A five-month study from Washington University suggests that a very low-carbohydrate ketogenic plan may help some individuals with prediabetes regain normal blood sugar levels and improve liver health more effectively than Mediterranean or low-fat diets.
A five-month diet study from Washington University School of Medicine suggests that a very low-carbohydrate ketogenic plan may help some people with prediabetes return to normal blood sugar levels more effectively than Mediterranean-style or low-fat eating patterns.
The trial involved 42 adults with obesity, prediabetes and fatty liver disease, according to the report from Mangish and the study details in related summaries. Participants were randomly assigned to one of three diets: a ketogenic plan, a Mediterranean-style diet, or a low-fat, mostly plant-based diet. All three groups lost a similar amount of weight, which points to weight loss as a major driver of better metabolic health, rather than any single diet pattern alone.
Even so, the low-carbohydrate approach appeared to do more than help the scale. It was linked to larger improvements in markers associated with type 2 diabetes and to a greater reduction in liver fat, an important factor in people with fatty liver disease. That matters because excess liver fat is closely tied to insulin resistance, the condition that makes it harder for the body to control blood sugar.
The findings fit with earlier research. Harvard Health has reported on a randomised clinical trial in 150 adults with prediabetes in which a low-carb diet improved long-term blood sugar measures and fasting glucose over six months, alongside meaningful weight loss. A separate Stanford University KETO-MED study found that both a ketogenic diet and a Mediterranean-plus diet improved glucose control and cardiovascular risk factors, although the ketogenic plan produced a larger fall in HbA1c, a standard measure of average blood sugar.
Other recent analyses have reached broadly similar conclusions. A systematic review in Nutrients found low-carbohydrate diets outperformed low-fat diets for HbA1c reduction in people with type 2 diabetes, while a network meta-analysis in overweight and obese adults found all three patterns , Mediterranean, low-carb and low-fat , could support weight loss, with low-carb often among the strongest performers. Taken together, the research suggests that carbohydrate restriction can be a useful tool for some patients, but the best diet is still likely to be the one a person can follow consistently over time.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
