Is the keto diet good for liver cirrhosis?
The ketogenic or keto diet is a high fat, low-carbohydrate eating plan. While some early studies suggest that keto may improve liver function in certain conditions like nonalcoholic fatty liver disease (NAFLD), its effects on advanced liver damage, such as cirrhosis, are less clear and potentially concerning.Liver cirrhosis is the final stage of chronic liver damage, where healthy tissue is replaced with scar tissue, impairing liver function. Diet plays a critical role in managing cirrhosis, and healthcare professionals often advise people to follow a balanced diet that supports liver health and prevents further complications.However, several animal studies suggest that the keto diet may worsen liver injury in the context of fibrosis or cirrhosis. A 2021 study in mice found that a high fat ketogenic diet increased cholesterol buildup in the liver. It also noted that the keto diet increased liver inflammation and markers of scarring.These findings suggest that in cases of existing liver damage, a keto diet may accelerate liver dysfunction rather than improve it.However, in some short-term human studies, results are more promising. A 2020 study showed that a 6-day controlled ketogenic diet in adults with nonalcoholic fatty liver disease showed rapid reductions in liver fat and better insulin resistance. A 2025 review of very-low-calorie keto diets (VLCKD) showed substantial reductions in liver fat, improved insulin sensitivity, and lower liver enzyme levels. However, it noted that long-term safety data, especially in cirrhosis, are still limited. These studies suggest short-term benefits in reducing fat and inflammation in early liver disease, but they involved people with fatty liver before cirrhosis developed.Cirrhosis represents advanced, irreversible liver damage. Most keto studies exclude patients with cirrhosis, and animal data warn of possible harm from increased fibrosis and inflammation.While ketogenic diets may help reverse liver fat and early fibrosis, there is no strong evidence supporting their safety or benefit in established cirrhosis.Anyone with liver disease who is considering a major dietary change like the keto diet should do so only under the close guidance of a hepatologist or clinical nutrition specialist. More research is needed to determine whether this type of diet is safe or effective in cirrhosis management.
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