Macro partitioning
Low-Carbohydrate High-Fat (LCHF) and Ketogenic diets do not significantly alter ALT levels in individuals with MASLD compared to control diets.
Current evidence from this meta-analysis does not support LCHF or Ketogenic diets as significantly effective for lowering liver enzymes (ALT) in people with MASLD compared to control diets. The wide variation in how 'low-carb' was defined across studies makes it difficult to draw firm conclusions, but it did not show the significant benefits seen with fasting or MedDiet.
LCHF/ketogenic diets (n = 6) and Omega-3 fatty acids supplementation (n = 4) did not significantly alter ALT.
Why this rating
Meta-analysis of 6 RCTs, but results were non-significant with substantial heterogeneity.
Source
The impact of dietary interventions on liver health biomarkers in individuals with metabolic dysfunction-associated steatotic liver disease (MASLD): a systematic literature review and meta-analysis of randomized controlled trials
Ute Stern et al. · European Journal of Nutrition · 2026
DOI 10.1007/s00394-025-03870-z
More from this paper
- Fasting interventions significantly reduce liver health biomarkers (ALT and liver stiffness) in individuals with MASLD compared to control diets.Good
- The Mediterranean Diet (MedDiet) significantly improves liver health biomarkers (ALT, liver stiffness, and MRI-PDFF) in individuals with MASLD.Good
- Omega-3 fatty acid supplementation does not significantly alter ALT levels in individuals with MASLD.Moderate
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