Background: Metabolic dysfunction associated fatty liver disease (MAFLD) is a common co-morbidity in patients with severe and complicated obesity, with weight loss as the principal treatment goal. It has recently been suggested that ketosis achieved through restricting dietary carbohydrate may improve liver steatosis. The level of ketones present in the blood indicates the degree of ketosis achieved, but whether this relates to the magnitude of a decrease in fat accumulation in the liver is unclear.
Aim: To evaluate the relationship between plasma ketone concentrations and liver fatness as assess using non invasive elastography in patients with obesity following a low carbohydrate diet.
Objective: To measure and evaluate changes in serum ketone concentrations in response to an 8 week low carbohydrate diet, in individuals with obesity.
To measure and evaluate changes in liver fatness using a non invasive ultrasound based scan (fibroscan).
Hypothesis: Fasting ketone concentrations will be inversely associated with liver fat levels. Post intervention ketone levels will be associated with reduction in liver fatness.