In a low-calorie diet study combined with weekly nutritional counselling and aerobic exercise (30–45 min/day at least three times per week) by Nobili et al., which was performed for the duration of a year, a significant reduction in BMI resulted in improvements in fasting glucose, insulin levels, serum lipid levels and aminotransferases and hepatic steatosis in sonography. Here, INS is linked to fatty liver disease.