Ketogenic Diet is not just for reviving up your metabolism to lose weight, but now known for its ability to help improve mental health. According to the National Institute of Mental Health (NIMH), mental health conditions affect an estimated 57.8 million or more adults in the United States.
BY: GUY JABBAR
For individuals coping with severe mental illnesses like schizophrenia or bipolar disorder, conventional treatment involving antipsychotic medications presents a complex dilemma.
While these drugs play a crucial role in balancing brain chemistry, they frequently lead to metabolic issues—such as insulin resistance and obesity—that can be distressing enough to prompt some patients to discontinue their medication.
A recent pilot study conducted by Stanford Medicine researchers reveals that a ketogenic diet not only restores metabolic health in patients with serious mental illnesses who continue their medications, but it also significantly improves their psychiatric conditions.
The study, published in Psychiatry Research on March 27, underscores the potential of dietary interventions as a potent adjunct in mental illness treatment.
This promising finding offers hope for patients to regain some control over their health beyond the conventional standard of care.
Dr. Shebani Sethi, an associate professor of psychiatry and behavioral sciences and the first author of the study, expressed optimism about these results.
Meanwhile, the senior author of the paper is Dr. Laura Saslow, an associate professor specializing in health behavior and biological sciences at the University of Michigan.
Doctor Makes Connection
Dr. Sethi, who holds board certifications in both obesity and psychiatry, vividly recalls the moment when she first recognized the intriguing link.
During her tenure as a medical student at an obesity clinic, she encountered a patient with treatment-resistant schizophrenia.
Remarkably, this individual experienced a reduction in auditory hallucinations upon adopting a ketogenic diet.
Driven by curiosity, Dr. Sethi delved into the existing medical literature. Although there were only a handful of decades-old case reports on using the ketogenic diet to address schizophrenia, a robust history of success existed in treating epileptic seizures with this dietary approach.
“The ketogenic diet has demonstrated efficacy in treating treatment-resistant epileptic seizures by modulating neuronal excitability in the brain,” explained Dr. Sethi.
“Given this success, we decided to investigate its potential application in psychiatric conditions.”
Subsequently, Dr. Sethi introduced the term “metabolic psychiatry,” a novel field that examines mental health through the lens of energy conversion.
High-Fat, Protein, Low-Carb Diet
During the four-month pilot trial, Dr. Sethi’s team closely monitored 21 adult participants diagnosed with schizophrenia or bipolar disorder.
These individuals were already on antipsychotic medications and exhibited metabolic abnormalities, including weight gain, insulin resistance, hypertriglyceridemia, dyslipidemia, or impaired glucose tolerance.
The participants received instructions to adhere to a ketogenic diet, comprising approximately 10% of calories from carbohydrates, 30% from protein, and 60% from fat.
Interestingly, they were not specifically instructed to track their calorie intake.
“The primary focus of the dietary approach is on whole, non-processed foods, emphasizing protein and non-starchy vegetables, while not imposing restrictions on fats,” explained Dr. Sethi.
She actively shared keto-friendly meal concepts with the participants and provided them with keto cookbooks and access to a health coach.
Throughout the trial, the research team closely monitored adherence to the diet by measuring blood ketone levels weekly.
NOTE: Ketones are produced when the body metabolizes fat instead of glucose for energy, were the key indicators.
By the trial’s conclusion, 14 patients demonstrated full adherence, six were partially adherent, and only one did not adhere to the dietary guidelines.
Positive Results Found
During the trial, the participants underwent a range of psychiatric and metabolic assessments.
Prior to the trial, 29% of the participants met the criteria for metabolic syndrome, which is characterized by having at least three out of five conditions: abdominal obesity, elevated triglycerides, low HDL cholesterol, elevated blood pressure, and elevated fasting glucose levels.
Remarkably, after adhering to a ketogenic diet for four months, none of the participants exhibited signs of metabolic syndrome.
RELATED VIDEO: Learn how to get started with the Custom Keto Diet Plan
According to the research, on average, the participants experienced significant improvements during the trial:
- They lost 10% of their body weight.
- Their waist circumference decreased by 11%.
- They achieved lower blood pressure, reduced body mass index, and improved triglyceride and blood sugar levels.
- Most notably, they reversed obesity and metabolic syndrome, even while continuing antipsychotic medications—an encouraging outcome.
The psychiatric benefits were equally remarkable:
- Participants showed a 31% improvement on the clinical global impressions scale, a psychiatrist rating for mental illness.
- Three-quarters of the group demonstrated clinically meaningful improvement.
- Overall, participants reported better sleep and greater life satisfaction.
Dr. Sethi highlighted these positive changes: “Participants felt improvements in energy, mood, and quality of life. They expressed a sense of being healthier and more hopeful.”
The researchers were pleased that most participants adhered to the diet. The adherent group experienced more benefits compared to the semi-adherent group, suggesting a potential dose-response relationship.
Improved Metabolic and Brain Health
“There is mounting evidence that psychiatric disorders, such as schizophrenia and bipolar disorder, may arise from metabolic imbalances within the brain, impacting neuronal excitability,” Dr. Sethi explained.
The research team suggests that just as a ketogenic diet enhances overall metabolic health, it also positively influences brain metabolism.
“Improving metabolic health in general likely has a beneficial impact on brain health,” Dr. Sethi emphasized.
“The ketogenic diet, by providing ketones as an alternative energy source to glucose, can potentially address energy dysfunction in the brain.”
While multiple mechanisms may be at play, the primary goal of this small pilot trial is to identify signals that will inform the design of more extensive and robust studies.
As a physician, Dr. Sethi cares for patients dealing with serious mental illnesses and conditions like obesity or metabolic syndrome.
Unfortunately, few studies have specifically addressed this underserved population.
Dr. Sethi is the founder and director of the metabolic psychiatry clinic at Stanford Medicine. She expressed her motivation:
“Many of my patients grapple with both illnesses, and my hope was to explore whether metabolic interventions could offer them relief. They seek additional support and simply want to experience better well-being.”
The study also received contributions from researchers at the University of Michigan, the University of California, San Francisco, and Duke University.
Bottom Line
The ketogenic (keto) diet is a low carb, high fat diet that offers many health benefits. Some of the benefits of the ketogenic diet include Weight loss, Improved skin acne, Reduced risk of certain cancers, Improved heart health, and Brain function protection. Click here to learn how you can get started with the Custom Keto Diet Plan
