WASHINGTON: A ketogenic diet may offer an additional benefit for people with fatty liver disease, reducing liver fat more effectively than Mediterranean and low-fat diets, even when all three approaches produce similar weight loss, a new study has found.
Researchers at Washington University School of Medicine studied 42 people with obesity, prediabetes and fatty liver disease to examine how different dietary patterns affect liver health.
Participants were randomly assigned to follow one of three eating plans: a ketogenic diet, a Mediterranean diet or a low-fat diet emphasizing plant-based foods.
Researchers provided all meals and adjusted calorie intake to help participants lose about 10% of their initial body weight. Reaching that target took approximately four to five months.
The diets differed significantly in their nutritional composition. The ketogenic plan provided about 4% of calories from carbohydrates and 73% from fat. The Mediterranean diet obtained about half its calories from carbohydrates, while the low-fat, plant-based plan provided approximately 70% from carbohydrates.
All three groups experienced reductions in body fat and improvements in insulin sensitivity, which measures how effectively the body responds to insulin to regulate blood sugar levels.
However, the most significant difference emerged in liver fat reduction.
Participants following the ketogenic diet experienced an average 67% reduction in liver fat, compared with approximately 45% among those following either the Mediterranean or low-fat diet.
The percentages represent reductions from participants' initial liver fat levels rather than the proportion of fat remaining in the liver.
The researchers also monitored hormone levels over 24 hours and found that participants on the ketogenic diet experienced a greater decline in insulin levels and a larger increase in glucagon, a hormone that helps regulate how the liver stores and releases energy.
The findings suggest that the balance of carbohydrates and fats in a diet may influence liver health independently of weight loss.
The study, published in the journal Cell Metabolism, benefited from providing participants with all their meals, allowing researchers to maintain greater control over dietary intake.
However, the researchers cautioned that the controlled conditions do not establish how easily people could follow these diets independently or whether the benefits would continue after the trial ended.
They said longer-term studies are needed to determine whether the additional reduction in liver fat associated with the ketogenic diet can be sustained and whether it leads to meaningful improvements in long-term health.
