It is an eye-catching promise: a simple diet that can dramatically reduce dangerous fat in the liver – without giving up indulgent foods such as bacon, sausages, eggs and cheese.
asserted
that → catch → bacon
And, given recent disappointing headlines about the potential of processed meats to increase cancer risk, it sounds almost too good to be true.
But that's exactly what a group of American scientists investigating the body-wide impact of a range of eating plans have discovered.
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group → give → plans
In a study, published recently in the journal Cell Metabolism, researchers split 55 volunteers into three groups, each instructed to follow a popular diet plan.
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each → publish → plan
All were obese and had prediabetes – dangerously high blood sugar that can progress to type 2 diabetes – as well as fatty liver disease, where fat builds up in the organ and can eventually cause serious liver damage.
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fat → have → damage
Together the conditions are known to substantially increase the risk of heart attacks and strokes.
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conditions → know → attacks
During the study, one group was given a Mediterranean diet, rich in fruit and vegetables, whole grains, fish, nuts and olive oil.
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group → give → fruit
Meals included oatmeal with almonds and blueberries, minestrone, salmon, quinoa and black beans, chicken pesto pasta and roasted sweet potatoes.
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Meals → include → almonds
The ketogenic diet can dramatically reduce dangerous fat in the liver – and it doesn't involve giving up indulgent foods such as bacon, sausages, eggs and cheese
The second group followed a very-low-fat, 'plant-forward' diet based largely around fruit, vegetable, grains, beans and other pulses, with 70 per cent of calories coming from carbohydrates and just 15 per cent from fat.
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cent → reduce → fat
They ate meals such as oatmeal and fruit, red beans and rice, vegetable wraps, mixed grains, sweet potato and black bean soup and vegetable chilli.
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They → eat → oatmeal
It was not strictly vegetarian – some meals included salmon.
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meals → include → salmon
The final group was put on a ketogenic diet, also known as keto, which severely restricts carbohydrates in favour of high-fat foods such as meat, eggs and cheese.
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which → put → meat
Just four per cent of their calories came from carbohydrates, while 73 per cent came from fat.
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cent → come → fat
Their meals included omelettes with bacon and sausage, cheesy beef, pulled pork, salmon with cauliflower mash, pot roast and chicken with asparagus.
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meals → include → asparagus
After five months, volunteers in all three groups lost roughly the same amount of weight – about 10 per cent of their starting weight.
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volunteers → lose → weight
However, when other health factors were looked at, the differences were striking.
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differences → look → ?
Most significantly, the amount of fat in the livers of the keto diet group dropped on average by 67 per cent, compared to 45 per cent in both the Mediterranean and plant-forward diets.
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amount → drop → diets
Half of the keto group experienced prediabetes remission – with blood sugars returning to normal – versus 29 per cent in the Mediterranean group and just 7 per cent in the plant-forward group.
And volunteers in the keto group saw a 20 per cent drop in blood sugar, on average, compared to a fall of just 8 per cent in the other two diet groups.
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volunteers → experience → groups
And there was another surprise: despite the keto group's high fat and saturated fat intake, there were no significant differences between the diets when harmful LDL cholesterol and ApoB were tested for.
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cholesterol → be → diets
Both of these markers, found in the blood, increase the risk of heart disease.
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Both → find → disease
The researchers said the findings showed that the benefits were not simply down to losing weight – what the volunteers ate appeared to matter too.
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ate → say → what
'Our study demonstrates the superiority of a very-low-carbohydrate ketogenic diet in improving hepatic [liver] metabolic function... and lowering other risk factors for diabetes and cardiovascular disease,' they wrote.
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they → demonstrate → diabetes
In other words, despite all three groups losing roughly the same amount of weight, the ketogenic diet appeared to deliver additional benefits – particularly for the liver and blood sugar control.
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diet → lose → liver
The researchers acknowledged several limitations.
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researchers → acknowledge → limitations
The study was small, with just 42 people completing it, and it remains unclear whether people would need to stick to the restrictive ketogenic diet to maintain the benefits.
uncertain
people → complete → benefits
Nor could the researchers say whether a less extreme low-carbohydrate diet might have produced similar results without requiring people to enter ketosis.
They said larger and longer studies were now needed to confirm the findings.
But the research throws up an intriguing question: Is the keto diet the healthiest option, when it comes to reversing liver damage and blood sugar issues?
uncertain
it → say → damage
could more of us benefit from following a low-carb plan such as this, even if we aren't struggling with life-threatening health problems?
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we → benefit → problems
First, it's useful to look at exactly what the keto diet is – and why it remains controversial.
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it → look → ?
The plan was developed more than a century ago, not as a way to lose weight, but as a treatment for epilepsy.
Doctors had observed that fasting appeared to reduce seizures in some patients.
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fasting → develop → patients
starving people was obviously not a practical long-term treatment.
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starving → starve → people
So in 1921, Dr Russell Wilder, a physician at the Mayo Clinic in Minnesota, developed a diet designed to mimic some of the effects of fasting.
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Wilder → develop → fasting
He called it the ketogenic diet.
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He → call → it
Normally, the body gets much of its energy from glucose, which comes from carbohydrates such as bread, pasta, rice and potatoes.
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which → get → bread
But when carbohydrate intake is drastically reduced, the body begins breaking down fat and producing chemicals called ketones, which it can use as an alternative source of energy.
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it → reduce → energy
This state is known as ketosis.
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state → know → ketosis
The diet remains an established treatment for some people with drug-resistant epilepsy, but over recent decades it has become far better known as a weight-loss regime.
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it → remain → regime
Studies have found that ketogenic and other low-carbohydrate diets can help people lose weight and may improve blood sugar control and triglyceride levels, particularly in people who are obese or have type 2 diabetes.
uncertain
who → find → diabetes
But whether keto is superior to other healthy diets in the long term remains fiercely debated.
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is → debate → term
Research comparing popular diets has generally found that several different approaches can produce meaningful weight loss, with differences between them tending to shrink over time.
There are also concerns about what happens when carbohydrates are replaced with large quantities of fat – particularly saturated fat from foods such as butter, cheese and fatty meat.
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carbohydrates → compare → butter
The defining feature is that carbohydrates are kept extremely low – typically below about 10 per cent of daily calories, and often considerably lower – forcing the body into ketosis.
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carbohydrates → keep → ketosis
That means the diet can be followed in very different ways.
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diet → mean → ways
…and 33 more, not listed.
The Aporia
