Keto and inflammation?

[Daves_Not_Here]

Has anyone who is eating the keto diet experienced a reduction of inflammation?

I've been experimenting with the diet, and have been purposely very cautious about jumping to early conclusions.  I figure I'm susceptible to the placebo effect as much as anyone, and don't want to become infatuated with the latest bright, shiny object I've discovered.  That said, I am now pretty confident that keto has made a positive impact on my inflammation response.  Here's why:

For 30 years I have been living with a painfully arthritic ankle that was broken and reconstructed in an orthopedic surgery.  On a pain scale from 1 to 10, it ranges from 2 to 8 depending on the weather and how much I've worked it.   It's no big deal -- just a part of life that I've accepted and control with anti-inflammatory medications and pain killers.  For 30 years, it's never been under a 2, not for one day.  Eight years ago, I adopted a much more active lifestyle, got to my high-school weight, and even though I otherwise felt great, my ankle was still a constant nagging pain.

About a month ago, I went from eating low-carb to going into ketosis as evidenced by the urine litmus strips.  And for 3 solid weeks, my ankle pain is at 0, for the first time in 30 years.  It literally feels like it was never broken.  

Here's why I don't think it's a placebo effect:  My 19 year old daughter, who has never seen me walk without a limp, is incredulous.  Both my ankles are now the same size (yes, I've verified with a tape measure).  I've lost weight, but I'm still 30 pounds over where I was 8 years ago.  While I had heard keto has an anti-inflammatory effect, I had no expectation or hope that my ankle could ever be improved, so this is a complete surprise.  And I don't think I am so self-delusional that I can't be trusted to tell the difference between excruciating and zero pain.

Anyone else had a similar experience?

[Dominique]

No personal experience, but you may want to check research by Dr. Dominic D’Agostino. I’ve listened to several interviews and podcasts (for instance, this one) with him, and he appears to be legit / science-based.

[Daves_Not_Here]

Thanks, @Dominique -- very interesting.  I've seen D'Agostino's name pop up in relation to keto but have not listened to him yet.  Looking at the agenda on the link you provided let's me know what I'll be listening to on my drive home!

[Dominique]

Another thing that comes to mind is watch what happens if/when you reintroduce carbs, whether temporarily or permanently (very few people seem to stick to keto for life). And if/when doing so, you may want to experiment with both dosing (start with a low dose and increase progressively) and type of carbs (start with the "healthy" ones). My guess is that if carbs are indeed what causes/maintain inflammation, it’s not any amount and/or any type of carbs that triggers the inflammation.

[Daves_Not_Here]

@Dominique - I agree with your guess with a slight wrinkle -- my sense is not that carbs cause inflammation, but that ketosis inhibits inflammation through the production of beta-hydroxybutyrate, which "seems to inhibit the NLRP3 inflammasome" (quoting from http://thepaleodiet.com/anti-inflammatory-effects-ketogenic-diet/).  So if carbs break you out of ketosis, then their quality is immaterial (to this question).

Quantity, however, could matter -- I haven't figured out yet if ketosis is an on/off phenomenon, or if it occurs on a continuum, such that one could access both sources of energy at the same time (?), and still be producing enough beta-hydroxybutyrate to inhibit inflammation.  My litmus strips indicate variance of my ketone levels along a continuum but I feel the same.

As far as not sticking with it, I realized I may be initially enamored but the lack of pain is pretty nice.  I had forgotten what it feels like to walk all day in comfort, so I'm willing to stay off the Oreos if it means I continue to feel this good.  My carbs now are avocado, broccoli, spinach, cauliflower, cabbage and salad greens.  

[Mukluk4]

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@Daves_Not_Here wrote:

 My carbs now are avocado, broccoli, spinach, cauliflower, cabbage and salad greens.  

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Dear Jesus, that sounds horrible.

Are you logging activities and intensities both before and after you started this journey (or even before/after pain stopped)?  Any change there would have an effect on pain. Other diets changes may also impact this, so it's hard to anecdotally identify that carbs is the root.

I have very arthritic knees and I use a concoction of  Fish Oil, Aleve, and Green Tea which has done wonders for me personally.

[Daves_Not_Here]

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@Mukluk4 wrote:
Dear Jesus, that sounds horrible.

Are you logging activities and intensities both before and after you started this journey (or even before/after pain stopped)?  Any change there would have an effect on pain. Other diets changes may also impact this, so it's hard to anecdotally identify that carbs is the root.

I have very arthritic knees and I use a concoction of  Fish Oil, Aleve, and Green Tea which has done wonders for me personally.

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I'm not catching your point.  These carbs taste plenty good to me.  I'm eating for me, not you.  Would you have me go back to donuts and regain the weight just so I wouldn't commit the sin of eating low-carb?

I don't understand your question about if I log activity.  I own a Fitbit, so yes.  I've been capturing exercise and intensity throughout, linked to Strava, and logging my food and weight meticulously.  In 30 years, I've gone through a lot of medications, diet changes, activity levels, and body weights, and the arthritic pain has varied but never gone away.  Now, exactly correlated with ketosis, which is widely reported to inhibit inflammation, I've had 3 solid weeks of zero pain.  Why wouldn't I at least consider the obvious?

This is pretty strong anecdotal evidence, and I don't know why I would dismiss it in search of a less plausible explanation unless I had an anti-low-carb bias.  Correlation does not equal causation.  But nor does it preclude causation.

[Daves_Not_Here]

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@Dominique wrote:

No personal experience, but you may want to check research by Dr. Dominic D’Agostino. I’ve listened to several interviews and podcasts (for instance, this one) with him, and he appears to be legit / science-based.

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@Dominique    Thanks again for this - I finally got the time to listen to this podcast during my drive time - very interesting.  I appreciate the combination of his intellectual curiosity and humility in his presentation

I've been taking in a lot of Phinney and Attia's videos, and find them to be persuasive.  Here's a nice overview article:

https://asweetlife.org/the-ketogenic-diet-and-peter-attias-war-on-insulin/

[TheDoctorClara]

  Have you read keto clarity by jimmy moore  and Eric C. Westman M.D. ? It was the first book I read when switching to keto , Another book I found very helpful was The keto diet by Leanne Vogel . I did keto for four months before I had a cheat meal and it through me out of ketosis and the cravings began again. in four months I lost about 40 pounds , I had more energy and I had less brain fog. I have a friend that has been doing keto for two years because of a predisposition for inflammation  that runs in her family , in a year she lost over 60 pound , Her overall inflammation went down and she continues on keto to keep the inflammation in check . she has no regrets and has been able to become more active throughout the process. This isn't a fad diet for her but a way of living and for any dietary changes to have long term affects they need to be long term commitments . that's what alot of people dont get they want a quick fix and then to be able to return to how they ate before and expect the weight or health problems not to return .  The healthiest people put in work to be healthy they dont continually flip flop back and forth. I'm re dedicating my self back to keto as soon as possible because I'm morbidly obese , and I'm at a higher risk for health problems as I age. I'm young now so if I can get myself on track for a healthy life , Ill be able to get more out of life. I know alot of critics will say keto is just a fad but I've seen too much good and common sense come  come out of it to not give it a shot . and the four months I was hard core keto I felt better , my energy was up , my self confidence was up and i didn't have constant cravings. I ate when i was hungry not when i was bored . Im coming home to keto so if you need support I'm here for you , Its time to beat the temptations and live our lives healthy.

[Daves_Not_Here]

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@TheDoctorClara wrote:

  Have you read keto clarity by jimmy moore  and Eric C. Westman M.D. ? It was the first book I read when switching to keto , Another book I found very helpful was The keto diet by Leanne Vogel .

I have a friend that has been doing keto for two years because of a predisposition for inflammation  that runs in her family , in a year she lost over 60 pound , Her overall inflammation went down and she continues on keto to keep the inflammation in check .

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Thanks @TheDoctorClara for the book recommendations!  I'm putting them on my To Read list.

I continue to be amazed at the qualitative improvements in my life that I'm ascribing to eating keto - the loss of inflammation permits me to walk around with so much more vigor now that I'm not favoring my injured ankle.  But the mental improvement is even more dramatic -- my short-term memory has improved and I'm pretty much stress-free.  For years, I've attempted to practice mindfulness, meditation, and various personal improvement strategies in an effort to achieve some measure of serenity in a chaotic world, but nothing has ever worked as well as this.

After about a month, I'm probably still in a honeymoon period of novelty, but I feel so good that the idea of a "cheat" meal that would interrupt the effect is not appealing.  Plus, my cravings are very low, so it's not hard to avoid the junk.

Sounds like you have the right idea -- getting this figured out when you're young is the way to go.

[Dominique]

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@TheDoctorClara wrote:

I did keto for four months before I had a cheat meal and it threw me out of ketosis and the cravings began again. In four months I lost about 40 pounds

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@TheDoctorClara: four months of adherence to a diet (whether it’s keto or any other approach) shouldn’t be wiped out by a single cheat meal, or even cheat day, or even cheat week. The main reason why you no longer were able to adhere to your diet was more likely that you had been losing too much too fast. The approach described in "Losing All Your Weight At Once" (referenced in this post) makes sense to me. I know @Daves_Not_Here is against slow-paced weight loss (and it’s not what I’m advocating) and I understand his point: when someone has 100+ lbs to lose, losing at a 0.5 lbs weekly pace just isn’t a realistic option. However, a super-fast pace (like 2.5 lbs per week in your case) most likely won’t be sustainable for very long, for a number of rather well understood reasons.