The diet pendulum is swinging in the opposite direction of our low-fat craze that started in the 1970s. These days, you're probably hearing a lot about how eating fat can help us get thin. But what you might not know is that healthy fats might also be that missing ingredient in our diet to help alleviate chronic pain.
Today, we see some practitioners recommending high-fat diets, like the ketogenic diet, as possibly helpful for a number of conditions that cause chronic pain syndromes such as neurodegenerative disease, migraines, mood disorders, and autoimmune problems. In other words, what if we could reach for the avocados and coconut oil instead of popping ibuprofen?
A ketogenic diet isn't right for everyone, and you should discuss it with your health care practitioner first. Still, as a doctor of physical therapy and a certified clinical nutritionist, here's what I wish more people knew about the diet:
What is a ketogenic diet?
A ketogenic diet minimizes carbohydrate intake to the point where our bodies break down our own fat stores to make energy. It is comprised of high fat, moderate protein, and low carbohydrates. This shift in macronutrient ratios induces a metabolic process called ketosis, which occurs when our body’s energy-making powerhouse centers (mitochondria) switch from making energy from glucose to making energy from ketone bodies. Ketone bodies (acetoacetate, acetone, beta-hydroxybutyrate) become the primary source of energy when carbohydrates are minimally available.
There are a few theories for how ketosis might help alleviate pain for various conditions.
First, research suggests that ketosis could be helpful in burning fat and losing weight—and less weight means giving our joints a break. With the Standard American Diet, we eat simple carbohydrates all day long. This constant drip (or deluge) of glucose has left us overweight and inflamed. Using ketosis helps lighten the load of adipose tissue and the pressure on our joints, meaning less pain.
Plus, the ketogenic diet is void of any sugar, which is inflammatory. Sugar, in excess, raises our inflammation markers and mass-produces insulin, which manufactures fat. The ketogenic diet shuts off the insulin surges that raise blood sugar and create inflammation. Less inflammation contributes to less pain.
Further, ketogenic diets seem to boost a natural chemical in our bodies called adenosine, which acts as an analgesic or pain reliever.
What to eat on a ketogenic diet:
Ultimately, on a ketogenic diet you'd have your macronutrient range be 70 percent fats, 25 percent protein and 5 percent carbohydrate. Here's what eating on a ketogenic diet looks like:
- Fats like grass-fed butter, whole pastured eggs, avocado, and coconut oil
- Raw nuts like walnuts, macadamia, Brazil nuts, pistachios, and almonds
- Chia, pumpkin, and hemp seeds (they provide healthy omega-3 fats and plenty of vitamins and minerals)
- Wild-caught salmon, sardines, mackerel, and shellfish (they're great protein sources and also provide healthy fats that ignite satiety and fight inflammation)
- Cold-pressed, extra-virgin, organic coconut oil, sesame oil, avocado, walnut, and olive oil
- Dark, leafy greens like chard, spinach, kale, collards, along with broccoli and cauliflower. Non-starchy veggies are a staple in the ketogenic diet.
- Berries of all kinds, which are low-glycemic. They can be combined with nut butters or coconut cream for a great ketogenic dessert.
What to avoid eating on a ketogenic diet:
You’ll want to steer clear of all processed foods, artificial sweeteners, high-glycemic fruits, grains, refined fats/oils, milk, soy products and alcohol. Avoid pro-inflammatory omega-6 oils like safflower, corn, and soybean.
Discuss with your doctor if it might make sense for you to try a ketogenic diet for three weeks. You might notice your pain decrease—and more energy and less brain fog are often welcome bonuses.