The ketogenic diet is a dietary approach that is characterized by low consumption of carbohydrates, less than 50 grams per day, and a higher intake of fat. Although this dietary approach is surrounded by controversy, advocates believe that its benefits outweigh potential risks. Evidence of the diet's health effects is long-standing, with a systematic review of studies finding overwhelming evidence dating back to the 1990s that the ketogenic diet is effective for treating drug-resistant epilepsy. Later, it became a popular weight loss diet.
However, recent studies suggest that the ketogenic diet may benefit people with autoimmune diseases, including rheumatoid arthritis, multiple sclerosis, lupus, and psoriasis. One reason why might be how the ketogenic diet helps reduce inflammation in the body, which may be beneficial for those with autoimmune disorders.
According to Dr. Jonathan Rasouli, a neurosurgeon and director of complex and adult spinal deformity surgery at Staten Island University Hospital, chronic inflammation plays a "major role" in autoimmune disease. "Just like being under constant psychological stress, when our bodies are in a pro-inflammatory state, we are prone to developing diseases," he explained. This is why "scientists are constantly trying to develop ways to combat chronic inflammation in our bodies in order to stop diseases from developing," said Rasouli.
A recent randomized, controlled trial looked at two groups eating either a whole-food diet with very little processed food or a ketogenic diet. While both groups showed reduced pain and inflammation, the ketogenic group experienced a significantly greater reduction in pain and inflammation.
Another review of studies found evidence that the diet can reduce obesity-related inflammation in the body.
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Inflammatory bowel disease, such as Crohn's disease, is an inflammatory disease of the bowel that has no cure. Standard treatment involves steroids, anti-inflammatories, and biologics drugs to reduce symptoms. However, a case report from 2016 involving a 14-year-old boy diagnosed with Crohn's disease found that when the boy was advised to follow a paleolithic ketogenic diet, which excluded grains, milk, dairy, refined sugars, vegetable oils, oilseeds, nightshades, and artificial sweeteners, along with standard drugs, he showed no change in symptoms. Within two weeks he was off medication; within three weeks, his symptoms had resolved and he reported "restored energy and increased physical and mental fitness." There is evidence that this diet may help inflammatory bowel disease by altering our gut microbiome in ways that reduce inflammation.
Rheumatoid arthritis is an autoimmune and inflammatory disease that is typically treated with anti-inflammatory drugs like ibuprofen and acetaminophen, which have been associated with serious adverse effects. A systematic review of studies finds that eating a ketogenic diet is associated with significantly decreased systemic inflammation, which relieves one of the main drivers of rheumatoid arthritis.
Psoriasis causes patches of thick red skin and silvery scales to develop on different parts of the body, including the face, scalp, elbows, and knees. Researchers studied the effects of a very-low-calorie ketogenic diet on psoriasis patients to find that this approach can be considered a successful strategy and therapeutic option for management of the condition. Another study found that in adult overweight patients with stable chronic psoriasis, an "aggressive" dietary weight loss program consisting of a ketogenic regimen followed by a "balanced, low-calorie, Mediterranean-like diet" showed effectiveness as a first-line strategy for reducing disease severity.
Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system. A phase 2 clinical trial of ketogenic diets in relapsing MS found they were safe and tolerable.
Additionally, a study conducted by the University of Texas Southwestern Medical Center revealed that the ketogenic diet may improve cognitive function in those with Alzheimer's disease. The researchers found that a high-fat, low-carb diet increased ketone levels in the blood, which helped improve cognitive function in patients with Alzheimer's.
While the benefits of a ketogenic diet for autoimmune disorders are promising, it's important to note that it may not be suitable for everyone. Individuals with pancreatic or liver disease, gallbladder disease, and certain genetic disorders may not be able to tolerate the high-fat intake required for the diet. It's essential to speak with a healthcare provider before starting any new diet or making significant dietary changes.
Despite the potential benefits, the ketogenic diet remains a controversial topic in the medical community. Some experts argue that the long-term effects of the diet are unknown, while others question the sustainability of the diet in the long run.
However, as research continues to emerge, it's becoming increasingly clear that the ketogenic diet has potential benefits for those with autoimmune diseases. Inflammation plays a significant role in autoimmune diseases, and the ketogenic diet's ability to reduce inflammation in the body may be beneficial for those with these conditions.
In conclusion, while the ketogenic diet may not be a cure for autoimmune diseases, it offers hope for individuals suffering from these debilitating conditions. Its potential to reduce inflammation, boost cognitive function, and alleviate symptoms associated with autoimmune disorders makes it a promising dietary approach. As always, it's essential to consult a healthcare professional before starting any new diet or making significant dietary changes.