The strict ketogenic diet is considered a healing form of nutrition for some complaints, such as epilepsy. For certain other diseases, however, the ketogenic diet seems to be able to worsen the symptoms.
The ketogenic diet is not useful for every disease
On the ketogenic diet, a large proportion of the daily calorie requirement comes from fat (75 to 90 percent), a moderate proportion from protein (enough to meet protein requirements), and only a very small proportion from carbohydrates (5 to 10 percent or a maximum of 50 g carbohydrates).
So if fat is such an important nutrient in the ketogenic diet, then it is of course extremely important to choose the right, i.e. high-quality fats – especially if you want to use the ketogenic diet as a healing food for certain diseases.
For skin conditions like psoriasis, fats affect the disease in very different ways (at least in mice), depending on the type of fat, according to a study published in October 2019 in the Journal of Investigative Dermatology.
Study: The ketogenic diet makes skin worse
Amazingly, fats that are generally considered to be particularly healthy, like the medium-chain fatty acids found in coconut oil, made skin look worse, especially when combined with omega-3 fatty acids found in fish oil or even from plant sources like nuts and seeds.
“Our study helps us to better understand the possible effects of a ketogenic diet on inflammatory skin diseases. We now also know how important it is to choose the right fats,” explained scientist Barbara Kofler from Paracelsus Medical University, Salzburg.
“We found that a balanced ketogenic diet that is high in long-chain fats (such as olive oil, soybean oil, fish, nuts, avocado, and meat) did not further promote inflammatory skin processes.
Ketogenic diets with large amounts of medium-chain fatty acids combined with omega-3 fatty acids should therefore not be practiced in inflammatory skin diseases, as they could aggravate the inflammatory processes.”
What happens in the body when eating the wrong fats?
Roland Lang, a scientist at the dermatological faculty of the Paracelsus Medical University in Salzburg explained: “If you consume large amounts of medium-chain fats (MCT fats) as part of a ketogenic diet, this not only leads to an increase in the inflammatory messenger substances (cytokines), but also to an accumulation of so-called neutrophilic granulocytes in the skin, which led to a worse complexion in the mice.
Neutrophilic granulocytes belong to the white blood cells. These are specialized immune cells that can form receptors for medium-chain fatty acids, which means that they are activated by medium-chain fatty acids and inflammatory defense reactions can occur.
Since an increased activity of the neutrophilic granulocytes is also associated with other autoimmune diseases, i.e. not only psoriasis but also with e.g. B. lupus erythematosus or rheumatoid arthritis, one should avoid factors that further fuel this activity of the neutrophilic granulocytes. Otherwise, other autoimmune diseases could develop.
Ketogenic diets are becoming increasingly popular
Ketogenic diets are becoming more and more popular, on the one hand, because they hope to defeat some diseases with them, but on the other hand, because it is repeatedly claimed that they can be used to lose weight so wonderfully. Inflammatory diseases in particular should be able to be tackled with ketogenic diets.
Since medium-chain fatty acids and omega-3 fatty acids are generally advertised as an anti-inflammatory, many people use the latter as dietary supplements (e.g. in the form of fish oil capsules).
However, those on a ketogenic diet may consume these fats in much higher amounts, so according to the study above, this may not be advisable if you have inflammatory skin conditions.
Diets high in fat and carbohydrates are pro-inflammatory
Previous studies have already shown that diets that are both high in fat and high in carbohydrates can promote the progression of psoriasis and the spontaneous occurrence of skin inflammation.
The scientists in the above study now suspected that carbohydrates were the problem and that a ketogenic diet, which is high in fat but low in carbohydrates, must have a positive effect on inflammation. They also thought that it would make sense to swap long-chain fats, at least in part, for medium-chain fats and for omega-3 fatty acids to increase the anti-inflammatory effect of a low-carbohydrate diet.
Ketogenic diet: Better not for psoriasis
But that was not the case. The inflammation increased under this form of the ketogenic diet. On the other hand, with a ketogenic diet based on long-chain fats, the inflammation did not get worse.
In the presented study, the fat content of the ketogenic mouse diet was 77 percent, which the researchers found to be extremely high but quite common in a true ketogenic diet. dr Kofler advises, “Most people on the ketogenic diet don’t have to worry about unwanted inflammatory skin reactions. However, if you already suffer from psoriasis, you should probably not practice a ketogenic diet.”