- Design
- Pilot randomised controlled trial, 3 months
- Population
- 20 adults with newly diagnosed MASLD
- Primary outcome
- Metabolic, inflammatory and elastography measures
- Effect
- Within-group improvements; several between-group differences not significant
An International Immunopharmacology pilot randomised 20 adults with newly diagnosed MASLD to three months of a C8 medium-chain fatty acid supplement (about 20 g a day) or a standard low-carbohydrate diet.
The supplement raised β-hydroxybutyrate, indicating nutritional ketosis. Over time, fasting glucose, insulin resistance, body fat, BMI, inflammasome markers in blood cells, steatosis and liver stiffness changed. But for several outcomes there was no significant difference between groups, and the authors describe the findings as exploratory.
Patients with MASLD often ask about ketogenic diets and supplements. This study is too small and short to show that inducing ketosis is better than other dietary approaches, and short-term stiffness changes may not reflect fibrosis.
The proven treatment for MASLD remains weight loss through sustainable diet and activity.
- Advise weight loss through sustainable diet and physical activity as first-line MASLD treatment
- Tell patients who ask that ketogenic supplements are unproven for MASLD
- Interpret short-term changes in liver stiffness cautiously; they may not reflect fibrosis
Why it matters
It answers, for now, a question patients often bring to clinic.
Don't overread it
Twenty patients, three months, and no clear between-group difference for several outcomes.
The statistics, in plain English
Within-group changes over time are not the same as a difference between groups; without a significant group-by-time interaction, the supplement has not been shown to outperform the comparison diet.
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