A human study demonstrated that the administration of Bifidobacterium longum with fructo-oligosaccharides, plus lifestyle modifications, were able to significantly reduce serum aspartate transaminase (AST) levels, tumor necrosis factor (TNF)-α, CRP (C-reactive protein), HOMA-IR (Homeostasis Assessment Model-Insulin Resistance), serum endotoxin, steatosis, and the non-alcoholic steatohepatitis (NASH) activity index when compared to lifestyle modification alone [58]. This evidence concerns the gene TNF and metabolic dysfunction-associated steatohepatitis.