A Washington University study reveals that a ketogenic diet may offer significant short-term benefits for liver health and blood sugar regulation in people with obesity and prediabetes, outperforming Mediterranean and low-fat diets despite similar weight loss outcomes.
A study from Washington University School of Medicine in St Louis suggests that not all weight loss produces the same health gains, even when the pounds come off at similar rates. Writing in the journal Cell Metabolism, researchers found that people who lost weight on a ketogenic diet showed sharper improvements in liver health and blood sugar control than those who followed a Mediterranean-style diet or a high-carbohydrate, low-fat eating plan.
The trial involved 55 adults with obesity who also had prediabetes and excess liver fat, a combination that puts them at increased risk of type 2 diabetes and progressive liver disease. Over about five months, participants were assigned one of three diet patterns: a very low-carbohydrate, high-fat ketogenic diet, a Mediterranean diet, or a high-carbohydrate, low-fat diet. The researchers provided all meals and arranged weekly meetings with dietitians to help ensure the diets were followed closely.
Although the macronutrient mix differed sharply between the three plans, weight loss was broadly similar across the groups. Muscle insulin sensitivity improved by about 50% in all three, which led the researchers to conclude that losing weight itself was probably the main driver of that particular gain. The study also found that all three diets improved the liver’s response to insulin, but the ketogenic group improved by roughly two to three times more than the others.
That difference was mirrored in other measures. Liver fat fell by 67% in the ketogenic group, compared with 45% in both the Mediterranean and low-fat groups. Blood sugar and insulin levels over 24 hours also improved more in the keto group, with glucose dropping 20% versus 8% in the other two groups, and insulin falling 74% compared with 44% and 27% respectively. ScienceDaily, summarising the trial, reported that about half of the people in the keto group no longer met the criteria for prediabetes after four to five months.
The findings do not mean the other diets failed. All three plans improved metabolic health, and the researchers cautioned that the study was relatively small and short-term. But the results do add weight to the idea that diet composition can matter beyond the number on the scale, especially for people with obesity and fatty liver disease. With fatty liver affecting a large share of obese adults worldwide and becoming an increasingly common cause of chronic liver disease and cirrhosis, the study points to ketogenic eating as a potentially more effective short-term option for reducing liver fat and improving metabolic risk in some patients.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
