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Small trial finds keto diet offers superior liver metabolic benefits compared to Mediterranean diet

A study in Cell Metabolism reveals that while keto, Mediterranean, and plant-focused diets yield similar weight loss, keto provides greater reductions in liver fat for individuals with obesity.

Updated Aug 27, 2026 · 18:24 UTC1 reports

The short version

  • A new clinical trial of 55 participants with obesity, prediabetes, and fatty liver disease found that a ketogenic diet delivered significant metabolic benefits to the liver compared to Mediterranean and low-fat plant-focused diets.
  • While all three diets led to similar weight loss and improvements in muscle insulin sensitivity, the keto diet resulted in decreased liver fat, reduced triglyceride production, and prediabetes remission in roughly half of its keto participants.
  • Nutrition experts note the study's small sample size and short timeline mean further long-term research is needed before concluding keto's lasting superiority.

Key facts

  • A clinical trial published in Cell Metabolism evaluated 55 participants with obesity, prediabetes, and fatty liver disease across three eating regimens: ketogenic, Mediterranean, and low-fat plant-focused diets.[Scientific American]
  • Participants across all three diets lost similar amounts of weight, approximately 10 percent of their starting weight, and experienced comparable improvements in blood cholesterol profiles and muscle insulin sensitivity.[Scientific American]
  • Participants following the keto diet experienced increased liver insulin sensitivity, a reduction in liver fat, and decreased triglyceride production in the liver.[Scientific American]
  • Approximately half of the participants assigned to the keto group saw remission of their prediabetes.[Scientific American]
  • Participants assigned to the Mediterranean diet experienced larger reductions in body fat mass and smaller reductions in fat-free mass compared to the other diets, according to independent expert Sai Das.[Scientific American]

What remains uncertain

  • The long-term effects and sustainability of the ketogenic diet remain unknown due to the study's small sample size of 55 participants and short timeline.[Scientific American]
  • Whether combining a ketogenic diet with GLP-1 weight-loss medications like semaglutide or tirzepatide produces enhanced therapeutic outcomes requires future research.[Scientific American]

Sources