This trial evaluated the effects of co-supplementing Camelina sativa oil (CSO) and a prebiotic as modulators of the gut microbiota on cardiometabolic risk factors and mental health in NAFLD patients. In all, 44 subjects with NAFLD were allocated to either an intervention (20 g d^-1 CSO + resistant dextrin) or a placebo (20 g d^-1 CSO + maltodextrin) group and received a calorie-restricted diet (-500 kcal d^-1) for 12 weeks. Fasting plasma levels of gucose, insulin, hs-CRP, endotoxin, antioxidant enzyme activity, total antioxidant capacity (TAC), malondialdehyde (MDA), 8-iso-prostaglandin F2α, and uric acid were measured at the baseline and post-intervention. The depression, anxiety and stress scale (DASS) and the general health questionnaire (GHQ) were used to assess mental health. Co-supplementing CSO and resistant dextrin significantly decreased the level of insulin concentration (-0.84 μU ml^-1, p = 0.011), HOMA-IR (-0.27, p = 0.021), hs-CRP (-1.25 pg ml^-1, p = 0.023), endotoxin (-3.70 EU mL^-1, p = 0.001), cortisol (-2.43, p = 0.033), GHQ (-5.03, p = 0.035), DASS (-9.01, p = 0.024), and MDA (-0.54 nmol mL^-1, p = 0.021) and increased the levels of TAC (0.16 mmol L^-1, p = 0.032) and superoxide dismutase (106.32 U g^-1 Hb, p = 0.45) in the intervention group compared with the placebo group. No significant changes were observed in the levels of other biomarkers. Co-supplementing CSO and resistant dextrin in combination with a low-calorie diet may improve metabolic risk factors and mental health in NAFLD patients.

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