Randomised controlled trialindependent cross-checkabstract checked★ key study I-FAT-102 in-depth review
Swapping ghee for rapeseed oil improved fatty liver and cholesterol
The effects of replacing ghee with rapeseed oil on liver steatosis and enzymes, lipid profile, insulin resistance and anthropometric measurements in patients with non-alcoholic fatty liver disease: a randomised controlled clinical trial.
Overview
Maleki Sedgi F et al.. Br J Nutr 2024 · PMID 38501177 · DOI 10.1017/S0007114524000564
Less liver fat, LDL -7.5 mg/dL, triglycerides -40 mg/dL over 12 weeks.
Does the study support the specific claim? No · Methodological quality: low
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Test replacing ghee with rapeseed oil.
- How was the study done?
Randomised trial, 12 weeks.
- How many people, animals or samples were studied?
110 Iranian adults with fatty liver.
- What was actually found?
Better liver fat, lipids, sugar and weight.
- How large was the observed effect?
LDL -7.5 mg/dL.
- What do the results mean in everyday life?
Plant oil is a better daily cooking fat than ghee.
- What are the study's limitations?
Open label; weight loss.
- What does it say about Elawady's specific claim?
Contradicts 'ghee does not affect arteries' indirectly.
- Do the results apply to Germany and Europe?
Middle East; relevant to Egypt.
- What can explicitly not be concluded from this study?
Cannot show fewer heart attacks.
Scientific in-depth review
1. Full reference
- Authors
- Maleki Sedgi F et al.
- Journal
- Br J Nutr
- Year
- 2024
- Identifier
- PMID 38501177 DOI 10.1017/S0007114524000564
- Verification
- verified – PubMed efetch 2026-10-26
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
not stated in abstract
2. Research question
Does replacing ghee with rapeseed oil improve NAFLD and metabolic markers?
3. Study design and population
- Study design
- Randomised controlled trial – 12-week randomised controlled trial (advice-based substitution)
- Population
Adults with NAFLD who consumed ghee daily (Iran)
- Country
Iran
- Period
12 weeks
- Sample size
110 (70 men, 40 women)
- Inclusion and exclusion criteria
NAFLD; daily ghee users
4. Methods and endpoints
- Exposure / intervention
Replace ghee with same amount of rapeseed oil
- Comparator
Continue ghee; healthy-diet advice
- Endpoints
Steatosis, liver enzymes, lipids, glycaemia, anthropometry
- Statistical methods
Between-group comparisons
5. Actual results
- Results
Steatosis reduced more with rapeseed oil (P<0.001); changes in intervention group: ALT -14.4, GGT -1.8, TAG -39.7 mg/dL, total cholesterol -17.2 mg/dL, LDL -7.5 mg/dL, fasting glucose -7.5 mg/dL, insulin -3.05 mU/L, HOMA-IR -0.9, weight -4.3 kg, waist -5.6 cm.
- Absolute risks
not applicable (surrogate outcomes)
- Authors' conclusion
Consumption of rapeseed oil instead of ghee caused improvements in liver steatosis and enzymes, glycaemic variables and anthropometric measurements.
6. Strengths
- Randomised
- Ghee-specific
- Middle Eastern population
7. Weaknesses
- Unblinded advice trial
- Weight loss in intervention arm confounds lipid changes
- Abstract reports within-group changes; some figures (BMI -0.04) look inconsistent
- Short
8. Risk of bias
- Orienting tool
- RoB 2
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
- Rationale
Open label; co-interventions.
9. Assessment of the statistical interpretation
LDL -7.5 mg/dL = about 0.19 mmol/L; by CTT scaling about 5% fewer vascular events if sustained (assumption; stats/C-FAT-01_butter_ghee.py).
10. Relevance to the specific claim
Direct randomised evidence that replacing ghee by a plant oil lowers LDL cholesterol and improves metabolic markers in regional ghee users.
11. Independent contrary findings
Uncontrolled ghee-feeding studies report no LDL rise (not added; very low quality).
12. Transferability to Germany and Europe
Highly relevant to Egyptian ghee use.
13. Overall methodological judgement
Low-to-moderate quality; consistent with the saturated-fat/LDL evidence.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | low |
| Risk of bias | some concerns |
| Precision of results | low |
| Directness | direct |
| Reproducibility | partly replicated |
| Consistency with the overall evidence | consistent |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
Hard outcomes.
15. Linked fact checks
- Natural fats such as baladi ghee and butter are not a cause of clogged arteries (contrary to the previously dominant view); 'good fats do not stick'. – Studies contradicting or limiting the claim