Researchers compared three popular weight-loss approaches to determine which one delivered the most significant improvements to metabolic health. The study, published in Cell Metabolism, involved 42 adults with obesity, prediabetes, and elevated liver fat who followed either a ketogenic diet, Mediterranean diet, or low-fat plant-based diet for approximately five months until reaching a 10 percent weight loss.
All three dietary approaches successfully helped participants lose weight, but the ketogenic diet emerged as the clear winner for improving liver health markers. Participants following the keto regimen experienced a 67 percent reduction in liver fat—significantly higher than the 45 percent decrease observed in both other groups. Additionally, liver insulin sensitivity increased two to three times more in the keto group compared to the other diets.
The ketogenic approach also demonstrated remarkable effects on prediabetes, with half of its participants achieving remission compared to 29 percent on the Mediterranean diet and only 7 percent on the low-fat plan. Surprisingly, despite deriving 73 percent of calories from fats, the keto group did not experience harmful cholesterol changes. Researchers attribute these benefits to the diet’s severe carbohydrate restriction, which may reduce liver fat production while promoting existing fat breakdown.
Scientists caution that the relatively small sample size limits generalizability, and additional large-scale studies are needed to confirm these findings and explore whether less restrictive low-carb diets produce similar benefits.

Keto vs Mediterranean vs low-fat.