People know me as a keto-lover, but what do you really know about this diet? Stay up to date with the latest research on keto and how it may or may not impact your health.

I often get asked about my keto eating and if I feel any inflammation.  As a long-time keto eater, I’ve been there, done that.  I was in my 20s when I first started eating keto, and with my active lifestyle, I wanted to know if I felt any inflammation.


Why does inflammation rise on a ketogenic diet? What can I do to decrease my cholesterol levels? When is the best time to check your blood sugar? Consider the EHJ research from 2018, which discovered a relationship between low-carb diets and all-cause mortality.

Get the answers to these questions and more in my Q&A this week.

Please keep in mind that these responses do not constitute medical advice or the formation of a doctor-patient relationship. These responses are meant to be basic guidelines; any modifications should be discussed with your doctor.

Ketones cause more inflammation?

Inflammation (joint discomfort) is more frequent on the keto diet. I’m enraged as well. We consume grass-fed beef, partly grass-fed cheese/yogurt, and veggies. We don’t consume sweets or alcoholic beverages. In the morning, we’ll drink coffee.

Kathleen. Kathleen, hello there.

Food intolerances may induce inflammation in a number of ways. Dairy products, eggs, and many refined flours and cereals are examples of this.

The easiest approach to figure out who’s to blame is to go on an elimination diet. It may be aggravating, but it’s worth it if you can track out the perpetrator. You’ve already done a decent job of eliminating wheat and bread products if you follow the keto diet. You should now eliminate dairy and eggs from your diet and observe whether your symptoms improve. Whether this is the case, gently introduce them one at a time to see if they return. If they don’t go away, delve a little deeper. Nuts? What’s the deal with peanut flour? Vegetables? Are there any other possibilities?

Good luck in your search for the perpetrator and on your road to recovery, Bret Sher, M.D.

What is your reaction to the EHJ 2018 study?

I looked through your pages for a response to the August 2018 study Low-carbohydrate diets and all-cause and cause-specific mortality in the European Heart Journal: A Population-Based Cohort Study and Pooling Prospective Studies, which appears to provide strong evidence against the keto diet and other low-carb diets, but all I found was a brief note written before the study was published. A search of additional keto-friendly websites turned up nothing. This seems to be a good research, and I’m certain your readers will enjoy the analysis.

Todd Todd, you pose a good question. I’m guessing you’re referring to this research.

Unfortunately, there are a few flaws in this research. Those in the lowest carbohydrate quartile clearly consumed 40% of their calories as carbs, or 214 grams per day on average. Whether you’re wondering if this research applies to individuals who follow a low-carb diet (less than 20, 50, or even 100 grams of carbs per day), the answer is a resounding NO!

Furthermore, this quartile included more males, individuals with lower education, and smokers, introducing confounding factors and a bias against healthier users. This is a major flaw in these nutrition epidemiology studies, which is why we rate them as poor or very weak evidence. Here’s more on our evidence-justification guidelines, as well as a link to our discussion of observational research.


Best wishes, Sher, Bret.

What can I do to decrease my cholesterol levels?

What should I do to remain under 200 calories? My blood pressure has been somewhat higher since my previous test three months ago, according to a recent blood test.

Derek Derek, hello there.

See our guide on cholesterol and low-carb diets for a more comprehensive response.

I hope this clarifies your issues and the differences between total cholesterol and LDL, as well as what these values imply.

Best of luck! Sher, Bret.

When is the best time to check my blood sugar?

I used to be tested in the morning, but now I’m fasting (16/8), is it better to get tested just before I break the fast?

Carl Why not think about both possibilities? Some individuals experience the dawn phenomenon, in which their blood sugar levels rise in the morning and then fall as the day passes and the first meal approaches. If this is the case with my patients, I’d want to know. Here’s a link to a page on our website that explains the twilight phenomena.

Best wishes, Sher, Bret.

Other inquiries and responses

There will be a lot of questions and answers after that:

Low Carbohydrate Diet Questions and Answers

This article broadly covered the following related topics:

  • keto anti inflammatory foods
  • ketogenic diet nerve regeneration
  • keto diet and inflammation
  • ketogenic diet arthritis
  • ketosis anti inflammatory
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