In a randomised trial published in Cell Metabolism, 42 people with obesity, prediabetes and fatty liver all lost around 10% of their body weight. In the keto group liver fat fell from 19.4% to 6.2%, more than on a Mediterranean diet or on a very low-fat plant-forward diet.
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Plenty of people say calories don't count on keto. In two studies run on hospital wards, keto neither burned many extra calories nor curbed appetite by itself; weight came down, as on any diet, when people took in less energy than they used.
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A common belief is that keto brings the body close to ketoacidosis. Ketones rise in both states, but ketoacidosis needs a shortage of insulin and acidic blood. Type 1 diabetes and SGLT2 tablets are where caution is needed.
3 minutes read3 min
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