine while monocyte TF activity is strongly associated with the production of endotoxemia among patients diagnosed with chronic liver failure. Both M-CSF and monocyte TF activity take part in pathophysiology of oxidative stress. The good news is consumption of RPO, with [its] wholesome array of tocotrienols, tocopherols and carotenoids helps in ameliorating chronic liver diseases with decreased level of plasma M-CSF and monocyte TF activity, as demonstrated in this study."