Serum levels of interleukin-6 and dehydroepiandrosterone sulphate in response to either fasting or a ketogenic diet in rheumatoid arthritis patients

Objective To investigate the effects of either a 7-day fast or a 7-day ketogenic diet upon serum interleukin-6 (IL-6) and dehydroepiandrosterone sulphate (DHEAS ) in RA patients. Methods We measured serum concentrations of DHEAS and IL-6 in 23 BA patients with a ctive disease, 10 of whom followed a 7-day sub-total fast and 13 of whom co nsumed a ketogenic diet (isoenergetic, carbohydrate < 40 g/day) for 7 days. Clinical and laboratory variables were measured at baseline, on day 7 and after re-feeding on day 21. Correlation analyses were used to assess the as sociations between ser um IL-6, DHEAS and disease activity variables at eac h timepoint. Results Fasting, but not the ketogenic diet, deer-eased serum IL-6 concentrations b y 37% (p < 0.03) and improved disease activity at day 7 Both fasting and th e ketogenic diet increased serum DHEAS levels by 34% as compared with basel ine (both p < 0.006). Levels of lL-6, but not DHEAS, correlated with severa l disease activity variables. Conclusion Both fasting and a ketogenic diet significantly increased ser-um DHEAS conc entrations in RA patients. Only fasting significantly decreased serum IL-6 levels and improved disease activity. As the increases in serum DHEAS were similar in response to both fasting and a ketogenic diet, it is unlikely th at the fall in serum IL-6 or clinical improvements after fasting were direc tly related to increases in serum DHEAS. The fasting-induced fall in serum IL-6 may underlie the fall in. CRP and ESR observed in RA patients in respo nse to a 7-day fast.