High-fat keto diet may help people with bipolar disorder and schizophrenia, study finds

Drugs prescribed to treat serious mental illnesses can cause “significant metabolic side effects” such as insulin resistance and weight gain, and all patients studied had at least one of these symptoms. Researchers say he was suffering from .

After four months on a ketogenic diet, 79 percent of participants showed “clinically meaningful improvement” in their psychiatric symptoms.

Because this study was small and relatively short-term, further research is needed to determine whether dietary changes have meaningful long-term effects on patients with schizophrenia and bipolar disorder. But the findings are part of a growing body of research suggesting a strong link between brain health and diet. Ketogenic diets are also being studied in the treatment of Alzheimer's disease and epilepsy.

Researchers theorize that diet may improve psychiatric symptoms by correcting metabolic problems.

“The actual theory is that we're providing the brain with energy to avoid these metabolic defects.” Shebani Sethiclinical associate professor of psychiatry and behavioral sciences at Stanford University and lead author of the study.

Sethi said researchers know that the ketogenic diet benefits the brain, but it's “still unclear how effective this diet is, especially for schizophrenia and bipolar disorder.” “I haven't.”

• Patients were told to reduce their carbohydrate intake to 20 grams per day. Eat 1 cup of vegetables a day and 2 cups of salad a day. And drink 8 glasses of water a day. Sethi said she encouraged her patients to use avocado, coconut and olive oil and not be afraid of butter. They weren't told to count calories. The patient continued to take prescribed medication and was assigned a health coach.
• Patients were monitored with weekly blood tests to determine how well they were eating. Fourteen of her participants remained on the diet, and six were “semi-adherent.” One did not comply and two more dropped out of the study.
• Participants improved by an average of 31% on a psychiatric assessment of mental illness severity called the Clinical Global Impression Scale.
• People who followed a ketogenic diet lost an average of 12 percent in body weight, 13 percent in waist circumference, and 36 percent in visceral adipose tissue (fat around organs).
• Before starting the diet, 29 percent of participants had at least three of the five markers of metabolic syndrome. Risk of heart disease, diabetes, and other chronic diseases. After following the diet for four months, none of the participants developed metabolic syndrome.

Uma NaidooThe nutritional psychiatrist and author of This is Your Brain on Food said the clinical trial's results are “promising,” but it was also a small group of participants and the results will not be tested in a larger study. He said it needs to be reproduced.

“This is not a one-size-fits-all approach. The fact that it worked in small clinical trials in these people, based on what appears to be well-considered science, suggests that it will work for everyone. It doesn't mean it's effective,” Naidu said. “Nutritional psychiatry is an emerging field that people should pay attention to, but that doesn't mean you shouldn't take medication if your doctor recommends it.”

Drew Ramsey, a nutritional psychiatrist and author of “Eating to Beat Depression and Anxiety,” said in an email that the pilot study is a “well-documented and thoughtful trial.” However, he said, “There is no control group or randomization that needs to be suppressed.” our enthusiasm. ”

“Big questions regarding the keto diet and patients with severe mental illness revolve around compliance, sustainability, and potential adverse metabolic effects,” Ramsey wrote in an email.

When you eat a high-fat diet, your body burns fat for energy instead of glucose. This process produces ketones, which are acids produced when the body breaks down fat. Ketone bodies do not rely on the same “metabolic machinery” that the body uses to turn glucose into energy, Sethi says.

The ketogenic (or keto) diet was used by doctors. 1 century ago To treat epilepsy. The restrictive diet, which avoids bread, pasta, and starchy fruits and vegetables, has gained widespread attention over the past decade, especially on TikTok and Instagram, with proponents claiming it can lead to weight loss. Ta.

But some experts say it's widespread. false alarm Regarding the benefits of diet, the American Heart Association said that diet can often cause an increase in LDL cholesterol levels.

Common side effects of switching to a ketogenic diet include headaches, fatigue, and constipation. The researchers said some participants experienced these side effects during the first three weeks of starting the diet.

Research into how the ketogenic diet affects mental illness is “in its infancy,” researchers say. The keto diet is already being studied to treat obesity, type 2 diabetes, and epilepsy. According to the researchers who conducted the clinical trial,numerous studies” shows that ketogenics can treat epilepsy, particularly in children, with some patients “achieving long-term seizure freedom.”

“What seems to be effective in reducing brain strokes is stabilizing the nerve membranes and reducing inflammation,” Sethi said. “We burn glucose or ketone bodies for energy, so it also provides an alternative fuel to glucose.”

Funding for the pilot study was provided by the Baszucki Group Research Fund (co-founded by Roblox founder David Baszucki and his wife Jan Ellison Baszucki), the Kuen Lau Fund, and the Obesity Treatment Foundation.

The next step is to conduct a randomized controlled trial with more participants, Sethi said. Several randomized trials are already underway, including at the University of California, San Francisco.

Sethi said she is also interested in researching whether the keto diet affects people with bulimia or bulimia.

Sethi said the ketogenic diet “is not suitable for everyone” and that people should only start a ketogenic diet “under medical supervision.”

“I take a tailored approach to who I prescribe and why,” she says.

Have questions about healthy eating? Email [email protected] I may answer your question in a future column.

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