The Claim
Among adults with metabolic dysfunction-associated steatotic liver disease (MASLD), a 12-week ketogenic diet (75% fat, ≤5% carbohydrate) is associated with a significantly greater reduction in liver fat, as measured by CAP, compared to a calorie-restricted diet (50–55% carbohydrate), with a median difference of 62.0 dB/m versus 36.0 dB/m (p < 0.001, Cohen’s d = 0.93), suggesting macronutrient composition may influence hepatic fat clearance beyond caloric intake alone.
What the research says
Supports is higher
Support is ahead, but a single strong opposing study can change this.
These are independent scores, not a percentage. Higher-grade studies count more, so a single strong opposing study can outweigh several weaker ones.
In adults with MASLD, a ketogenic diet high in fat and very low in carbohydrates reduces liver fat more than a calorie-restricted diet with moderate carbohydrates, as measured by CAP scores.
See the scientific wording
Among adults with metabolic dysfunction-associated steatotic liver disease (MASLD), a 12-week ketogenic diet (75% fat, ≤5% carbohydrate) is associated with a significantly greater reduction in liver fat, as measured by CAP, compared to a calorie-restricted diet (50–55% carbohydrate), with a median difference of 62.0 dB/m versus 36.0 dB/m (p < 0.001, Cohen’s d = 0.93), suggesting macronutrient composition may influence hepatic fat clearance beyond caloric intake alone.
When carbs are cut very low, the body stops making new fat in the liver and starts burning existing fat for energy instead. This happens because insulin drops, which turns off the liver's fat-making machines. At the same time, the liver starts breaking down fat from body stores and turning it into ketones, which clears fat out of the liver faster. Less fat is made, and more fat is burned, so liver fat drops quickly.
What the research says
1 studyIn people with fatty liver, a very low-carb diet removed more fat from the liver than a regular low-calorie diet—even when both diets led to the same amount of weight loss. This suggests what you eat matters as much as how much you eat.
Score breakdown, mechanism chain, raw evidence, ideal studies needed & 1 supporting studies
Not medical advice. For informational purposes only. Always consult a qualified healthcare professional before making health decisions.