Here we go again. Could a low-carb, high-fat diet make more drugs obsolete? A small study from Alabama suggests that LCHF diets may control the pain of knee osteoarthritis better than common anti-inflammatory pain medicines.
Pain Medicine: The effect of low-carbohydrate and low-fat diets on pain in individuals with knee osteoarthritisThe study randomized 21 older adults with knee osteoarthritis to a low-carbohydrate diet (less than 40 grams of carbs per day), a low-fat diet (calorie restricted, with 20% of calories from fat and 60% from carbs), or a control diet (no modifications).
After 12 weeks, the low-fat and low-carb groups saw similar weight loss of 15 to 20 pounds (7 to 9 kilograms). However, only the low-carb group saw improvements in pain interference scores, quality of life, and pain intensity. The control and low-fat groups showed no such benefits.
The authors hypothesize that since weight loss was similar between the low-fat and low-carb groups, the benefit must have been due instead to differences in oxidative stress and inflammation, but the study did not directly test this. In addition, there was no mention of the need for medications between the groups, so we don't know that a low-carb diet will reduce the need for pain medicines (although it seems like a safe inference given the reduced pain scores).
Although improving quality of life for those suffering with arthritis is a promising potential benefit for ketogenic diets, and the anecdotal reports are prevalent, more information is needed before we can draw stronger scientific conclusions. Yet once again we are confronted with the same question: Why not give it a try? Since the side effects tend to be weight loss, improved metabolic health, greater energy and better well-being, it seems like a better risk-benefit ratio than most available alternatives.
Hear more about using a keto diet for pain relief from Drs. Èvelyne Bourdua-Roy and Hala Lahlou, and the potential role of insulin in pain pathogenesis from our prior news story.
Thanks for reading,
Bret Scher MD FACC