A recent clinical trial conducted by researchers at Stanford Medicine suggests that a ketogenic diet, characterized by low carbohydrate and high-fat foods, could potentially alleviate symptoms of serious mental illnesses while mitigating side effects such as weight gain commonly associated with treatment medications.
The trial recruited 23 participants diagnosed with either schizophrenia or bipolar disorder, instructing them to adhere to a diet comprising 10 percent carbohydrates, 30 percent protein, and approximately 60 percent fat.
According to researchers, medications prescribed for treating serious mental illnesses often induce significant metabolic side effects, including insulin resistance and weight gain. All participants in the study exhibited at least one of these conditions.
Over the course of four months on the ketogenic diet, 79 percent of participants demonstrated “clinically meaningful improvement” in psychiatric symptoms.
While the study was limited in size and duration, further research is warranted to assess the long-term impact of dietary changes on individuals with schizophrenia or bipolar disorder. Nevertheless, these findings contribute to a growing body of evidence highlighting the profound connection between diet and brain health. Notably, the ketogenic diet has been investigated for its potential benefits in treating conditions such as Alzheimer’s disease and epilepsy.
Researchers hypothesize that the ketogenic diet may ameliorate psychiatric symptoms by addressing underlying metabolic dysfunctions.
Lead author of the study, Shebani Sethi, a clinical associate professor of psychiatry and behavioral sciences at Stanford Medicine, explained, “The working theory is that we’re providing energy to the brain that circumvents these metabolic deficits.”
However, the efficacy of the ketogenic diet in treating schizophrenia or bipolar disorder specifically is still emerging, Sethi noted.
Key findings from the study:
Participants were instructed to limit carbohydrate intake to 20 grams per day, consume one cup of vegetables and two cups of salad daily, and drink eight glasses of water.
Weekly blood tests were conducted to monitor adherence to the diet.
Fourteen participants adhered to the diet, six were semi-adherent, one was non-adherent, and two dropped out of the study.
On average, participants experienced a 31 percent improvement in psychiatric symptoms according to the Clinical Global Impression scale.
Individuals who adhered to the ketogenic diet lost an average of 12 percent of their body weight, reduced waist circumference by 13 percent, and decreased visceral adipose tissue by 36 percent.
None of the participants met the criteria for metabolic syndrome after four months on the diet.
Experts weigh in:
Uma Naidoo, a nutritional psychiatrist and author, described the findings as “promising” but emphasized the need for replication in larger studies.
Drew Ramsey, another nutritional psychiatrist and author, noted the absence of a control group or randomization in the study, urging caution in interpreting the results.
Background information:
The ketogenic diet prompts the body to utilize fat for energy production, resulting in the production of ketones. Ketones serve as an alternative energy source independent of the body’s usual glucose metabolism.
The ketogenic diet, historically used to treat epilepsy, restricts consumption of carbohydrate-rich foods. However, its recent popularity has raised concerns about misinformation regarding its benefits and potential adverse effects, including increased LDL cholesterol levels.
Common side effects of the ketogenic diet include headaches, fatigue, and constipation, with some participants experiencing these symptoms during the initial weeks of the diet.
Future research:
The next phase involves conducting randomized controlled trials with larger participant pools. Several trials are currently underway, including one at the University of California, San Francisco.
Sethi expressed interest in investigating the potential impact of the ketogenic diet on individuals with bulimia or binge-eating disorder.
While Sethi acknowledged that the ketogenic diet is not suitable for everyone, she emphasized the importance of physician oversight before embarking on such dietary changes.