Keto diet outperforms Mediterranean and plant-based plans in metabolic trial

In a head-to-head trial, 55 obese participants with fatty liver disease and prediabetes were assigned to follow either a Mediterranean, a low-fat plant-focused, or a ketogenic diet, receiving weekly dietician support and pre-prepared meals. After losing roughly 10% of their starting weight, all groups displayed improved insulin sensitivity and cholesterol profiles, but the ketogenic arm achieved markedly better liver outcomes, including lower triglyceride synthesis, increased liver insulin sensitivity, and reduced liver fat, with about half of its participants reversing prediabetes.

Lead author Samuel Klein emphasized that cutting carbohydrate intake, especially sugars, drives these metabolic gains independent of weight loss. Independent researchers highlighted the study’s solid design but cautioned that its short duration and modest sample size limit conclusions about long-term effects. The results, published in Cell Metabolism, suggest keto may be a valuable dietary option for patients needing rapid liver-fat reduction, potentially complementing weight-loss medications.