Keto Diet and Joint Pain: Exploring Benefits and Risks
Health ConditionsRheumatic Conditions

Will the Keto Diet Help Ease RA Joint Pain and Inflammation?

Will the Keto Diet Help Ease RA Joint Pain and Inflammation?
Nadine Greeff/Stocksy
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Updated on December 9, 2025
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Sometimes being overweight can put pressure on joints like your knees and hips. If you have joint issues like rheumatoid arthritis (RA), your doctor may recommend weight loss to help relieve pain.

One diet that many people talk about is the ketogenic diet, also called keto — a high-fat, low-carb plan. The ketogenic diet involves eating far fewer carbohydrates and more fats than a typical diet. It’s based on the idea that reducing carbohydrates (the body’s primary source of energy) forces the body to burn fat for fuel. Here’s how it affects your joints and inflammation.

Can the Keto Diet Help RA Joint Pain?

While the keto diet could help you lose weight, eliminating grains, fruits, vegetables, and other nutritious food groups could deplete your body of essential vitamins and minerals. The keto diet can also be high in saturated fat, which can increase inflammation markers, or signs of inflammation measured by blood tests.

Because of this, the keto diet is “not a good choice for people with systemic inflammatory conditions, because it completely goes against the science we know that prevents inflammation in the body,” says Lona Sandon, PhD, RDN, an associate professor in the department of clinical nutrition at UT Southwestern in Dallas, who also has RA.

Additionally, the type of fat you eat matters, says Sandon. “Poly- and monounsaturated fats that come from foods such as fish, walnuts, and olive oil are best to help decrease inflammation, which is the root cause of joint pain,” she adds.

But “this diet is higher in the fats that promote inflammation,” says Sandon. “If your keto diet contains a fair amount of red meat, you will be eating more of the types of saturated fats that increase the inflammatory compounds that make you feel worse.”

One type of fatty acid specifically found in red meat promotes inflammatory markers called cytokines and leukotrienes, which can cause more damage and inflammation in the body, according to Sandon.

Bottom line: “It is absolutely terrible for people with RA,” says Sandon. “People with RA need more antioxidant vitamins [which are found in fruits and vegetables] than those who do not live with a chronic inflammatory disorder.”

Does Keto Help Promote Weight Loss?

With the keto diet, you aim to put your body into a state called ketosis, which happens when you don’t have enough carbohydrates to burn for energy, so your body begins to burn fat instead.

“If you can get through the first three days to get into ketosis, it can help shut down appetite and control cravings,” says Sandon. “From a weight loss perspective, it can be effective in the short term. But eventually you do get hungry, and you need to get back to eating regular food again.”

While research has found that the keto diet may help people with obesity lose weight in the short term (around two years), the findings are limited and mixed on whether the eating plan is effective and healthy over the long term. In this way, it may not be the most sustainable weight loss diet.

What to Eat for Inflammation Relief

Many experts agree that the Mediterranean diet is advised for people who have RA because of its beneficial effects on disease activity, although there is insufficient evidence to recommend it for all types of arthritis. It emphasizes a plant-based eating approach, loaded with vegetables and healthy fats, including olive oil and omega-3 fatty acids from fish.

While there is no single diet that can treat RA, the American College of Rheumatology has reported that the Mediterranean diet has benefited many people with the illness.

Research has shown that the ideal balance of food each week for people with RA includes three portions of whole grains (preferably gluten-free), five portions of fruits and vegetables (like berries, citrus fruits, and leafy greens), low-fat yogurt or skim milk, three portions of fish or white meat, two portions of legumes, and two portions of eggs, cheeses, or red meats once a week.

 All of the above are good sources of natural antioxidants and offer anti-inflammatory effects.

They also recommend avoiding processed foods, foods with high sodium levels, oils, butter, sugar, and animal products.

The ITIS Diet May Help Ease Fatigue, Joint Swelling, and Other RA Symptoms

The ITIS, or inflammation diet — which is based on the Mediterranean diet but pinpoints specific foods known for their anti-inflammatory and pain-reducing qualities — has helped study participants report less pain, swelling, and, for some, about half the fatigue they typically experience while living with RA.

Along with the typical Mediterranean diet foods, the ITIS diet includes the following foods and supplements:

  • A daily green juice
  • Oily fish like sardines, salmon, or tuna twice per week
  • Healthy fats called monounsaturated fats, found in foods like avocado, nuts, sesame seeds, and tahini
  • Daily chia seeds and flaxseed oil
  • Unsweetened yogurt and miso (a soybean paste)
  • Fruits high in enzymes, like pineapple and papaya
  • Daily green tea
  • Turmeric (with black pepper for absorption) and ginger

The ITIS diet also excludes a few items that the Mediterranean diet allows, such as gluten and wheat flour, tomatoes, potatoes, eggplant, and large quantities of salt.

What Diet Is Best for Rheumatoid Arthritis?

When it comes to minimizing the symptoms of RA, no one diet works for everyone. “It depends on the person,” says Christine Palumbo, RD, a nutrition expert in Naperville, Illinois. “For some people, gluten can be a trigger. For others, salmon, nuts, or eggplant can be inflammatory.”

Palumbo suggests people who have RA-related joint pain consider food sensitivity testing or try an elimination or exclusion diet under a doctor’s supervision, where you avoid common culprit foods like dairy, gluten, nightshade vegetables (which include tomatoes, white potatoes, and bell peppers), and alcohol.

The Takeaway

  • Healthy weight loss can help relieve joint pressure and pain, especially for those with conditions like rheumatoid arthritis.
  • The ketogenic diet may help people lose weight in the short term, but it excludes essential vitamins and minerals needed to keep joints healthy. It’s also high in inflammatory saturated fats, which can exacerbate symptoms.
  • Research has found that the Mediterranean and ITIS diets may help relieve joint pain, fatigue, and swelling associated with rheumatoid arthritis. It includes anti-inflammatory fruits and vegetables, fish and lean protein, and nuts and seeds.
  • To determine which foods increase your rheumatoid arthritis symptoms, consider a food sensitivity or temporary elimination diet under a doctor’s supervision.

Resources We Trust

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Weight Loss Benefits for Arthritis. Arthritis Foundation.
  2. Coniglio S et al. Unsaturated Fatty Acids and Their Immunomodulatory Properties. Biology. February 9, 2023.
  3. Cuzzo B et al. Physiology, Leukotrienes. StatPearls. August 14, 2023.
  4. Ketosis. Cleveland Clinic. August 15, 2022.
  5. Masood W et al. Ketogenic Diet. StatPearls. June 16, 2023.
  6. Athanassiou P et al. Nutritional Pearls: Diet and Rheumatoid Arthritis. Mediterranean Journal of Rheumatology. May 15, 2020.
  7. Diet Considerations for Those Living With Rheumatic Illnesses. American College of Rheumatology. April 28, 2023.
  8. Rondanelli M et al. Ideal Food Pyramid for Patients With Rheumatoid Arthritis: A Narrative Review. Clinical Nutrition. March 2021.
  9. Rath L. ITIS: A Supercharged Mediterranean Diet for RA. Arthritis Foundation.
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