A low-carbohydrate, high-fat ketogenic diet may be a more effective strategy than the Mediterranean or low-fat diets for reversing type 2 diabetes and improving metabolic health, a new study suggests. The research also indicated potential benefits for reducing the risk of fatty liver disease.
Scientists from Washington University School of Medicine in St. Louis tracked 42 participants who were obese, had prediabetes, and fatty liver disease. Participants were randomly assigned to one of three diets: ketogenic (73% fat, 4% carbohydrates), Mediterranean, or low-fat (70% carbohydrates). All participants received all meals and met weekly with a dietitian.
After four to five months, all participants lost approximately 10% of their starting body weight. While all three diets led to significant improvements in blood sugar control, the ketogenic diet group experienced greater reductions in liver fat, dropping by about 67% compared to 45% in the other groups. The study also observed a greater increase in glucagon, a hormone that helps the liver burn fat, in the ketogenic diet group.
Regarding diabetes remission, half of the participants following the ketogenic diet no longer met the criteria for prediabetes after five months. This compared to a third of those on the Mediterranean diet and only 7% of those on the low-fat diet.
Dr. Samuel Klein, the study's lead author, noted that reducing carbohydrate intake can have important metabolic effects beyond weight loss alone for individuals with prediabetes. Surprisingly, the ketogenic diet group did not experience an increase in blood fat or cholesterol levels, despite its high fat content, which is a point of consideration for some experts.
Fatty liver disease, medically known as metabolic dysfunction-associated steatotic liver disease (MASLD), is a growing concern, with studies indicating a significant rise in diagnoses over the past decade. It is often asymptomatic in its early stages and can lead to serious complications, including cancer and liver failure. However, lifestyle changes, such as diet and weight loss, can often slow, halt, or even reverse the condition before significant damage occurs.
Type 2 diabetes occurs when the body either doesn't produce enough insulin or becomes resistant to it, leading to high blood sugar levels. Excess fat in the liver is a known risk factor, as it can impair glucose control and increase insulin resistance. Weight loss is considered a primary factor in managing and potentially reversing these conditions.
While the study highlights the potential benefits of the ketogenic diet for liver and metabolic health, experts not involved in the research emphasize that significant weight loss remains a crucial driver for improved health across all examined diets. They suggest that the primary benefit observed was largely attributed to achieving a 10% body weight reduction.