Ketogenic Diet in Rheumatoid Arthritis (RA)

Inclusion Criteria: * Diagnosis of RA according to the ACR/EULAR 2010 criteria for RA. * On stable doses of DMARDs and/ or biological agents (≥ 2 months prior to study enrollment) Exclusion Criteria: * Chronic inflammatory/ autoimmune disease other than RA (e.g. gout, inflammatory bowel disease such as Crohn's disease or ulcerative colitis, lupus, myositis, etc.) * Prednisone or other glucocorticoid use in the last 4 weeks (exception: intra-articular glucocorticoid injections) * Insulin use * Hospitalization in the 30 days prior to study enrollment * Acute or uncontrolled disease (e.g. cirrhosis, COPD, CKD) * Malignancy * Chronic infection (HIV, hep B/C, etc.) * Heavy drinking * On a ketogenic diet or exogenous ketone supplement (lses than 3 months prior to study enrollment) * Recent weight loss (\>5% in the last 2 months)