INS and metabolic dysfunction-associated steatotic liver disease: In a randomized controlled trial of 60 obese adults with NAFLD and elevated serum ALT levels, the results revealed that consumption of the DASH diet for eight weeks decreased BMI and steatosis severity, as well as improved aminotransferases and metabolic markers, including insulin, HOMA index, serum TG, and the total to HDL cholesterol ratio compared to control group (97).