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Taking people in CanadaNo phase

Tests a ketogenic diet before liver surgery in people with fatty liver

Compares a 4 week low-carbohydrate diet with standard diet advice before liver surgery.

Key facts

Who runs it
Anton Skaro
Where
London, CanadaSee the site
Trial code
Registry title
Preoperative Ketogenic Diet for Reduction of Hepatic Steatosis
Status
Recruiting
People taking part
124 people, planned
Started
1 May 2024
Expected to end
Dec 2032
Type of study
Interventional, 2 groupsOne group gets no study treatment, for comparison.
Treatments tested
  • Ketogenic Diet
Record updated
19 May 2026

Who can take part

AI summary

From the trial's eligibility criteria. Machine-read from the registry text on this page, so it can be wrong. The registry text below and the trial team decide who can take part.

The trial is looking for adults having liver surgery for colorectal cancer that spread to the liver, who also have fatty liver. It tests a 4-week ketogenic diet before surgery.

Age
18 years or older
Sex
All sexes can join
Disease stage
Colorectal cancer that has spread to the liver (colorectal liver metastases), with fatty liver seen on imaging (CT or MR) or biopsy, and planned for liver resection (open or laparoscopic)
Earlier treatment
Must not be taking sodium glucose co-transporter 2 (SGLT-2) inhibitors

Main reasons for not taking part

  • Liver surgery for any other reason
  • Taking SGLT-2 inhibitors
  • No fatty liver
  • Liver fibrosis or cirrhosis
  • Alcohol-related fatty liver

The registry criteria, word for word

Show all 9 criteriaShow less

Who can take part

  • Patients 18 years of age or older undergoing any type of liver resection (e.g. wedge, formal hepatectomy), either open or laparoscopic, for colorectal liver metastases (CRLM)
  • Patients with evidence of hepatic steatosis on pre-operative imaging (CT or MR) or biopsy
  • Ability to use an app based nutritional program to track macronutrient uptake throughout the dietary intervention

Who cannot take part

  • Patients undergoing liver resection for any other indication
  • Patients with a known bleeding disorder
  • Patients on sodium glucose co-transporter 2 (SGLT-2) inhibitors (these are contraindicated with a ketogenic diet)
  • Patients without evidence of hepatic steatosis
  • Patients with evidence of liver fibrosis or cirrhosis on preoperative bloodwork or imaging
  • Patients with alcohol-related hepatic steatosis

Where in Canada

  • London Health Sciences Centre/Western UniversityLondon, CanadaContact: Crystal Engelage, PhDTaking people

About the trial

What the trial wants to find out

Non-alcoholic fatty liver disease is becoming increasingly common in Canada and throughout the world. Fatty liver can increase the risks of perioperative complications for those who need liver surgery. A ketogenic diet is low in carbohydrates and can be very effective in reducing liver fat content. The purpose of this randomized control trial is to compare the effect of a short duration (4 week) preoperative ketogenic diet on operative and disease outcomes in patients undergoing liver surgery. One arm will be randomized to the ketogenic diet and the other will receive standard of care pre-operative dietary consultation.

The 2 groups in the trial

  • Ketogenic Diet ArmTreatment being tested

    Participants in this group will be counselled by a registered dietician and then undergo a 4-week preoperative well formulated ketogenic diet. They will record all nutritional uptake during the diet using an app called Cronometer and provide weekly summary reports to the study team.

    Treatment: Ketogenic Diet

  • Control ArmNo study treatment, for comparison

    Participants in this group will be counselled by a registered dietician and then undergo a 4-week standard of care diet, as recommended by Canada's Food Guide. They will record all nutritional uptake during the diet using an app called Cronometer and provide weekly summary reports to the study team.

Questions to ask the study team

  1. How often do I need to come in, and for how long each time?
  2. Are travel costs paid?
  3. Can I keep my own doctor?
  4. What happens if I want to stop?

Contact the study team: see the registry record → Contacts and Locations

Print a page for my doctor

Data and sources

Registry record
Listed on ClinicalTrials.gov.
Official title
Implementation of a Preoperative Ketogenic Diet for Reduction of Hepatic Steatosis Prior to Hepatectomy: a Randomized Control Trial
Plain-language title
Tests a ketogenic diet before liver surgery in people with fatty liverGenerated from the registry record. The registry title is the official one.
AI summary
From the trial's eligibility criteria. Read by machine on 12 November 2026.
Record updated
19 May 2026