What This Trial Looked At
Non-alcoholic fatty liver disease (NAFLD) is one of the most common chronic liver conditions worldwide, closely tied to overweight, insulin resistance, and oxidative stress in the liver. In 2019 a Serbian research team led by Korovljev and Ostojic ran a focused pilot trial in Clinical Nutrition ESPEN to test whether hydrogen-rich water — known for selectively reducing oxidative damage — could meaningfully shift liver fat in people already living with mild-to-moderate NAFLD.
The trial was a randomised, double-blind, placebo-controlled crossover study in 12 overweight adults diagnosed with mild-to-moderate NAFLD. Participants drank 1 litre per day of either hydrogen-rich water or placebo water for 28 days. The researchers measured liver fat content, body composition, and a panel of liver-enzyme and chemistry markers before and after each phase.
What They Found
The most striking result was a meaningful reduction in liver fat. After 28 days of hydrogen-rich water, participants showed an approximately 20 percent decrease in liver fat content compared with the placebo phase — a change that, in a four-week window, is clinically notable for a condition that often progresses slowly over years.
Just as important is what did not change. Body weight and overall body composition did not differ significantly between the hydrogen and placebo phases. That matters because it suggests the reduction in liver fat was a specific effect of the hydrogen-rich water, not the by-product of incidental weight loss during the trial.
Liver-enzyme profiles also showed improvement, consistent with the broader pattern of reduced hepatic oxidative stress and inflammation that hydrogen has been hypothesised to produce in laboratory work on liver tissue.
What This Means in Context
This is a pilot trial — explicitly framed by the authors as a first step rather than a definitive answer. The sample of 12 is small, the four-week duration is short relative to how NAFLD evolves, and the findings need confirmation in larger, longer studies before hydrogen-rich water can be positioned as part of any clinical protocol.
What the trial does establish is a clean signal. In a tightly controlled crossover design — where each participant served as their own control — hydrogen-rich water produced a specific and measurable reduction in liver fat, independent of weight change. The authors concluded that the findings give a rational basis for the larger trials needed to formally establish safety and efficacy of molecular hydrogen in NAFLD.
What It Means for You
If you have been diagnosed with fatty liver — or are working to reduce risk factors that head in that direction — this small pilot offers an early signal that hydrogen-rich water may be a useful complement to the dietary and lifestyle changes that remain the foundation of NAFLD care. The evidence is preliminary and hydrogen-rich water is not a replacement for the treatment plan your doctor has recommended. Discuss any new complementary approach with your treating physician.
Citation: Korovljev, D., Stajer, V., Ostojic, J., LeBaron, T.W., & Ostojic, S.M. (2019). Hydrogen-rich water reduces liver fat accumulation and improves liver enzyme profiles in patients with non-alcoholic fatty liver disease: a randomized controlled pilot trial. Clinical Nutrition ESPEN, 31, 121–125. PubMed
