A recent clinical trial demonstrates that a ketogenic diet may deliver profound metabolic benefits, including a 67% reduction in liver fat and improved blood sugar control, surpassing traditional diets in adults with obesity and fatty liver disease.
A ketogenic diet may do more than help with weight loss, according to a clinical trial published in Cell Metabolism that looked at adults with obesity, prediabetes and fatty liver disease. Researchers compared a very low-carbohydrate ketogenic plan with a Mediterranean diet and a very low-fat, plant-forward diet, and found that although participants shed about the same amount of weight across all three groups, the keto group saw far larger reductions in liver fat.
That distinction matters because fatty liver is not simply a by-product of body weight. In the trial, people on the ketogenic diet cut liver fat by an average of 67%, compared with about 45% in both the Mediterranean and plant-forward groups. The researchers also found that the keto group’s liver insulin sensitivity improved more sharply, suggesting the benefits went beyond the scale and into core metabolic function.
The blood sugar findings moved in the same direction. According to the study, average glucose levels over a 24-hour period fell by about 20% in the ketogenic group, versus roughly 8% in the other two diets. By the end of the four- to five-month intervention, about half of those on keto no longer met the definition of prediabetes, compared with 29% of participants on the Mediterranean diet and 7% of those on the plant-forward plan.
Researchers said the difference may stem from the much lower carbohydrate intake in the ketogenic diet, which pushes the body towards greater fat use and appears to affect hormones involved in glucose control and fat mobilisation, including glucagon. But the findings come with clear limits. The trial was small, included only people with obesity, prediabetes and fatty liver disease, and was closely supervised, with food provided and regular dietitian support. That makes it hard to know whether the same results would hold in ordinary life.
Even so, the study adds to evidence that not all weight loss has the same metabolic effects. The participants reached similar weight-loss goals, but their livers responded very differently depending on what they ate. For people at risk of progressing from prediabetes to diabetes, and for those carrying excess fat in the liver, that could make diet composition as important as the number on the scale.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
