Can a keto diet improve knee pain?

If you have aching knees, can a keto diet help? And if it does, is it simply because the keto diet helps you lose weight, taking stress off your joints, or is something more happening, such as reduced inflammation?

Diet Doctor medical director Dr. Bret Scher, in this DDNewsvideo, examines the findings of two studies, one from 2022 and the other from 2019. Both suggest that knee pain does indeed improve on a keto diet. 

And the reason for the improvement is likely both weight loss and reduced markers of inflammation.

“Any weight loss is going to be beneficial for lower body arthritis symptoms,” says Dr. Scher. “But if you can eat in a way that also helps lower systemic inflammation, that’s probably beneficial as well.”

The 2022 study is from researchers at Virta Health. It is part of their ongoing series of research studies that have followed 262 patients with type 2 diabetes undergoing intensive online coaching and support to eat a low-carb ketogenic diet. 

Virta compares these patients to 87 patients receiving the usual care for type 2 diabetes. (The Virta study is a registered clinical trial, but participants were not randomized into the intervention and control arms. You can find more of our reports about Virta’s ongoing findings here.)

Publishing in March 2022 in the journal BMC Musculoskeletal Disorders, the Virta researchers report that they collected data from patients about knee pain and function as part of their two-year trial. 

Compared to the group getting the usual care for type 2 diabetes, those on the keto diet had statistically significant improvement in knee pain and function, likely due to weight loss from their abdomen and reduced markers of inflammation.

BMC Musculoskeletal Disorders: Continuous care intervention with carbohydrate restriction improves physical function of the knees among patients with type 2 diabetes: a non-randomized study

Diet Doctor wrote about an earlier study in 2019, which was a small trial that randomized 21 adults with knee pain to one of three diets for 12 weeks: low carb, low fat, or a control (no change) diet.

While participants on both the low carb and low fat diets lost similar amounts of weight, only those on low carb experienced improvements in knee pain and function. The researchers hypothesized that this was likely due to the low carb diet reducing inflammation.

While both studies are preliminary and more research is needed, it is an encouraging finding for the millions of people with sore, aching knees, Dr. Scher notes.

“Of course, it is not going to work for everyone. It is not going to be one miracle cure. But what’s the downside of trying if you’re suffering from arthritis? There’s data that suggests it’s beneficial,” he says.

Each week, Dr. Scher creates two or three videos that review relevant or interesting scientific studies in the fields of nutrition, exercise, health, or disease and carefully analyses the researchers’ methods and findings. In doing so, he helps you better understand how to judge the quality of various research papers and make informed decisions about your own health and wellness. 

You can find more of Dr. Scher’s news videos on the Diet Doctor Youtube Channel. Subscribe to the feed so that you don’t miss any of his videos.

Or you can find out more about how to get started on a keto diet here

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3 comments

  1. 5 comments removed
  2. Nick D. Raptis
    Dr. Bret,
    Thanks again for another informative video (Knee Pain). After 31 years of diabetes and many years of osteoarthritis in my knees with daily pain, a <20 carb/day lifestyle over the last 18 months accompanied by 60lb. weight loss and ditching 30 years of GERD and Hypertension meds, has completely taken away the pain. I can do something that I was unable to do for the last 20 years: run! I am 64 and feeling better than ever. Keep up the great work of turning lives around at DietDoctor!

    Nick Raptis

  3. Carole Feay
    Dr Scher,

    I am a nurse and worked the last 2 decades in surgery, mostly orthopedics, while suffering from type 2 diabetes and osteoarthritis myself. In my late 40s I had a hip replaced and 10 years later, both my knees. 5 years ago I was scheduled to have my other hip replaced when another surgeon told me about the ketogenic diet and his success with it. I started the fall of 2017 and have been pain free since then. The only time I have joint pain is when I eat something (mostly prepackaged) that has some wheat flour for thickening. The results are like clockwork.

    Not only are my remaining major joints pain free, my partially fused feet and wrists are also pain free (!) and I have lost and kept off 70 lbs.

    It was initially Dr Sarah Hallberg’s TED talk the surgeon suggested I watch, and then your continually helpful and informative Diet Doctor website and podcast that have been my guide. I am so grateful for finding you and have shared your site with many others.

    Many thanks!

    Carole

  4. 4kimberly1958
    I would like to say that I have had days where my knee pain was unbearable, especially at night. Lots of swelling, a few times fluid had to be drained. I have no cartilage on one side of my right knee and arthritis in both. I want to tell you that there is definitely truth that eating the keto way has reduced significantly my knee pain from a level high of 10 extreme pain to most days 0-1 none or barley. And for more proof, I went off my Keto meal plans after eye surgery and I couldn't really take the time to do recipes. It was like the pain had been awakened and it was awful. Once I got back on the keto plan, the pain was gone and that was a light bulb moment for me. The way I eat triggers pain or no pain. I have since purchased a Peloton bike and continued with my low-carb mal plan. I have lost 18 pounds and feel good, but most of all have no knee pain.

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