What does the research say about keto and fatty liver
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It may seem counterintuitive to eat a high-fat diet to manage fatty liver. But more research highlights the beneficial effects of a high-fat, low-carbohydrate diet on Fatty Liver Disease. 

2018 study evaluated the effects of carbohydrate-restricted induced ketosis in 262 obese or overweight patients. After one year, participants had improved their blood sugar parameters, reduced their cardiovascular risk factors, and reduced the need for medications to manage high blood pressure and diabetes. Liver enzymes (ALT) used to measure liver health also improved in this trial.

Participants also had sustained weight loss during this trial. Another noteworthy result was a reduction in the diabetes lab test HbA1c, which related to improved liver enzyme levels regardless of weight loss. This highlights the role insulin sensitivity and blood glucose management can play in reducing the risk and worsening of fatty liver.

2020 meta-analysis of 154 articles reviewed the benefits of the keto diet on Fatty Liver Disease. The authors concluded, in addition to caloric restriction, macronutrient distribution also plays a role in NAFLD treatment. 

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