The Study
The effects of ketogenic diet and calorie-restricted diet on metabolic dysfunction-associated steatotic liver disease: a retrospective study
This study watched two groups of people who picked their own diets — one ate very low-carb, the other ate fewer calories. It saw that the low-carb group lost more liver fat, but we can't be sure the diet caused it because maybe those people were already more health-conscious in other ways.
Analysis score
Maximum 72 for a cohort study.
Where the score came from
This study tested two diets for people with fatty liver: one very low in carbs (ketogenic) and one just lower in calories. Both helped, but the low-carb one worked faster on the liver.
Where does this study sit?
Reviews of RCTs (Meta-analyses)
Max 100Randomized Trials
Max 90Reviews of Cohort Studies
Max 85Cohort Studies
Max 72Reviews of Case-Control Studies
Max 63Case-Control Studies
Max 58Cross-Sectional & Case Series
Max 50Expert Opinion
Max 556 / 100
Quality score
Groups of people are followed over time to see who develops an outcome. Strong for identifying risk factors and associations, but cannot prove causation as firmly as RCTs.
Key takeaways
Summary
Based on the study abstract and findings.
- 1The low-carb diet cleared liver fat nearly twice as much as the calorie-restricted diet — but also took away more muscle, which is bad for long-term health.
- 2After 12 weeks: low-carb diet cut liver fat 62 dB/m vs.
- 336 dB/m; lowered insulin more (6.4 vs.
- 44.7 μIU/mL); lost 3.0 kg muscle vs.
- 51.8 kg.
Score breakdown, methodology, conflicts of interest, evidence analysis & raw study data
Publication
Journal
Frontiers in Nutrition
Year
2026
Authors
Wei-jie Sun, Lin Xing, Su-fen Zhao, Hui-min Ying
Related Content
Claims (5)
Among adults with metabolic dysfunction-associated steatotic liver disease, a 12-week ketogenic diet results in a median muscle mass loss of 3.0 kg, while a calorie-restricted diet results in a median loss of 1.8 kg.
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.
Among adults with metabolic dysfunction-associated steatotic liver disease, a 12-week ketogenic diet results in a larger median reduction in fasting insulin levels (6.4 μIU/mL) than a calorie-restricted diet (4.7 μIU/mL), with statistical significance.
In adults with metabolic dysfunction-associated steatotic liver disease, a 12-week ketogenic diet results in larger reductions in visceral fat and waist-to-height ratio than a calorie-restricted diet.
In adults with fatty liver disease, losing belly fat during a 12-week ketogenic diet is more closely linked to reduced liver fat than losing the same amount of belly fat during a calorie-restricted diet.
Not medical advice. For informational purposes only. Always consult a qualified healthcare professional before making health decisions.