The Keto Diet For Arthritis
Osteoarthritis is the most common form of arthritis. It affects nearly 27 million people in the United States alone, and more than 40% of people over the age of 70.
This debilitating disease occurs when cartilage in the joints breaks down. As the protective cushion deteriorates, bones begin to rub against each another. The end result is pain, inflammation, disability and a significant decline in the quality of life.
And while a number of factors can increase the risk of OA including age, genetics, high impact jobs and the mechanical stress associated with carrying extra body fat new research shows that your diet can also play a big role in the development and progression of the disease.
Today, we cover the links between a high carbohydrate diet and the development of OA. Youll also discover the two dietary factors that are most problematic. And how you can eat to prevent arthritis as well as reduce pain and symptoms in case youre already suffering.
Inflammatory Cytokines Vs N
Next, they looked at the presence of the actual inflammatory cytokines in joint tissues like IL-17. They found that in comparison to the mice that were not on an n-3 PUFA-rich diet, those that were on the diet had much lower levels of cytokines in their joints. This means that inflammation was decreasing because the stuff that causes inflammation wasnt there as much.
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What Is The Ketogenic Diet
Chances are, you have at least heard about this eating plan. Often referred to simply as keto, this is a low-carbohydrate, high-fat diet that was originally created to help treat epileptic children not responding to medications.
When we lower the number of carbohydrates that we consume, we transform the bodys reliance on glucose and force it to rely on ketones for its primary source of energy.
This may sound extreme, but ketosis is actually a built-in mechanism that our bodies use to thrive. The keto diet can vary, but generally speaking, it calls for a consumption of 65-75% of calories from fat, 20-30% from protein, and only 5-10% from carbs.
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Ketogenic Diet In Psoriatic Arthritis
PsA is associated with several metabolic abnormalities. Insulin resistance, hypertension, diabetes, and hyperuricemia are common comorbidities defining the spectrum of the systemic psoriatic disease . Literature about the effects of nutritional interventions in PsA is limited , with no specific dietary indication for PsA patients. In psoriasis, it has been shown that a ketogenic nutritional regimen led to significant improvement in disease activity indices . Through the assessment of nuclear magnetic medicine metabolomic profile, it was also possible to demonstrate a marked amelioration in biochemical parameters indicative of metabolites related to psoriasis . It has been suggested that, in psoriatic patients, KD may facilitate weight loss and modulate systemic inflammation resulting in a quick response to systemic therapy .
We could not retrieve studies about KD in PsA but some information can be derived from a study conducted on PsA patients during the Ramadan fasting . Adawi et al. demonstrated that intermittent fasting improved the clinical manifestation of PsA, including PsA disease activity scores, enthesitis and dactylitis. Furthermore, the patients’ improvement was independent of changes in the patients’ weight . PsA has been strongly associated with Th17 and IL-17A increase . In addition to the aforementioned KD effects, BHB induces the production of IL-10 via dendritic HCAr, resulting in an inhibitory effect on Th17 .
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Going Forward With Gout
So what should you eat when you have gout? I recommend copious amounts of whole grains, plant-based protein, fresh vegetables and fruits, daily nuts, legumes, low-fat dairy, oily fish, and chicken and eggs in moderation, says Dr. Beyl.
He suggests that gout patients avoid red meat, shellfish, high-fructose corn syrup, refined sugar, liquor, and beer.
Its important to remember that the right kind of diet can play an important role in managing gout, as long as its used with and not in place of prescription drugs. I always encourage strict compliance with our gout medications, but try very hard to emphasize the importance of diet to treat the patient as a whole not just their arthritis, says Dr. Beyl.
In other words, the diet that is sustainable, helps you feel great all around, and helps keep gout symptoms controlled is the way to go.
If you do decide to make a change in your diet for any reason, seek out medical supervision from your doctor or a registered dietitian who is experienced with inflammatory conditions.
Get access to our Gout Patient Guidelines by subscribing to CreakyJoints today.
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Seven Days Fasting Followed By Vegan Diet
Fraser et al. observed that subtotal fasting where patients were allowed to have limited amount of vitamin and mineral supplementation, carbohydrate, and energy in form of vegetable juice decreased CD4+ lymphocyte activation and numbers. Activation of CD4+ T cell and further differentiation to Th1 and Th17 lineages are shown to be responsible for progression of RA . Thus, decreased T cell activation owing to 710 day fasting suggests a transient immunosuppression, thereby suppressing RA . Michalsen et al. have also shown beneficial effect of fasting on clinical improvement in RA patients as compared to non-fasting group, although the results were independent of alterations in intestinal flora .
A fasting of 710days with partial nutrient intake of vegetable broth, herbal teas, parsley, garlic, and decoction of potatoes juice extracts from carrots, beets, and celery and a controlled daily energy intake followed by 1year of a vegan diet as compared to omnivorous diet was studied in different trials . Together these studies observed remarkable decrease in swollen and tender joints, pain, erythrocyte sedimentation rate , and C-reactive protein .
The Better Way To Eat To Help Control Inflammation
Many experts agree that the Mediterranean diet is advised for people who have RA, as well as other types of arthritis. It emphasizes a plant-based eating approach, loaded with vegetables and healthy fats, including olive oil and omega-3 fatty acids from fish.
Its also the dietary approach with the most solid data behind it. Research published in the journal Frontiers in Nutrition investigated dietary interventions for rheumatoid arthritis and determined that an ideal meal would include raw or moderately cooked vegetables , with the addition of spices like turmeric and ginger, seasonal fruits, and probiotic yogurt all of which are good sources of natural antioxidants and deliver anti-inflammatory effects. They also recommend avoiding processed foods, foods with high sodium levels, oils, butter, sugar, and animal products.
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Possible Side Effects Of Ketogenic Diet
At the beginning of this type of diet, one may experience something called as a keto flu.
It causes fever, dizziness and other flu-like symptoms as the body is switching from carbs to fat . It may last a for a couple of days.
A long-term ketogenic diet has shown to produce a reduction in bone mineral content in children .
Low bone mineral density is associated with disease severity in rheumatoid arthritis patients .
A ketogenic diet may cause constipation, it can be avoided by a high intake of fiber in the diet .
It can also cause low blood sugar, inflammation of the pancreas and some kidney problems .
The Keto Diet For Pain
Where theres inflammation, theres usually pain.
In the case of acute inflammation, pain can be useful. Its your body saying: hey just wanted to let you know, somethings wrong here.
But in the case of chronic inflammation, pain can become a burden. Chronic inflammation can become chronic pain.
The most common painkillers nonsteroidal anti-inflammatory drugs like aspirin, Advil, etc. work by reducing inflammation. But NSAIDs come with side effects that range from liver toxicity to gastrointestinal bleeding not a good long-term pain management strategy.
There are safer methods. Fasting, for instance, has shown promise for reducing the pain and inflammation of rheumatoid arthritis.
Similar to fasting, the ketogenic diet also reduces inflammation by:
- Lowering blood sugar
- Inhibiting the inflammasome
Ketos anti-inflammatory effect also appears to reduce pain.
In one rodent study on pain, rats were fed a high-carb control diet, while others were fed a high-fat low-carb ketogenic diet.
The animals were put on warm plates of varying temperatures, then observed for signs of discomfort like licking or hindpaw raising.
The keto-fed rats could handle higher temperatures for longer, suggesting that pain tolerance is higher when youre in ketosis.
In other words: something about the ketogenic diet increased pain tolerance. Keto, the researchers theorized, may decrease pain by:
- Boosting the pain-killing neurochemical adenosine
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Citrus Fruits Cause Inflammation
Some people believe that they should avoid citrus fruits because the acidity is inflammatory. However, this is not the case. In fact, citrus fruits have anti-inflammatory benefits, as well as being rich in vitamin C and antioxidants.
Grapefruit juice can, however, interact with some medicines that doctors use to treat arthritis. People who are undergoing treatment should check with a doctor before incorporating it into their diet.
Understanding The Keto Diet
The ketogenic diet is not new, even though its been making headlines now more than ever. The extremely low-carb, high-fat, moderate-protein diet has been used for nearly 100 years to help control seizures in children with epilepsy.
The theory behind a keto-like diet is that once the body has depleted its stores of glycogen the back-up energy in the liver and muscles it will look to the bodys fat stores as fuel, says Sophia Kamveris, MS, RD, LDN, a Boston-based nutritionist and author of The 28-Day Gout Diet Plan.
A result of this metabolic state called ketosis is decreased hunger and increased weight loss. Proponents of the keto diet believe that it can also be helpful in managing diabetes, Alzheimers, and more.
But does a classic ketogenic diet which is made up of around 70 to 80 percent fat, 20 percent protein, and 5 percent carbohydrates make sense for a person with gout, a type of inflammatory arthritis? While there is some interesting research on the topic, many experts say not so fast.
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Will The Keto Diet Help Me Lose Weight
Studies have shown that a ketogenic diet can cause rapid weight loss in most people, reducing the stress put on your joints! This is partly because of the diets low carb content and the great selection of natural foods. The 2019 study of low-carb diets found that weight loss benefits disappear after a year, similar to other dietary methods, but the health benefits persist . This makes the Keto diet a great way to help with your joint pain and have you walking/running around like you used to!
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How Ketosis Might Help Manage Gout
Researchers at Yale University looked at how putting the body into a state of ketosis can impact the inflammation that contributes to diseases like gout. When they fed rats a ketogenic diet and then induced a gout flare, the animals had less joint inflammation and swelling than they did when they were not on the keto diet.
But: We are not trying to say that a ketogenic diet prevents or cures gout, says Emily Goldberg, PhD, postdoctoral fellow in the departments of comparative medicine and immunobiology at Yale University. What this research did show, she says, is that it is possible to target the source of inflammation in gout to prevent acute symptoms of the disease.
Scientists have also looked, in test tubes, at the impacts that ketone production might have on humans. The results have been promising however, scientists say that further research is needed before they can recommend a keto diet to help keep gout under control.
However The Link Between Protein Consumption And Gout Is Far From Conclusive
In a 2004 study published in The New England Journal of Medicine, researchers linked meat and seafood consumption to increased gout risk. But a more controlled study was conducted in 2014. Publishing their results on the American College of Rheumatology website, researchers found that six months of a high-protein, low-carb diet reduced uric acid levels in 74 overweight or obese participants. Another study published in 2013 found that vegans have higher uric acid levels than meat eaters. Overall, these studies suggests that meat probably isnt the problem when it comes to gout.
Sugar is the more likely culprit in this equation. Fructose, the sugar found in fruit and corn syrup, is now known to increase uric acid production. At the same time, fructose also prevents uric acid clearance in the body. This is because when your liver becomes loaded with fructose it can interfere with protein metabolism and deplete ATP . When your ATP drops, your uric acid production increases.
Whats more, when you ingest high levels of sugar, you become insulin resistance . It means that you have high levels of insulin in your body. And high levels of circulating insulin decreases uric acid clearance.
Reducing your sugar intake by reducing your carbohydrate intake is therefore an effective way of alleviating your gout symptoms.
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The Relationship Between Inflammation And Chronic Pain
Behind much of the pain, we feel on a daily basis is inflammation. Nerve damage, diabetes, and arthritis are all causes for a high amount of inflammation that can cause extreme pain.
Chronic inflammation can arise from many different factors. Sedentary lifestyle, stress, and toxins like those found in tobacco smoke can all lead to chronic pain and inflammation as time goes on. If you have a family predisposition to these issues, it can happen that much more quickly. What you choose to put into your body in the form of foods has a drastic effect on your inflammation levels.
Many people in pain who are suffering from inflammation are looking for alternative approaches. The highly addictive opioid pills dont appeal to many. They can cause serious side effects and become addictive very easily.
Being in ketosis helps reduce inflammation, but it can also help you ease pain related to:
- Increased adenosine levels. This chemical fights inflammation and can act as a pain reliever, as well.
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Histological And Immunohistochemistry Analyses
After decalcification with ethylene diamine tetra acetic acid for at least 4 weeks, the samples were embedded in paraffin and sectioned sagittally into 4-m slices. Then, the slices were stained with Safranin O-fast green and hematoxylin-eosin . Three blinded reviewers evaluated the grade of degenerative changes using the Osteoarthritis Research Society International Scoring System. The content of glycosaminoglycan in the cartilage was evaluated by Alcian blue staining.
For immunohistochemical staining, the slices were incubated in 3% hydrogen peroxide for 30 min, before being subjected to antigen retrieval. The specimens were incubated with primary antibodies against NLRP3 , ASC , Caspase-1 p20 , IL-1 , IL-18 , MMP13 , and COL2 at 4 °C overnight. After washing in PBS, the slides were incubated with goat anti-rabbit HRP-conjugated secondary antibody . Finally, the reactions were developed using 33-diaminobenzidine. The stained sections were photographed with a light microscope and were semi-quantitatively analyzed by the Image-Pro Plus software. We measured the optical density of the positively stained cells three times in randomly selected sections.