Researchers at the intersection of metabolic and mental health are studying the benefits of different dietary interventions. One of the diets that’s being studied very closely is the ketogenic diet.
Samantha V. Abram, PhD, and a team of researchers at the University of California San Francisco’s Department of Psychiatry and Behavioral Sciences developed a randomized, controlled study looking into whether a KETO diet might become a useful intervention in treating schizophrenia and other serious mental illnesses.
KETO is a very low-carbohydrate, high-fat diet designed to shift the body from using glucose as its main fuel source to using fat and producing ketones for energy.
In their work, Dr. Abram and her team noted that common antipsychotic medications can promote weight gain, glucose dysregulation, and hyperlipidemia. They’ve also been known to increase rates of metabolic syndrome in patients with schizophrenia-spectrum and bipolar-1 disorders.
Dr. Abram and her team randomized 58 participants into two groups. One group followed a KETO diet, while the others maintained their typical eating patterns. The Keto participants received 18 pre-made ketogenic meals a week.
Everyone who finished the 1-month phase was then invited into a 4-month extension where all participants followed the ketogenic diet.
Throughout the study, researchers tracked the following metabolic markers: weight, blood sugar, insulin resistance, and inflammation.
They also tracked psychiatric symptoms such as depression, negative symptoms such as affect and withdrawal, positive symptoms like hallucinations and delusions, as well as cognitive performance.
After one month, researchers found that participants in the KETO group showed significant improvements in weight, BMI, blood sugar control, and insulin resistance. Psychiatric symptoms and cognitive performance didn’t show significant improvement at this point.
However, after four months, participants showed improvement not only in metabolic markers, but also in depression, both positive and negative symptoms, and cognition.
Among their conclusions, the researchers suggest that a single month of a KETO diet may not be enough to induce psychiatric benefits. As ketone levels increased, depression and blood sugar levels improved. However, those improvements did not appear to be related to how much weight participants lost.
Now, it’s always crucial not to get ahead of what science is actually showing us. And keeping in mind that this was one of the first controlled studies of this kind, it’s especially important to be mindful of some of its limitations.
First, the study was made up of a small sample of participants, so we can’t generalize the outcomes. It’s also important to note that the 4-month phase didn’t include a control group. So those improvements can’t be linked to the diet as confidently as the findings from the 1-month randomized controlled phase.
While these findings show some promise, this research is still in its early stages, and the findings are not ready to be considered an established treatment protocol.
But I’m keeping an eye out for more of these kinds of studies.
If you want to read the complete research article, you can find it right here.
But now, I’d like to hear from you.
Where are you starting to see crossover between metabolic health and mental health in your clinical work? Please comment below.
Christina Fales, Psychology, Saint Louis, MO, USA says
It would be nice if the Keto diet could reduce negative and positive symptoms in schizophrenia. Unfortunately I think that is unlikely. Without a control group for the 4-month measures, all you have is the beneficial effects of Keto in schizophrenics. Weight loss has a powerful effect on most people’s mood and sense of optimism. Who’s to say that weight loss alone might not reduce the sense of hopelessness and stress in schizophrenic patients enough to reduce their negative & positive symptoms or even get them to abate.
Even in patients who did not experience weight loss, they might have benefited by the highly structured meal plans, which allows them to escape the feeling (that they might otherwise have) that they are eating in an uncontrolled manner. Too much reward-driven behavior (esp addictive behavior) is usually aversive on its own.
In short, weight loss and feeling more in control of one’s behavior, both have significant benefits on mood. Those alone might reduce stress on the patients to the point where negative & positive symptoms are alleviated.
Amy H, Medicine, A City, IN, USA says
Psychiatrist Georgia Ede writes about the profound effects of diet, including well-formulated low carb diets, on mental health and wellbeing in her book, Change Your Diet Change Your Mind.
Lucy Lucero, Student, Missoula, MT, USA says
After receiving a bipolar 1 diagnosis, I happened onto an article by Chris Palmer in Psych Today. That was over two years ago, been keto ever since. Gradually came off medication over the course of a year. Have been stable, healthy, lost 30lbs. It’s not a miracle without hiccups, but it’s certainly effective if done very deliberately.
Mandy B, Counseling, Chatsworth, CA, USA says
This was well structured and is positive enough to look into.
Linda Seidman, Counseling, Agoura , CA, USA says
I believe Chris Palmer, MD, of Harvard, has done a great deal of research, including RCT’s on this treatment approach.