Lysosomal Acid Lipase As A Molecular Target Of The Very Low Carbohydrate Ketogenic Diet In Morbidly Obese Patients The Potential Effects On Liver Steatosis And Cardiovascular Risk Factors

This study examined how a very low-carb ketogenic diet (VLCKD) affects severely obese patients preparing for weight-loss surgery. Researchers focused on an enzyme called lysosomal acid lipase (LAL), which helps break down fats in our cells. When this enzyme doesn't work well, it can contribute to fatty liver disease - a common problem in obese individuals that makes surgery riskier.

The study followed 52 severely obese patients who ate a very low-carb, high-protein ketogenic diet for 25 days. Before and after the diet, researchers measured their weight, blood sugar, cholesterol levels, and LAL enzyme activity. They also used ultrasound to check for liver fat accumulation and tested blood vessel function.

After just 25 days on the ketogenic diet, patients showed remarkable improvements. They lost weight, had better blood sugar control, improved cholesterol profiles, and significantly less severe liver fat buildup. Most importantly, their LAL enzyme activity increased substantially, suggesting their bodies became better at processing fats. The number of patients with severe fatty liver disease dropped significantly.

These findings suggest that ketogenic diets may help obese individuals by activating natural fat-processing mechanisms in their cells, not just by promoting weight loss. For patients interested in metabolic health, this research indicates that very low-carb diets may offer benefits beyond weight loss by actually improving how cells handle fats at the molecular level. In clinical practice, this supports using ketogenic diets as a preparation tool before bariatric surgery and highlights their potential for treating fatty liver disease in severely obese patients.