Hi Everyone,
I’ve been happy on keto for 16 months and lost 30 kg but the last 3 months I’ve had pain in both hips especially at night and when climbing stairs. I recently read in shock that keto can cause bone density loss and lead to osteoporosis and arthritis??? Any feedback? Thank you!
Bone loss / joint pain on longterm keto?
SnowOwl1
#1
amwassil
(Michael - When reality fails to meet expectations, the problem is not reality.)
#2
If you’re concerned eat more calcium either dairy and/or bone broth. Keto does not cause bone loss, but poor food choices might.
OldDog
(Gregory - You can teach an old dog new tricks.)
#3
Great weight loss!
A ketogenic way of eating is not your problem.
If it was, the thousands of people who have adapted a ketogenic way of eating would be complaining of hip pain, osteoporosis and arthritis.
We would need to know more about the details of what you eat to make suggestions about possible causes of your problems… Particularly in the last three months.
I had all kinds of joint pain before I gave up all grains among other things over three years ago.
Most joint pain outside of physical injury, is caused by inflammation brought on by poor diet choices.
Shortstuff
(Allie)
#4
Where did you read it?
I read lots of things but don’t necessarily believe them all.
FrankoBear
#6
Here is some reading to explore. Maybe over some bacon and eggs. Did someone say Harvard?
Search “keto” on the “eating Well” blog. The authors are very critical, so it makes good reading.
OldDog
(Gregory - You can teach an old dog new tricks.)
#7
Article from February and no link to the study that I could see…
If that were a legitimate study, the anti keto’ers would be all in our face with it…
I would like to see what the actual menu was…
There’s a got’cha in there somewhere…
There are plenty of long term keto’ers out there who I am sure would have volunteered their bone metabolism markers for study…
PaulL
(You've tried everything else; why not try bacon?)
#8
Bone loss might conceivably be caused by a protein insufficiency, but if your daily protein intake is 1.0-1.5 g/kg of lean body mass then you should be fine.
I find that my arthritis acts up if I eat too much carbohydrate, even if it’s not enough to inhibit ketosis. You might want to scrutinise your diet for “carb creep.”
NelleG
(Bacon for the Win)
#9
chances are the damage was done long before you started keto and you are just now becoming aware of it. That would be my bet anyhow.
anon81060937
#10
Physical activity is required to build bone. So is calcium.
What do you guys think about this? I don’t believe the following study is ketogenic though.
PaulL
(You've tried everything else; why not try bacon?)
#11
My first question is how much carbohydrate constitutes “severely” restricted carb intake?
My second question is why only two weeks on the low-carb diet, and only four on the “moderate” carb diet?
My other question is: how clinically significant are these results? And why are they even bothering with numbers that have p-values larger than 0.001?
My first comment is to echo Dr. Phinney: "A well-formulated ketogenic diet is not a high-protein diet, it is a moderate- protein diet.
OldDog
(Gregory - You can teach an old dog new tricks.)
#12
Too many unknowns…
How much fat in the respective diets? What kind of fats?
Source of protein?
A lot of PUFA’s?
amwassil
(Michael - When reality fails to meet expectations, the problem is not reality.)
#13
As if keto breath, keto belly button floss, keto BO, keto toe jam, keto diarrhea and keto constipation weren’t enough. Now we’ve got keto osteo. What’s next? 
FrankoBear
#14
2 year (long-term) study on Type-2 diabetics (at start) using a ketogenic diet. 262 participants.
These are not athletes, as per the previous reports. It helps contextualise the data, if people regard themselves as athletes or not.
Compared to 28 elite athletes tested over a 3.5 week time period (that generated the media reports (above)):
If @SnowOwl1 you are not an elite athlete in training for a world championship in the walking event, then the findings of impairment in bone health markers may not apply to you.
Shortstuff
(Allie)
#16
One of the first results is Diet Doctor whose article completely debunks the idea.
Zero difference between the groups. Nothing happened to bone strength.
FrankoBear
#18
Interesting. The links when collated and drilled down end up at mainly ketogenic diets and the treatment of epileptic children. There are some animal models for human disease. Again, a non-typical population with special requirements and unique confounders.
A lot of the links go to sites with vegan affiliations who equate the ketogenic diet with animal cruelty. But I had a look anyway and they repeat the same messages.
Children are growing is the first thing. There is high demand for nutrients during growth. Growing children have different hormone ratios than adults.
I looked at one 2008 paper referenced regarding treating children with idiopathic epilepsy (IE), as an example. In the results we can see a few confounders for poor bone growth: general health was suboptimal (at least that’s one thing that these kids have in common with most adults), the active form of Vitamin D in the blood were suboptimal. And dietary intake of calcium and Vitamin D were sub-optimal, suggesting the specific ketogenic diet may not have been very well formulated, or poor compliance from the patients. Vitamin D is a fat soluble pre-hormone, so a properly formulated ketogenic diet should provide adequate sufficiency. I wonder if the kids were allowed out in the sunshine?
Anyhow, we are not elite racing walker athletes nor are we epileptic children. I reckon it’s best to stay with the science that matches most closely to our/ your situation.
SnowOwl1
#19
Healthy fats like olive oil avocado coconut and nuts, lots of dairy like Greek yogurt and cheese and sour cream. Lots of vegetables and berries. Some sea food. I’m vegetarian so no meat at all.
lfod14
#20
Not sure about bone loss but I lost a ton of muscle mass due to not enough protein from what I was doing, at some point those intersect. At one point my joint pain was constantly a bother. Since upping protein by a lot and putting muscle back on that hasn’t been an issue. I’d make sure you’re getting in good protein levels and calcium.
OldDog
(Gregory - You can teach an old dog new tricks.)
#21
I can’t seem to find any information about the composition of these bone wasting keto diet studies.
Until I see the actual data, I’m going to assume high protein and high PUFA…
Anti keto’ers just focus on low carbs and ignore the rest of the diet…