A new preclinical study links the ketogenic diet to worsened colitis severity, identifying a gut microbe-immune pathway that may pose risks for inflammatory bowel disease patients.
Researchers found that while the diet maintained intestinal balance in healthy guts, it significantly exacerbated colitis when the lining was damaged. The mechanism involves increased β-hydroxybutyrate levels promoting expansion of Thomasclavelia spiroformis, which activates colonic γδ17 T cells driving IL-17A inflammation.
Human data showed that in ulcerative colitis patients, T. spiroformis abundance correlated with faecal β-HB and IL-17A, suggesting a disease-specific immunometabolic axis. No association was found in Crohn's disease.