Keto diet and liver fat: why protein did the heavy lifting
A controlled trial where all food was provided showed that a high protein, low carbohydrate diet cut liver fat by 67 percent, about three times more than two other diets, yet ketones were only 0.5 mmol per liter, so protein and carbohydrate restriction, not ketosis, did the work.
- What to do: Raise protein to about 35 grams per meal, pick chicken, fish, tofu and legumes, and keep carbohydrate portions small.
- Why it matters: About one in three adults has fatty liver, and ApoB fell on all three diets once participants lost about 10 percent of their weight.
- How to apply it: Cook with olive, sunflower or rapeseed oil, eat about 25 grams of nuts and 30 grams of fiber daily, and add vegetables to every meal.
- Metrics: 67 percent less liver fat, 23 percent of energy from saturated fat, 0.5 mmol per liter of ketones, apoB, HbA1c and fasting glucose.
- Tools: Eight Sleep Pod 6 for sleep temperature, Function Health lab panels, IM8 multinutrient, Momentous creatine.
- Risks: Saturated fat from butter, cream or coconut oil has no nutritional upside and can raise LDL once weight stabilizes.
- Exceptions: The trial could not isolate saturated fat, did not report vascular function and did not find different glucose tolerance across diets.