Clinical trial finds keto diet dramatically lowers liver fat and improves blood sugar
In a trial involving 42 adults with obesity and prediabetes, a ketogenic diet led to a 67% reduction in liver fat, compared with 45% for Mediterranean and low-fat diets. All three groups achieved similar weight loss of around 10%. Roughly half of the keto participants saw their prediabetes status resolve within months.
The trial supplied all meals to participants and adjusted calorie intake so each group achieved roughly 10% weight loss over four to five months, ensuring comparisons reflected diet composition rather than differing weight outcomes. Keto provided only 4% of calories from carbohydrates versus 50% for Mediterranean and 70% for plant-forward plans.
Researchers measured liver fat and tracked blood metabolism over 24-hour periods. While insulin sensitivity improved across all three diets, the keto group's liver fat reduction of 67% substantially exceeded the 45% seen in both other groups, and roughly half of keto participants moved out of the prediabetes range.
This trial could influence how clinicians counsel patients with obesity and fatty liver disease, suggesting that carbohydrate restriction may offer metabolic benefits beyond weight loss alone. If replicated, keto-style eating plans might become a more prominent first-line recommendation for prediabetes management. However, long-term adherence and the health effects of high saturated fat intake remain important considerations, and individual responses may vary widely.