Researchers studied 474 people with fatty liver disease and obesity who followed a low-carb diet for four months. The diet, called the ‘Strong Diet,’ helped reduce dangerous belly fat around organs, but only worked well for people with mild to moderate fatty liver disease. Those with severe fatty liver disease saw little improvement, suggesting that once the condition becomes advanced, dietary changes alone may not be enough to reverse the damage. This study highlights the importance of catching and treating fatty liver disease early.

The Quick Take

  • What they studied: Whether a four-month low-carb diet could reduce dangerous belly fat in obese people with fatty liver disease
  • Who participated: 474 adults with fatty liver disease and obesity (BMI over 35) from a nutrition clinic database between 2017-2019
  • Key finding: The low-carb diet significantly reduced belly fat around organs, but only in people with mild to moderate fatty liver disease, not severe cases
  • What it means for you: If you have early-stage fatty liver disease, a low-carb diet may help reduce dangerous belly fat, but severe cases may need additional treatments beyond diet alone

The Research Details

This study looked back at medical records from 2,040 patients at a nutrition clinic, focusing on 474 people who had both fatty liver disease and obesity. All participants followed a specific low-carb eating plan called the ‘Strong Diet’ for four months. Researchers used ultrasound scans to measure the amount of fat around internal organs (called visceral fat) and check liver stiffness before and after the diet intervention.

This type of study is valuable because it shows real-world results from actual patients rather than controlled lab conditions. The large number of participants and the four-month timeframe provide good evidence of what people can expect from this type of diet in practice.

The study used objective measurements (ultrasound scans) rather than self-reported data, which makes the results more reliable. However, since everyone knew they were on a diet, there’s no comparison group, which limits how strongly we can conclude the diet alone caused the improvements.

What the Results Show

The low-carb diet successfully reduced visceral adipose tissue (dangerous belly fat around organs) in people with mild to moderate fatty liver disease. These participants showed measurable improvements in both the amount of organ fat and liver health markers after four months. The diet appeared most effective in the earlier stages of the disease, when the liver still had good capacity for healing and recovery. Participants with moderate liver fat accumulation responded well to the dietary changes, showing that lifestyle interventions can be powerful tools when implemented at the right time.

People with severe fatty liver disease showed little to no improvement, even when following the same diet plan. Liver stiffness measurements, which indicate scarring and damage, remained largely unchanged in the severe cases. The researchers noted that this lack of response may be due to permanent changes in liver cells that prevent normal healing processes.

This study supports earlier research showing that belly fat and liver fat are closely connected, and that reducing one often helps reduce the other. It also confirms that dietary interventions work best in early-stage liver disease, which aligns with previous findings about the liver’s ability to heal when damage isn’t too advanced.

The study only looked at one specific low-carb diet plan, so results may not apply to other types of low-carb approaches. There was no control group eating a different diet for comparison. The four-month timeframe, while substantial, may not show the full long-term effects of the diet. Additionally, the study only included people with obesity, so results may not apply to normal-weight individuals with fatty liver disease.

The Bottom Line

If you have early-stage fatty liver disease and are obese, a structured low-carb diet may help reduce dangerous belly fat and improve liver health. However, if you have advanced fatty liver disease, don’t expect diet alone to reverse the condition - you’ll likely need additional medical treatments. Work with a healthcare provider to determine the severity of your condition before starting any major dietary changes.

This research is most relevant for people with obesity who have been diagnosed with fatty liver disease, especially those in the early to moderate stages. People with severe fatty liver disease should still follow healthy diets but shouldn’t expect dramatic improvements from diet alone.

Participants saw meaningful improvements in belly fat within four months of starting the low-carb diet. However, people with severe liver disease may need much longer timeframes and additional treatments to see any benefits.

Want to Apply This Research?

  • Track daily carbohydrate intake, aiming to follow a structured low-carb plan, and monitor waist circumference weekly as a proxy for visceral fat changes
  • Implement a specific low-carbohydrate eating pattern while logging all meals and snacks to ensure consistency with the intervention that showed success
  • Track weight, waist measurements, and energy levels monthly while working with healthcare providers to monitor liver health markers through regular blood tests and imaging

This information is for educational purposes only and should not replace professional medical advice. Always consult with your healthcare provider before making significant dietary changes, especially if you have liver disease or other medical conditions. Individual results may vary, and severe fatty liver disease requires comprehensive medical management beyond dietary interventions alone.