{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T16:28:02Z","timestamp":1790958482844,"version":"4.1.0"},"reference-count":52,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2021,3,17]],"date-time":"2021-03-17T00:00:00Z","timestamp":1615939200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Metagenics","award":["AWD-103016"],"award-info":[{"award-number":["AWD-103016"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Ketogenic diets (KDs) often contain high levels of saturated fat, which may increase liver fat, but the lower carbohydrate intake may have the opposite effect. Using a controlled feeding design, we compared liver fat responses to a hypocaloric KD with a placebo (PL) versus an energy-matched low-fat diet (LFD) in overweight adults. We also examined the added effect of a ketone supplement (KS). Overweight adults were randomized to a 6-week KD (KD + PL) or a KD with KS (KD + KS); an LFD group was recruited separately. All diets were estimated to provide 75% of energy expenditure. Weight loss was similar between groups (p &gt; 0.05). Liver fat assessed by magnetic resonance imaging decreased after 6 week (p = 0.004) with no group differences (p &gt; 0.05). A subset with nonalcoholic fatty liver disease (NAFLD) (liver fat &gt; 5%, n = 12) showed a greater reduction in liver fat, but no group differences. In KD participants with NAFLD, 92% of the variability in change in liver fat was explained by baseline liver fat (p &lt; 0.001). A short-term hypocaloric KD high in saturated fat does not adversely impact liver health and is not impacted by exogenous ketones. Hypocaloric low-fat and KDs can both be used in the short-term to significantly reduce liver fat in individuals with NAFLD.<\/jats:p>","DOI":"10.3390\/nu13030966","type":"journal-article","created":{"date-parts":[[2021,3,17]],"date-time":"2021-03-17T05:43:26Z","timestamp":1615959806000},"page":"966","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":53,"title":["Comparison of Ketogenic Diets with and without Ketone Salts versus a Low-Fat Diet: Liver Fat Responses in Overweight Adults"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7284-3048","authenticated-orcid":false,"given":"Christopher","family":"Crabtree","sequence":"first","affiliation":[{"name":"Department of Human Sciences, The Ohio State University, Columbus, OH 43201, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5527-9529","authenticated-orcid":false,"given":"Madison","family":"Kackley","sequence":"additional","affiliation":[{"name":"Department of Human Sciences, The Ohio State University, Columbus, OH 43201, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandru","family":"Buga","sequence":"additional","affiliation":[{"name":"Department of Human Sciences, The Ohio State University, Columbus, OH 43201, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon","family":"Fell","sequence":"additional","affiliation":[{"name":"Department of Human Sciences, The Ohio State University, Columbus, OH 43201, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"LaFountain","sequence":"additional","affiliation":[{"name":"Department of Human Sciences, The Ohio State University, Columbus, OH 43201, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parker","family":"Hyde","sequence":"additional","affiliation":[{"name":"Department of Human Sciences, The Ohio State University, Columbus, OH 43201, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teryn","family":"Sapper","sequence":"additional","affiliation":[{"name":"Department of Human Sciences, The Ohio State University, Columbus, OH 43201, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Kraemer","sequence":"additional","affiliation":[{"name":"Department of Human Sciences, The Ohio State University, Columbus, OH 43201, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debbie","family":"Scandling","sequence":"additional","affiliation":[{"name":"Dorothy M. Davis Heart &amp; Lung Research Institute, The Ohio State University, Columbus, OH 43210, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orlando","family":"Simonetti","sequence":"additional","affiliation":[{"name":"Dorothy M. Davis Heart &amp; Lung Research Institute, The Ohio State University, Columbus, OH 43210, USA"},{"name":"Departments of Radiology and Internal Medicine, The Ohio State University, Columbus, OH 43210, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8702-0351","authenticated-orcid":false,"given":"Jeff","family":"Volek","sequence":"additional","affiliation":[{"name":"Department of Human Sciences, The Ohio State University, Columbus, OH 43201, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,3,17]]},"reference":[{"key":"ref_1","first-page":"13","article-title":"The GBD 2015 Obesity Collaborators. 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