On The Keto Diet With Psoriasis? Choose Your Fats Wisely

The ketogenic, or keto diet, has been promoted as having positive effects on many physical symptoms, including skin quality and health. High in fats, the diet is claimed to provide high levels of the key nutrients for skin health.

However, if a new study published in the Journal of Investigative Dermatology is accurate, this may not be the case for all people. It turns out that all fats may not be the same when it comes to the skin health of those with psoriasis or psoriasiform-like skin inflammation.

The study, conducted by Austrian researchers, found that diets with large quantities of medium-chain triglycerides (MCTs) like cocnut oil, may be problematic for those with psoriasiform-like skin inflammation. This is especially true when combined with omega-3 fatty acids from fish oil and plant sources like nuts, seeds and their oils.

‘This study leads to a broader understanding of possible effects of ketogenic diets with a very high fat content on skin inflammation and underlines the importance of the composition of fatty acids in the diet,” explained co-lead investigator, Barbara Kofler, PhD, Research Program for Receptor Biochemistry and Tumor Metabolism, Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria. “We found that a well-balanced ketogenic diet, limited primarily to long-chain triglycerides (LCTs) like olive oil, soybean oil, fish, nuts, avocado, and meats, does not exacerbate skin inflammation. However, ketogenic diets containing high amounts of MCTs especially in combination with omega-3 fatty acids, should be used with caution since they may aggravate preexisting skin inflammatory conditions.”


With the recent rise in popularity of the ketogenic diet, driven by the promise of relief from a number of health issues combined with weight loss, it’s easy to understand how potential pitfalls might be overlooked. After all, what’s a few minor problems like skin lesions when you’re losing weight easily, your joints feel good and your memory seems to be improving?

We do know that ketogenic diets seem to provide anti-inflammatory relief in certain conditions. They’re being further evaluated with regard to their potential use as therapies in a variety of other diseases and conditions as well. Coconut oil (high in MCTs,) as well as fish oil (high in omega-3 fatty acids,) are heavily marketed and widely used by the general public on the basis of their reported positive health effects.

Previously, researchers have found associations between high-fat diets, combined with substantial carbohydrate intake, and increased progression of psoriasiform-like skin inflammation, as well as spontaneous dermatitis in mice. Investigators in this study believed that high-fat ketogenic diets would suppress psoriasiform-like skin inflammation via the removal or reduction of significant carbohydrates from the diet. They also presumed that adding MCT and/or omega-3 fatty acids would enhance those improvements.

While their findings failed to support their hypothesis, they did find that a ketogenic diet higher in long-chain triglycerides (LCTs) did not worsen skin inflammation.

Co-lead investigator Roland Lang, PhD, Department of Dermatology, Paracelsus Medical University, Salzburg, Austria, explained and elaborated on the study’s results this way; “Ketogenic diets supplemented with MCTs not only induce the expression of pro-inflammatory cytokines, but also lead to an accumulation of neutrophils in the skin resulting in a worse clinical appearance of the skin of the mice. Neutrophils are of particular interest since they are known to express a receptor for MCTs and therefore a ketogenic diet containing MCTs may have an impact on other neutrophil-mediated diseases not limited to the skin.”

Researchers gave mice in the study an extremely high-fat ketogenic diet (77 percent fat.) This level of fat is highly uncommon in ketogenic diets, except in cases where the patient is following a strict regime for medical conditions like drug-resistant epilepsy.

“I think most people following a ketogenic diet don’t need to worry about unwanted skin inflammation side effects. However, patients with psoriasis should not consider a ketogenic diet an adjuvant therapeutic option, noted Dr. Kofler.”

If you’re following a ketogenic diet plan and have psoriatic or other inflammatory skin conditions, be sure to choose your fats carefully.

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Journal Reference – Felix Locker, Julia Leitner, Sepideh Aminzadeh-Gohari, Daniela D. Weber, Philippe Sanio, Andreas Koller, René Günther Feichtinger, Richard Weiss, Barbara Kofler, Roland Lang. The Influence of Ketogenic Diets on Psoriasiform-Like Skin Inflammation. Journal of Investigative Dermatology, 2019

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