A Mediterranean diet rich in vegetables, nonred meat protein sources, and polyunsaturated fat was found to improve insulin sensitivity and reduce liver fat without weight loss over 6 weeks [32], and a short-term exercise intervention reduced markers of NAFLD and apoptosis (alanine aminotransferase and cytokeratin 18), also without significant weight loss [33], suggesting that it may be possible to improve NAFLD without losing weight. This evidence concerns the gene KRT18 and metabolic dysfunction-associated steatotic liver disease.