🥩 Ketogenic diet more effective at managing arthritis than Mediterranean diet

Arthritis is a condition characterised by chronic inflammation and significant impacts on quality of life.

The impact of diet on arthritis and inflammation is increasingly recognised, but evidence on specific dietary patterns is still scarce.

A recent study explored the effectiveness of a Mediterranean diet versus a ketogenic diet on managing inflammation in patients with psoriatic arthritis and obesity.

Both diets had the same calories, but the Ketogenic diet provided approximately 34% proteins, 55% fat, and 11% carbohydrates, while the Mediterranean diet provided 20% proteins, 40% fat, and 40% carbohydrates.

Interestingly, 13 people were on the Mediterranean diet, while 13 people were on the ketogenic diet for 8 weeks. After a pause of 6 weeks, the groups switched diets for another 8 weeks.

• Weight loss → Both diets significantly reduced participants’ weight, BMI, waist circumference, total fat mass, and visceral fat. However, the ketogenic diet led to greater reductions in all of these areas

• Inflammation and disease → The ketogenic diet led to significant reductions in both inflammation and disease activity, measured via the Psoriasis Area and Severity Index (PASI), Disease Activity Index for Psoriatic Arthritis (DAPSA), and inflammatory cytokines IL-6, IL-17, IL-23. The Mediterranean diet did not result in significant changes in any of these markers.

More research, mainly on large-scale studies, is needed.

🥊 Punchline

Both ketogenic and Mediterranean diets may help people with obesity and psoriatic arthritis lose body fat, but the ketogenic diet seems to provide significant benefits on psoriatic indices and markers of inflammation in this population.

🦴 What are the key nutrients for bone health?

It’s often thought that Calcium + Vitamin D = Healthy Bones

However, that’s not the full picture.

Other major nutrients, such as Magnesium and Vitamin K2, are equally important.

• Calcium is the main building block of your bones. Major sources are dairy products (milk, cheese, yogurt), leafy greens (spinach, kale), almonds, tofu, and fortified plant-based milk. However, increasing calcium intake doesn’t necessarily translate into more calcium deposited into the bones. Very high calcium supplementation is actually associated with calcium deposits in the arteries.

• Vitamin D is a hormone that helps the body absorb calcium efficiently and a host of other metabolic processes. Major sources are sunlight, fatty fish (salmon, mackerel), egg yolks and some fortified cereals. Without vitamin D or if vitamin D status is poor, calcium supplementation is less likely to be effective.

• Magnesium helps activate vitamin D and contributes to the bone structure. Major sources are nuts (almonds, cashews), seeds (pumpkin, chia), whole grains, legumes, spinach, and dark chocolate. Also helps lock calcium in your bones rather than your arteries.

• Vitamin K2 also help lock Calcium in your bones and teeth, reducing the risk of calcium deposits in blood vessels. Major sources are fermented foods (natto, sauerkraut), hard cheeses, egg yolks, and chicken.

Resistance training also helps with the remodelling of bones, as weight bearing exercises put the bone matrix under stress, promoting greater density.

🥊 Punchline

When we think about bone health, we often hear about calcium and vitamin D, but it’s not the full picture. Magnesium, Vitamin K2 and resistance exercise are the underestimated variables that ensure calcium is absorbed and directed to the right places.

🫐 How can antioxidants help with exercise performance?

Polyphenols are beneficial plant compounds with antioxidant properties that may have beneficial properties.

The science behind polyphenols and exercise performance is expanding.

By studying different types of polyphenols (e.g. from pomegranate), we now know that polyphenols can support post-exercise inflammation by modulating inflammatory pathways, reducing oxidative stress, and aiding recovery.

It is true that inflammation after exercise is essential for muscle growth and adaptation (think about muscle soreness after resistance training).

However, excessive inflammation can hinder recovery and lead to muscle soreness or injury.

Polyphenols, through their antioxidant and anti-inflammatory properties, help balance this response.

They help promote recovery without fully suppressing the beneficial inflammatory signals needed for muscle repair and adaptation.

This doesn’t mean that polyphenols supplements are the holy grail, but diet optimisation can be used in unison with training goals to enhance exercise performance.

However, there are still grey areas to cover. For example, there is no agreement yet on the optimal dose and timing of polyphenols intake.

🥊 Punchline

Polyphenols, with their antioxidant and anti-inflammatory properties, can help with post-exercise recovery by balancing inflammation, though optimal dosage and timing remain uncertain.