The Effects of Eight Weeks' Very Low-Calorie Ketogenic Diet (VLCKD) on Liver Health in Subjects Affected by Overweight and Obesity

Very low-calorie ketogenic diets (VLCKD) are widely employed in successful weight-loss strategies. Herein, we evaluated the efficacy and safety of a VLCKD on non-alcoholic fatty liver disease (NAFLD) and parameters commonly associated with this condition in overweight and obese subjects who did not take any drugs. This prospective, real-life study included thirty-three participants who followed a VLCKD for 8 weeks. NAFLD was diagnosed using transient elastography (FibroScan). Data on anthropometric measurements, bioimpedance analysis, and biochemical assays were gathered both before and after the dietary intervention. BMI (kg/m(2)) (from 33.84 +/- 6.55 to 30.89 +/- 6.38, p < 0.01), waist circumference (cm) (from 106.67 +/- 15.51 to 98.64 +/- 16.21, p < 0.01), and fat mass (Kg) (from 38.47 +/- 12.59 to 30.98 +/- 12.39, p < 0.01) were significantly lower after VLCKD. CAP (db/m), the FibroScan parameter quantifying fatty liver accumulation, showed a significant reduction after VLCKD (from 266.61 +/- 67.96 to 223 +/- 64.19, p < 0.01). After VLCKD, the fatty liver index (FLI), a benchmark of steatosis, also revealed a significant decline (from 62.82 +/- 27.46 to 44.09 +/- 31.24, p < 0.01). Moreover, fasting blood glucose, insulin, triglycerides, total cholesterol, LDL-cholesterol, ALT, gamma GT, and FT3 blood concentrations, as well as insulin resistance (quantified by HOMAIR) and systolic and diastolic blood pressure levels, were significantly lower after VLCKD (p < 0.01 for all the parameters). By contrast, HDL-cholesterol, 25 (OH) vitamin D, and FT4 blood concentrations were higher after VLCKD (p < 0.01 for all parameters). The variation (delta) of CAP after VLCKD did not show a correlation with the delta of any other parameter investigated in this study. We conclude that VLCKD is a helpful approach for NAFLD independent of changes in factors commonly associated with NAFLD (obesity, fat mass, insulin resistance, lipids, and blood pressure) as well as vitamin D and thyroid hormone levels.

Automated summary

A prospective, real-life study showed that a very low-calorie ketogenic diet (VLCKD) is effective and safe for non-alcoholic fatty liver disease (NAFLD) in overweight and obese individuals. VLCKD can significantly reduce weight, fat mass, and liver fat accumulation, while improving glucose, lipid, and blood pressure levels commonly associated with NAFLD. It also increases HDL cholesterol, vitamin D, and thyroid hormone levels.