A small clinical trial has found that a ketogenic diet may offer greater benefits for liver health and blood sugar control than other popular weight-loss diets, even when weight loss itself is similar. Published in the journal Cell Metabolism, the study compared low-carb keto, Mediterranean and low-fat plant-based diets in adults with obesity, prediabetes and excess liver fat, suggesting that what people eat, not just how much weight they lose, could influence metabolic health outcomes.

The trial involved 42 adults split across three diets, with roughly 14 people per group. Liver fat fell by about 67% in the keto group compared with around 45% in the other diets, while liver insulin sensitivity improved two to three times more among keto participants. Half of those on keto no longer met the criteria for prediabetes by the end of the study, versus 29% on the Mediterranean diet and just 7% on the low-fat diet, though experts caution the trial's small size and short duration limit how far the findings can be applied, and that keto may not suit those with heart disease risk.