Digestive Diseases and Sciences

, Volume 52, Issue 2, pp 589–593 | Cite as

The Effect of a Low-Carbohydrate, Ketogenic Diet on Nonalcoholic Fatty Liver Disease: A Pilot Study

  • David Tendler
  • Sauyu Lin
  • William S. YancyJr.
  • John Mavropoulos
  • Pam Sylvestre
  • Don C. Rockey
  • Eric C. WestmanEmail author
Original Article


Nonalcoholic fatty liver disease is an increasingly common condition that may progress to hepatic cirrhosis. This pilot study evaluated the effects of a low-carbohydrate, ketogenic diet on obesity-associated fatty liver disease. Five patients with a mean body mass index of 36.4 kg/m2 and biopsy evidence of fatty liver disease were instructed to follow the diet (<20 g/d of carbohydrate) with nutritional supplementation for 6 months. Patients returned for group meetings biweekly for 3 months, then monthly for the second 3 months. The mean weight change was −12.8 kg (range 0 to −25.9 kg). Four of 5 posttreatment liver biopsies showed histologic improvements in steatosis (P=.02) inflammatory grade (P=.02), and fibrosis (P=.07). Six months of a low-carbohydrate, ketogenic diet led to significant weight loss and histologic improvement of fatty liver disease. Further research is into this approach is warranted.


Nonalcoholic fatty liver disease NASH Low-carbohydrate ketogenic diet Cirrhosis Fatty liver 



This study was partially funded by an unrestricted research grant from the Robert C. Atkins Foundation. Dr. Yancy was supported by a Veterans’ Affairs Health Services Research Career Development Award (RCD 02-183-1)


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Copyright information

© Springer Science+Business Media, Inc. 2007

Authors and Affiliations

  • David Tendler
    • 1
  • Sauyu Lin
    • 1
  • William S. YancyJr.
    • 2
    • 3
  • John Mavropoulos
    • 2
  • Pam Sylvestre
    • 1
  • Don C. Rockey
    • 1
  • Eric C. Westman
    • 2
    • 4
    Email author
  1. 1.Division of GastroenterologyDepartment of Medicine, Duke University Health SystemDurhamUSA
  2. 2.Division of General Internal MedicineDepartment of Medicine, Duke University Health SystemDurhamUSA
  3. 3.Center for Health Services Research in Primary CareDepartment of Veterans’ Affairs Medical CenterDurhamUSA
  4. 4.Duke University Medical CenterDurhamUSA

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