A ketogenic diet and liver fat were examined in a small randomised trial comparing three diets during weight loss. The study reported a larger average reduction in liver fat in its ketogenic group. That finding concerns a supervised research setting, not a promise that a particular diet will reverse liver disease for every reader.

Ketogenic, Mediterranean and low-fat diets: the comparison

The research compared a very-low-carbohydrate ketogenic diet, a Mediterranean diet and a high-carbohydrate, low-fat diet in adults with obesity, prediabetes and fatty liver. The researchers supplied food and dietitian support. Groups lost a similar proportion of starting weight, allowing the study to examine whether diet composition made a further difference.

Liver-fat changes: averages, not individual predictions

Despite similar weight loss across groups, the ketogenic diet resulted in a 67% average reduction in liver fat, compared with 45% reductions in both the Mediterranean and plant-forward groups. Improvements in insulin sensitivity were observed in all groups, but the ketogenic group exhibited the most pronounced hormonal changes, including increased glucagon and decreased insulin levels, which may contribute to the reduction in liver fat.

Notably, about half of the ketogenic diet participants no longer met the criteria for prediabetes after the intervention, compared to 29% in the Mediterranean group and 7% in the plant-forward group. The reported blood-lipid findings in this trial do not establish the long-term cardiovascular safety of every ketogenic diet.

Context and Considerations

While these findings suggest that carbohydrate restriction may offer metabolic benefits beyond weight loss alone, it is important to recognise that this is a controlled clinical trial with a relatively small sample size and short duration. Further research is needed to confirm long-term effects and safety.

A useful reading of this study considers the small sample, supplied food, dietitian support and similar weight loss across groups. These features matter when interpreting whether a result would translate to everyday eating or a different patient group.

Research-use disclaimer: This article summarises current research findings and does not constitute medical advice or treatment recommendations. Individual dietary choices should be made in consultation with qualified healthcare professionals.

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Sources

WashU: liver benefits beyond weight loss, 27 August 2026 — https://source.washu.edu/2026/08/low-carb-diet-delivers-added-liver-benefits-beyond-weight-loss/

Cell Metabolism: Petersen et al., diet macronutrient content trial — https://www.cell.com/cell-metabolism/fulltext/S1550-4131(26)00293-7