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Getting the latest healthcare news for you
Getting the latest healthcare news for you
A new clinical trial found that a ketogenic diet delivers the greatest metabolic benefits for people with obesity and prediabetes — beyond just weight loss. After 4–5 months, 50% of keto participants no longer met prediabetes criteria, compared to 29% on Mediterranean and just 7% on a low-fat diet. Liver fat also dropped the most in the keto group, by an average of 67%.
A randomized clinical trial published in Cell Metabolism found that a ketogenic diet produces the greatest metabolic improvements in people with obesity, prediabetes, and fatty liver disease — even when total weight loss is held equal across diet groups. Researchers at Washington University School of Medicine assigned 42 participants to one of three diets (ketogenic, Mediterranean, or low-fat plant-forward) and tailored calorie intake so everyone lost roughly 10% of their body weight over 4–5 months.
While all three diets improved insulin sensitivity and reduced body fat, the keto group stood out on several key markers. The diet's dramatic carb restriction (just 4% of calories) triggered the largest increases in glucagon and the steepest drops in blood insulin — both of which help clear fat from the liver. Notably, keto participants showed no increase in blood fat or cholesterol despite eating the most fat.
By the Numbers:
Why it matters: With GLP-1 medications already transforming obesity treatment, this study suggests diet composition — not just calorie restriction — can add meaningful metabolic benefits. For clinicians managing patients with prediabetes and fatty liver disease, the keto diet may offer a powerful dietary complement to pharmacotherapy.
