Cunha GM, de Mello LLC, Hasenstab KA, et al. - In this investigation involving 46 patients, researchers contrasted the changes in visceral adipose tissue (VAT), liver fat fraction, and liver stiffness utilizing quantitative MRI during a very-low-calorie ketogenic (VLCK) diet and a standard low-calorie diet (LC). The research included secondary analysis of prospective collected clinical data. Patients who underwent weight loss therapies were randomized to either a LC or a VLCK diet.At baseline and after 2 months, VAT, liver fat fraction, and stiffness were measured. Data reported that the mean weight loss in the VLCK group was –9.7 ± 3.8 kg and in the LC group -1.67 ± 2.2 kg. It was noted that mean VAT reductions were –39.3 ± 40 cm² and –12.5 ± 38.3 cm², and mean liver proton density fat fraction (PDFF) reductions were –4.77 ± 4.2% and –0.79 ± 1.7%, respectively, in the VLCK group and in the LC group. There were no significant changes in liver stiffness from baseline to follow-up. A VLCK diet lead to greater weight loss compared with a standard low-calorie diet and in significantly greater decline in liver PDFF. As anthropometric measurements may not correlate with changes in liver fat, the use of quantitative MRI in monitoring strategies for patients undergoing weight-loss programs may be beneficial.