RCTs in NAFLD: Supplementation with inulin-type fructans (10–20 g/day) for 8–24 weeks (often alongside diet control) significantly reduced serum ALT and AST and lowered fasting insulin levels compared to a placebo. One trial (2020) [162] in NAFLD patients on a low-calorie diet found that adding inulin led to greater ALT reduction than diet alone. However, a recent RCT (2024) [163] with 16 g/day of inulin (and no weight loss regimen) showed improved gut Bifidobacteria but no significant change in liver fat or inflammation markers over 12 weeks. Here, INS is linked to metabolic dysfunction-associated steatotic liver disease.