Weighing the Merits of the Keto Diet 

By Linda Rath | Aug. 19, 2026 

People on the ketogenic (keto) diet seem to have it made. They feast on butter, eggs, cheese and pâté, while pounds melt away. Losing excess weight can improve your arthritis, and plenty of people have had success with keto. But if you’re trying to manage arthritis symptoms by sticking with an anti-inflammatory diet, should you even try a diet that’s high in pro-inflammatory saturated animal fats, like bacon and butter? Probably not. But sticking with a keto diet that leans on healthy fats may help your arthritis and your overall health. 

In some keto studies, including two published in the journal Nutrients in 2020 and 2021, people who were overweight or obese lost 15% to 20% of their initial weight in a matter of months; others reached their normal weight within 24 weeks. They were also healthier, with significantly lower blood pressure, triglycerides, cholesterol and blood sugar. For many, weight loss improved arthritis symptoms, too. And most reported feeling less hungry and having fewer cravings than with low-fat diets. 

How Does the Keto Diet Work? 

When followed religiously, keto puts your body in a state of ketosis (not to be confused with ketoacidosis, a complication of diabetes). In ketosis, the body burns fat for energy instead of sugar. Most people reach this state after about three days on the diet. To achieve ketosis, you must get at least 70% of your calories from fats. Healthy fats come from foods that are Mediterranean diet staples, including olive oil, salmon, tree nuts and avocados. Less than 20% of calories should come from protein and less than 10% (50 grams at most) from carbohydrates. 

Keto has been criticized as excessively high in protein, but the total amount of protein per day is quite small; eating too much will kick you out of ketosis. 

Although the keto diet can lead to safe and rapid weight loss, giving up carbohydrates isn’t easy. You must forgo pasta, bread, potatoes, sweets of any kind and most types of fruit. High-sugar veggies like carrots and beets are out, too. 

Is the Keto Diet Safe? 

According to a 2021 study in Frontiers in Nutrition, an especially strict form of the diet — with 90% of calories coming from fat — has been used for over a century to successfully treat childhood epilepsy. And a 2022 study in Nutrients says the keto diet has been shown to protect against other neurologic disorders, including Alzheimer’s disease.  

Should I Try the Keto Diet? 

No matter what type of arthritis you have, keto may help relieve inflammation and weight stress on your joints. But it can take some getting used to, especially if you normally eat lots of carbs or animal-based fats. One idea: Use it to jumpstart weight loss before switching to an eating plan that’s healthy but easier to maintain long term.  

Originally appeared in the Arthritis Foundation’s 2023 Arthritis Connection.