A new study suggests the ketogenic diet may offer significant benefits for liver health, particularly among people with obesity, prediabetes, and excess liver fat.
Research published in the journal Cell Metabolism examined 42 adults with obesity, prediabetes, and elevated levels of liver fat. The randomized clinical trial compared the effects of three different weight-loss diets: a low-carbohydrate ketogenic diet, a Mediterranean diet, and a low-fat, mostly plant-based diet.
Study Compares Three Weight-Loss Diets
The ketogenic diet used in the study consisted of approximately 4% carbohydrates and 73% fat. The Mediterranean diet provided around 50% of calories from carbohydrates and 35% from fat, while the low-fat diet included about 70% carbohydrates and 15% fat.
All three groups experienced improvements in muscle insulin sensitivity, with participants showing about a 50% improvement in their muscles’ ability to absorb blood sugar more efficiently.
However, the ketogenic diet produced greater improvements in certain liver-related health markers.
Keto Diet Reduced Liver Fat More Than Other Diets
Participants following the ketogenic diet experienced approximately a 67% reduction in liver fat, compared with about a 45% reduction among those following the Mediterranean and low-fat diets.
The reduction was associated with lower production of new fat in the liver, suggesting that the composition of a diet may influence metabolic health beyond weight loss alone.
Liver insulin sensitivity also improved two to three times more in the keto group compared with the other diet groups.
Keto Group Saw Greater Improvements in Prediabetes Markers
The study also found stronger improvements in glucose and insulin measurements among people following the ketogenic diet.
Approximately 50% of participants in the keto group no longer met the criteria for prediabetes by the end of the trial. This compared with 29% of participants following the Mediterranean diet and 7% of those following the low-fat diet.
Researchers noted that the study’s small sample size and short duration limit how widely the results can be applied. Each diet group included only about 14 participants.
Experts Say Diet Composition Matters
Registered dietitian nutritionist Ilana Muhlstein said the findings highlight that calories alone may not explain all metabolic changes associated with weight loss.
She explained that while all three groups lost weight, the participants experienced different internal changes depending on the type of nutrients they consumed.
According to Muhlstein, the keto group experienced changes associated with increased fat burning and reduced production of new liver fat.
Could Keto Help People With Fatty Liver?
Muhlstein said the findings may be especially relevant for people with prediabetes or fatty liver conditions, where reducing carbohydrate intake may encourage the body to use stored fat for energy.
She noted that the study was also interesting because participants following the ketogenic diet did not experience higher cholesterol or blood-fat measurements during the short research period.
However, she cautioned that people with a family history of heart disease or a higher risk of cardiovascular problems should discuss dietary changes with a healthcare professional.
Keto May Be a Short-Term Strategy, Not a Long-Term Solution
Although the study showed promising results, Muhlstein said she does not recommend following a ketogenic diet indefinitely because it can be high in saturated fat and may result in lower fiber intake.
Instead, she suggested that keto may be useful as a short-term approach for some people with obesity or prediabetes before transitioning to a Mediterranean-style diet, which is widely associated with benefits for heart and brain health.
