A recent study made headlines for claiming a ketogenic diet may worsen fatty liver disease and raise triglycerides. But when you take a closer look at the research, it’s clear that the conclusions are far less supported than the coverage suggests.

To clear things up, Dr. Bret Scher breaks down what the study actually found, where the methodology falls short, and what the broader body of research has to say about ketogenic therapy and liver health.

In this discussion, you'll learn:

• What the study examined and how the data was collected
• Why the lack of ketone measurement makes it impossible to confirm anyone was actually in ketosis
• How reverse causality may explain the findings entirely
• What baseline differences in BMI and adiposity reveal about the study population
• Why cross-sectional observational studies sit lower on the evidence hierarchy than RCTs
• What a meta-analysis of 62 randomized controlled trials shows about ketogenic diets and triglycerides
• What a 12-week supervised intervention revealed about ketogenic therapy and fatty liver reduction
• Why higher-quality controlled trial evidence should take precedence over headline-grabbing observational studies

For clinicians, researchers, and anyone navigating conflicting headlines about ketogenic therapy, this conversation is a reminder that the quality of evidence matters as much as the findings themselves.

🔎 Have questions about how to apply metabolic therapies effectively? Submit them at metabolicmind.org/questions to be featured in a future Metabolic Mailbag episode.

#KetogenicTherapy #MetabolicMind #FattyLiverDisease

Expert Featured:

Dr. Bret Scher

• Baszucki Group Medical Director
• https://x.com/bschermd

Resources Mentioned:

Association between dietary patterns and lipid profile in patients with non-alcoholic fatty liver disease: a retrospective cross-sectional study

• https://doi.org/10.3389/fnut.2026.1794910

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Follow our channel for more information and education from Bret Scher, MD, FACC, including interviews with leading experts in Metabolic Psychiatry.

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About us:

Metabolic Mind is a non-profit initiative of Baszucki Group working to transform the study and treatment of mental disorders by exploring the connection between metabolism and brain health. We leverage the science of metabolic psychiatry and personal stories to offer education, community, and hope to people struggling with mental health challenges and those who care for them.

Our channel is for informational purposes only. We are not providing individual or group medical or healthcare advice nor establishing a provider-patient relationship. Many of the interventions we discuss can have dramatic or potentially dangerous effects if done without proper supervision. Consult your healthcare provider before changing your lifestyle or medications.