Prebiotic Fibre Supplementation and Gut Microbiota in Non-alcoholic Fatty Liver Disease

Inclusion Criteria: * Adult subjects diagnosed with NAFLD on the basis of abnormal liver enzymes (ALT\>1.5x upper limit of normal) and ultrasonography * Exclusion of other causes of liver disease including viral hepatitis and alcoholic liver disease * Aspartate aminotransferase and alanine aminotransferase ≤10x upper limit of normal * Patients with type 2 diabetes treated with diet and exercise alone or metformin Exclusion Criteria: * Cirrhosis of the liver (FibroScan \>17.5 kilopascal or FibroTest \>0.8) or clinical features of cirrhosis. * Alcohol consumption \>20g/day (2 standard drinks) in women or \> 30g/d (3 drinks) in men * Alternate (e.g. TPN) or concomitant etiology for abnormal liver enzymes. * History of decompensated liver disease including ascites, encephalopathy or variceal bleeding * Concomitant use of any weight loss medication, previous bariatric or other intestinal surgery * Presence of active infection, pregnancy or lactation * Regular use of a probiotic or prebiotic supplement within 3 months prior to enrollment * Antibiotic use within 3 months prior to enrollment * Weight loss \>3 kg within preceding 3 months to enrollment * Uncontrolled cardiovascular or respiratory disease, active malignancy, or chronic infections * Use of agents such as vitamin E, omega-3 fatty acids or medications with evidence for effects on NAFLD (pioglitazone, Glucagon-like peptide-1 analogues, dipeptidyl peptidase IV inhibitors, ursodeoxycholic acid) * Patients with type 2 diabetes where HbA1c is \>9%