This study evaluated if the beneficial effects of long-term DHA supplementation alone or combined with physical exercise could be related with changes in the expression of Sirt1 and Foxo1. SIRT1 and FOXO1 have shown to play a role in lipid metabolism in obesity and MASLD conditions [23, 54, 61]. This evidence concerns the gene FOXO1 and obesity due to melanocortin 4 receptor deficiency.