Could keto diet improve autoimmune disease symptoms?
The most important takeaway is not that keto has โworkedโ for autoimmunity, but that a plausible biological pathway was seen in an animal model. That matters because it shifts the conversation from generic inflammation claims to a specific chain involving ketone production, gut microbes and immune signalling. But mouse findings are an early step, not proof of benefit in people living with multiple sclerosis or other autoimmune conditions.
For readers, the uncertainty is doing a lot of work here. Diet responses can differ widely depending on the disease, medications, baseline diet, body size, activity level and how strictly a ketogenic pattern is followed. Even if ketones prove useful, that does not automatically mean a whole keto diet is the best or only way to influence the same pathway. A future therapy could be a targeted supplement, a modified eating plan or something else entirely.
The practical question is whether the potential upside is worth the burden. Keto can be difficult to sustain, socially restrictive and not always nutritionally balanced if it crowds out fibre-rich foods, legumes, fruit or whole grains. For some people, especially those with chronic illness, adherence may matter more than theoretical precision. Any real-world use would need to consider palatability, safety, medication interactions and whether the diet is even appropriate for the individual.
This is a reminder to separate mechanism from recommendation. A promising immune mechanism can justify more research, but it does not yet justify broad advice for autoimmune patients to start keto. The best next step is human trials that test symptom effects, tolerability and long-term outcomes, while comparing keto with less restrictive approaches that may be easier to maintain.
How does the keto diet impact autoimmune disorders? โ
The researchers theorised that the keto diet could help to soothe an overactive immune system, potentially benefiting individuals with conditions, including multiple sclerosis (MS), systemic lupus erythematosus (SLE), inflammatory bowel disease (IBD), Addison’s disease, and Graves’ disease. They discovered the keto diet makes the gut and its microbes produce two factors, which reduce symptoms of multiple sclerosis (MS). Without carbohydrates to use as fuel, the body breaks down fat instead, producing compounds called ketone bodies. Ketone bodies provide energy for cells to burn and can also change the immune system. Working with a mouse model of multiple sclerosis (MS), the researchers found that mice who produced more of a particular ketone body, called ฮฒ-hydroxybutyrate (ฮฒHB), had less severe disease. The additional ฮฒHB also prompted the gut bacterium, Lactobacillus murinus, to produce a metabolite called indole lactic acid (ILA). This blocked the activation of T helper 17 immune cells, which are involved in multiple sclerosis (MS) and other autoimmune disorders. โWhat was really exciting was finding that we could protect these mice from inflammatory disease just by putting them on a diet that we supplemented with these compounds,โ says Dr Peter Turnbaugh, a researcher on the study. Itโs important to note, this research was conducted on mice, not humans. Further research, carried out specifically on humans, would be required to confirm the findings. โThe big question now is how much of this will translate into actual patients,โ says Dr Turnbaugh However, if the the keto diet is proven to have the same effect on humans, it could revolutionise the treatment of multiple sclerosis, and other autoimmune disorders. โThese results provide hope for the development of a more tolerable alternative to helping those people than asking them stick to a challenging restrictive diet,โ addsย Dr Turnbaugh.What does this mean for food and beverage?โ
This new research could potentially lead to a surge in foods, fortified with ฮฒ-hydroxybutyrate (ฮฒHB), aimed specifically at people with autoimmune disorders, who do not want to adopt a keto diet. Fortification, to createย functional foods and beveragesโ,ย is a fast-growing trend, with theย global functional food and beverage market now valued at over $281bn. It’s likely then to be just a matter of time before the benefits of the keto diet are integrated into foods and beverages through fortification. The results of this research could also lead to an increase in people with an autoimmune disorder, adopting the keto diet itself, to manage their symptoms.What is a ketogenic diet?โ
The ketogenic diet, better known as the keto diet, is a low-carbohydrate, high fat and moderate protein diet, which shifts the bodyโs metabolism from using glucose as the main fuel source to burning fat and producing ketones for energy.What are ketones?โ
Ketones are a type of chemical that the liver produces when it breaks down fats. The body uses ketones for energy during fasting, long periods of exercise or when it does not have access to carbohydrates.There are four versions of the ketogenic diet:โ
- Standard ketogenic diet (SKD):โย This is a very low-carbohydrate, moderate protein and high fat diet. It typically contains 70% fat, 20% protein, and only 10% carbohydrates.
- Cyclical ketogenic diet (CKD):โย This involves periods of higher carbohydrate re-feeds, such as five ketogenic days, followed by two high-carbohydrate days.
- Targeted ketogenic diet (TKD):โย This diet allows you to add carbohydrates around workouts.
- High protein ketogenic diet:โย This is similar to a standard ketogenic diet but includes more protein. The ratio is typically 60% fat, 35% protein, and 5% carbohydrates.
Published online: 4 November 2024
DOI: 10.1016/j.celrep.2024.114891
Authors: Margaret Alexander, Vaibhav Upadhyay, Rachel Rock et al.
Enjoyed this article? Sign up for our newsletter to receive regular insights and stay connected.