Evaluate the Effect of Synbiotics on MAFLD

Inclusion Criteria: * Subjects with MAFLD with CAP ≥ 270 by fibroscan * Age ≥ 50 * Subjects with diabetes or components of metabolic syndrome * Subjects have been taking stable medication 3 months prior to enrolment and are expected to remain stable throughout the study period * Written informed consent can be obtained Exclusion Criteria: * Known history of any secondary causes of MAFLD including alcoholic liver disease, drug-induced liver injury, autoimmune hepatitis, viral hepatitis, cholestatic liver disease and metabolic/genetic liver disease * Active malignancy (on any kind of treatments for the known cancer) * Known diabetes with poor control (HbA1c \> 8.5%) within 3 months * Significant alcohol consumption (over 10g per day: a half pint or half bottle of beer or a standard-size wine glass) * Subjects who are using insulin and Glucagon-like peptide-1(GLP1) such as dulaglutide, semaglutide * Consumption of systemic corticosteroids or methotrexate in the last 6 months * Use of antibiotics, probiotics or prebiotics one month prior to enrolment * Taking any supplements which are claimed to possibly protect the liver or improve liver functions including vitamin E and omega-3 * Any condition or allergy history for probiotics * Any allergy to vitamin E, omega-3 or lactose