Effects of Hydro‐Ethanolic Extract of Portulaca oleracea (Purslane) on Depression, Anxiety, and Stress Symptoms in Patients With Non‐Alcoholic Fatty Liver Disease: A Randomized Double‐Blind Controlled Trial

Introduction Non‐alcoholic fatty liver disease (NAFLD) is a prevalent chronic liver condition globally. Managing anxiety, depression, and stress is crucial in NAFLD care. Preliminary hypotheses suggest that Portulaca oleracea extract may improve mental health by modulating stress‐related hormones. The high flavonoid content and antioxidant characteristics may diminish inflammation and oxidative stress, which are principal factors contributing to both neuropsychological disorders and NAFLD‐related mental health issues. This study assessed changes in depression, anxiety, and stress levels using the DASS‐21 scale in NAFLD patients after 8 weeks of supplementation with Portulaca oleracea extract. Methods In a randomized clinical trial, 70 patients were divided into two groups: an intervention group ( n = 35) and a placebo group ( n = 35). The intervention group was administered 700 mg of P. oleracea extract daily for 8 weeks, whereas the control group received a placebo. Each participant received a calorie‐restricted diet and directives for physical activity. Mental well‐being was assessed with the Depression, Anxiety, and Stress Scale (DASS‐21). Dietary consumption was documented by 3‐day recalls both before and following the intervention. Results The average age of the participants was 44.01 ± 8.6 years, with 34 (48.6%) being women. There were significant differences in weight and waist circumference in the intervention group as opposed to the group that received a placebo ( p < 0.001). Depression and stress scores in the intervention group changed significantly compared to those in the study's placebo group, even after controlling for possible causes ( p = 0.002, 0.05, respectively). However, before and after controlling for variables including weight and physical activity, there were no appreciable variations in the two groups' anxiety scores ( p = 0.1 and 0.12, respectively). Conclusion Our findings suggest that an 8‐week supplementation with Portulaca oleracea can help alleviate depression and stress symptoms in patients with NAFLD. Trial Registration: Clinical trial registration code: IRCT20211116053073N1.