A tightly controlled clinical trial found a ketogenic diet cut liver fat by 67% and pushed about half of participants with prediabetes out of that risk zone.
Story Snapshot
- Ketogenic diet slashed liver fat by 67% over about five months.
- Mediterranean and plant-based diets cut liver fat by about 45%.
- About half on keto no longer met prediabetes criteria; fewer did on other diets.
- All groups lost roughly 10% of body weight; keto still outperformed on liver and glucose.
Keto Outpaced Two Respected Diets On Liver Fat
A randomized clinical trial in adults with obesity, prediabetes, and fatty liver disease reported a striking gap in liver fat reduction. The ketogenic group saw a 67% drop in liver fat, while both the Mediterranean and low-fat plant-based groups achieved about 45% reductions over a similar period.
The diets were tested head-to-head under clinical supervision. This design lets readers compare the effects with fewer excuses about calorie differences or coaching bias.
All three groups lost around 10% of their body weight, yet the ketogenic group still led on liver fat and glucose control. That point matters. Weight loss often improves fatty liver and blood sugar.
If weight loss was similar, then the macronutrient mix likely drove the extra benefit. The report also noted improved liver insulin sensitivity on keto, which aligns with the physiology of lower carbohydrate intake and reduced liver fat synthesis.
METABOLIC PERK: A clinical trial found the keto diet slashed liver fat by 67% — nearly double the reduction seen with Mediterranean and low-fat diets — in adults with obesity and prediabetes who all lost the same amount of weight.
Registered dietitian Ilana Muhlstein told Fox… pic.twitter.com/f1DuQotlTt
— Fox News Health (@foxnewshealth) September 3, 2026
Prediabetes Remission Was Common On Keto
About half of participants in the ketogenic group no longer met prediabetes criteria by the end of the intervention, compared with about 29% in the Mediterranean group and 7% in the plant-based group, according to a report summarizing the trial’s findings.
That is a practical signal for patients and clinicians. People want to know, “Will this move my number out of the danger range?” In this trial, many on keto crossed that line.
Investigators framed keto as a short-term option for some patients with obesity or prediabetes, not a forever rulebook. That framing aligns with how metabolic clinics often work: use sharper tools early, then transition to patterns a patient can live with long term. The study was published in Cell Metabolism and listed an August 27, 2026 publication date, adding weight to the reporting.
Why The Liver Responds So Fast
The liver is a traffic cop for energy. When carbohydrate intake drops, the liver produces less new fat and burns more stored fat. That switch can quickly clear liver fat.
Reviews and prior controlled trials have reported that very low-carbohydrate or ketogenic diets improve measures of fatty liver beyond what weight loss alone would predict, at least in the short- to medium-term. The new trial’s larger reduction in liver fat and improvements in insulin sensitivity fit that broader pattern.
Mechanism aside, the clinical signal is what matters to patients: lower liver fat, improved glucose markers, and real-world milestones such as prediabetes remission. A doctor does not need a biochemistry lecture to act on those outcomes.
Patients should still partner with clinicians to monitor lipids, liver enzymes, and adherence. Dietary changes with strong metabolic impact deserve medical guidance, especially when medications are in the mix.
What This Means For Everyday Choices
For a person in their 50s with abdominal weight, borderline morning glucose, and an ultrasound that hints at fatty liver, this study offers a clear path.
A well-formulated ketogenic diet could be used for several months to target liver fat and glucose control while losing weight, with a plan to shift to a sustainable pattern after the initial push.
The Mediterranean and plant-based diets still delivered solid reductions in liver fat and weight loss, which matters for people who prefer those styles.
Americans lean on personal responsibility and measurable results. This trial shows both. People did the work, lost similar weight across all groups, and those on keto got more liver and glucose payoff for their effort. That is not an argument against other diets.
It is a case for matching the tool to the job, tracking outcomes, and adjusting based on data. One brief caveat: reports describe a short-term trial with small groups, so decisions should be made with a clinician’s oversight.
How To Act On The Findings
Ask your doctor about a three- to five-month ketogenic trial if you have prediabetes and fatty liver disease. Request baseline and follow-up labs, including hemoglobin A1c, fasting insulin, liver enzymes, and a liver fat measure if available.
Set clear targets: 10% weight loss, improved liver enzymes, and better glucose control. If lipids worsen, consider adjustments or a different pattern. If adherence fails, pivot to Mediterranean or lower-carbohydrate, not necessarily ketogenic. The win is better liver and glucose health, not diet loyalty.
Sources:
foxnews.com, sciencedaily.com, sciencemediacentre.es
