Which is better for fatty liver, keto or the Mediterranean diet?
Both may help non-alcoholic fatty liver, largely through weight loss and cutting refined carbs and sugar. The Mediterranean diet has stronger research support and is often easier to sustain, while keto can help some people, but this is a decision to make with your doctor.
Comparing Two Approaches for Fatty Liver
Non-alcoholic fatty liver disease is a medical condition, and diet is one part of a broader management plan that should be guided by a healthcare professional. With that said, the two diets can be compared fairly.
What tends to help
For fatty liver, the biggest dietary drivers are usually losing excess weight, reducing added sugar (especially fructose from sugary drinks) and cutting refined carbohydrate. Both keto and Mediterranean eating can achieve this in different ways.
The Mediterranean diet
Rich in vegetables, olive oil, fish, legumes and whole foods, the Mediterranean pattern has substantial research behind it for metabolic and liver health, and many people find it easier to maintain long term.
The keto diet
Very low carbohydrate can reduce liver fat for some people, often via weight loss and lower sugar intake. Evidence is more limited than for the Mediterranean pattern, and long-term suitability varies. If you and your doctor consider a low-carb trial, you can estimate your macros to plan it sensibly.
Practical takeaway
The best diet is the effective one you can sustain, and for many that is the Mediterranean pattern. For related condition questions, you can read the keto FAQ.