Can a ketogenic diet reduce liver fat more than other diets?

News summary

ScienceDaily reported that in a clinical trial involving people with obesity, prediabetes, and fatty liver disease, ketogenic, Mediterranean, and low-fat plant-forward diets all produced about 10% weight loss, but liver-fat reduction was greatest with keto. The news report highlighted an average 67% drop in liver fat with keto versus about 45% with the other diets, and noted that roughly half of the keto group no longer met prediabetes criteria after several months. The central message was that metabolic benefits may depend not only on how much weight is lost, but also on the composition of the diet.

All three diets produced weight loss and improved insulin sensitivity, but liver-fat reduction was greater in the ketogenic group. ScienceDaily reported a 67% reduction with keto versus about 45% with the other two diets. The primary paper supports the central direction of this finding: with similar weight loss, the very-low-carbohydrate diet produced greater improvements in liver fat and some measures of hepatic metabolism.

The study does not show that keto is the best diet for everyone. A more precise conclusion is that, in this small group with obesity, prediabetes, and fatty liver, diet composition influenced liver fat even when weight loss was similar. Tolerability, fat quality, comorbidities, and long-term adherence still matter when choosing a dietary approach.

The trial included only 42 participants and lasted roughly four to five months. Participants had a specific metabolically unhealthy obesity phenotype, so the results may not generalize to everyone. The study was also not designed to compare long-term clinical outcomes such as diabetes, cardiovascular disease, or liver complications.