The ketogenic diet — or keto diet for short — is a very low-carb, high-fat diet that’s meant to put your body into a metabolic state called ketosis.
Though best known as a way to lose weight fast, the popular diet has also been linked to improvements in certain medical conditions, such as diabetes and heart disease.
There’s some evidence that it may also help alleviate gout. Gout is a form of inflammatory arthritis that affects 4 percent of all American adults, according to the Arthritis Foundation.
Before trying a keto diet, it’s important to note that it isn’t for everyone, and entering ketosis can actually trigger flare-ups.
Here’s more information on keto and gout to help you decide if the keto diet is for you.
It’s a bit of a mixed bag when it comes to the research on the effects of a keto diet on gout. Here’s what the experts are saying.
Is it beneficial for gout?
Possibly. In 2017, researchers at Yale University looked at how ketosis affects NLRP3 inflammasome, which is the protein complex that triggers the inflammation that contributes to gout. Animal and human studies showed that following a keto diet resulted in less joint inflammation.
While the evidence is promising, the researchers concluded that more studies are needed before the keto diet can be recommended as a treatment for gout.
Another way that the keto diet may be beneficial for gout is weight loss. Weight loss is the most effective way to lower uric acid levels and prevent gout flare-ups.
Does it increase the risk of gout?
It might. The keto diet is high in purine-rich foods. Purine is a chemical that the body breaks down into uric acid. Gout develops when there’s too much uric acid in the blood.
Excess uric acid can form needle-like crystals in a joint, causing pain, tenderness, swelling, and redness.
The best diet for gout is one that is low in purines and includes fruits, vegetables, whole grains, and low-fat dairy products. Along with medication, a low-purine diet is recommended to reduce the risk of gout.
A 2012 study found that people experience an increased risk of gout when they first enter into ketosis due to an increase in uric acid levels. However, the risk is short-term and improves once your body adapts to being in ketosis.
Can it help prevent gout?
No. The available research suggests that the keto diet may help target the source of the inflammation to prevent acute symptoms of gout. But it hasn’t been shown to prevent the condition.
The keto diet is generally considered safe for healthy people and may be especially beneficial for people who have certain conditions, such as:
Switching to a low-carb diet and being in ketosis can cause side effects, including flu-like symptoms. These symptoms are often referred to as “low-carb flu” or “keto flu.” They’re usually short-lived and improve as your body gets used to the diet.
Common side effects include:
If your symptoms continue, consult your healthcare provider.
Is it safe for people with gout?
Before making any drastic changes to your diet, it’s important to speak with your doctor.
Foods high in purines, especially from animal sources, increase the risk of gout flare-ups by almost five times. Though there are different types of keto diets, they all contain high-purine foods.
Managing gout usually involves a combination of medication, diet, and lifestyle changes.
Gout medications include nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids. They’re used to ease symptoms of acute attacks like pain and inflammation, and to control uric acid levels to prevent future attacks and complications.
Following a healthy diet that doesn’t include high-purine foods and beverages is also recommended.
Foods that are high in uric acid and known to trigger gout flare-ups include:
- red meat: beef, pork, and lamb
- organ meat: liver, kidney, and sweetbread
- seafood: shellfish, tuna, and anchovies
- high-sugar foods and beverages: pastries, candies, and sweetened beverages
- alcohol
A 2015 review article suggests there’s evidence that certain foods and drinks may lower the risk of gout flare-ups. Adding the following to your diet may be beneficial:
- coffee
- low-fat dairy products, such as milk and yogurt
- vitamin C
Other ways you can reduce your risk of gout flare-ups and improve related symptoms include:
- Consuming cherry juice. The juice can treat flare-ups by lowering the levels of uric acid in the body.
- Drinking plenty of water. Water helps your kidneys flush out uric acid, shorten the duration of a flare-up, and reduce the severity of your symptoms.
- Exercising and maintaining a healthy weight. Weight loss lowers uric acid levels and your risk of heart disease and stroke, both of which are more common in people with gout.
The keto diet is a low-carb, high-fat diet. While the diet may have some proven health benefits, it’s not for everyone.
The research on its ability to alleviate gout symptoms is promising, but more is needed.
If you have gout, eating a healthy diet that limits high-purine foods and maintaining a healthy weight and lifestyle is probably the better way to go. Your doctor can help you determine the best management plan for you.