In a total of 50 people with NAFLD (confirmed by fibroscan examination) the supplementation with 30 g/day of brown milled flaxseed for 12 weeks was associated to an improvement in BMI, waist circumference, serum transaminases, hs-CRP, TNF-alpha, glucose and insulin concentrations compared to control, while HOMA-IR, hepatic fibrosis and steatosis scores were improved in both groups even if significantly greater in the flaxseed group compared to control [87]. This evidence concerns the gene TNF and metabolic dysfunction-associated steatotic liver disease.