Ketogenic Diet Cuts Liver Fat by 67 Percent in Clinical Trial, Outperforming Mediterranean and Plant-Based Diets
A clinical trial published in Cell Metabolism found that a ketogenic diet reduced liver fat by 67 percent in adults with obesity, prediabetes, and fatty liver disease. The Mediterranean and plant-based diets in the same study produced a 45 percent reduction, and about half of keto participants no longer met criteria for prediabetes after four to five months.
A clinical trial published in Cell Metabolism on August 27 found that a ketogenic diet reduced liver fat by 67 percent in adults with obesity, prediabetes, and fatty liver disease, significantly outperforming both Mediterranean and plant-based diets.
Researchers at Washington University School of Medicine in St. Louis enrolled 42 participants who completed the study. The trial compared three diets: a ketogenic diet (4 percent carbohydrate, 73 percent fat, 23 percent protein), a Mediterranean diet (50 percent carbohydrate, 35 percent fat, 15 percent protein), and a low-fat, plant-forward diet (70 percent carbohydrate, 15 percent fat, 15 percent protein).
All three groups lost about 10 percent of their body weight. But the ketogenic group saw liver fat drop by 67 percent, compared to 45 percent in the other two groups.
About half of participants in the ketogenic group no longer met the criteria for prediabetes after four to five months. That compared to 29 percent in the Mediterranean group and 7 percent in the plant-forward group.
The ketogenic diet also produced a two-to-three-fold greater improvement in liver insulin sensitivity. Researchers noted a significant drop in blood insulin levels and a rise in glucagon, a hormone that helps break down stored liver fat.
Despite the high fat content of the ketogenic diet, including 23 percent from saturated fat, participants did not show significant negative changes in LDL cholesterol or other cardiovascular markers compared to the other groups.
Researchers cautioned that the study was short-term and conducted under controlled conditions where all food was provided. The findings apply most directly to adults with obesity, prediabetes, and fatty liver disease, and do not necessarily reflect long-term outcomes or the feasibility of the diet without supervision.
The study adds to a growing body of research on how diet composition, beyond just calorie restriction, affects metabolic health.
