A controlled trial reveals that a very low-carbohydrate ketogenic diet offers notable short-term improvements in liver fat reduction and glucose control in individuals with obesity, prediabetes, and fatty liver disease, surpassing other dietary approaches even when calorie intake is matched.
A very low-carbohydrate ketogenic diet appears to offer extra short-term metabolic gains for people with obesity, prediabetes and fatty liver disease, even when weight loss is matched with other eating plans. In a controlled trial led by researchers at Washington University School of Medicine in St Louis and published in Cell Metabolism on 27 August, the keto group saw the biggest fall in liver fat and the largest share of participants who no longer met the definition of prediabetes.
The study enrolled 42 adults and supplied all of their food, allowing researchers to compare a ketogenic diet, a Mediterranean diet and a low-fat, plant-forward diet under tightly controlled conditions. Although the calorie intake was adjusted so that all three groups lost about 10% of their body weight over roughly four to five months, the composition of the diet still mattered. The ketogenic plan, in which just 4% of calories came from carbohydrates and 73% from fat, reduced liver fat by an average of 67%, compared with about 45% in the other two groups, according to the report highlighted by ScienceDaily.
All three diets improved insulin sensitivity and reduced body fat, but the keto group showed the strongest shifts in hormones linked to glucose control, including higher glucagon and lower insulin. That may help explain why liver fat fell so much more sharply. The researchers also reported that, despite the high fat intake, blood fats and cholesterol did not rise during the study, a result that may surprise readers who associate ketogenic eating with adverse lipid changes.
The trial builds on earlier work from Washington University suggesting that ketogenesis, the process of making ketones from fat, can protect against fatty liver injury and high blood sugar in animal models. Still, the new findings come with clear limits: the study was small, lasted only a few months and cannot show whether the benefits would persist or be safe over the long term. Even so, it suggests that, alongside weight loss, the type of diet may play an important role in how prediabetes and fatty liver respond to treatment.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
