Ketogenic diet may be beneficial for people with psychiatric disorders

A new study, led by researchers at Stanford Medicinein the United States, showed that the ketogenic diet may be beneficial for people with psychiatric conditions such as schizophrenia or bipolar disorder . According to the work, this type of diet could improve the metabolic health of these patients and help improve psychiatric symptoms.

The results of search were published at the end of March in the scientific journal Psychiatry Research. According to researchers, the standard treatment for these psychiatric conditions, using antipsychotic medications, can cause metabolic side effects such as insulin resistance and obesity.

Therefore, a dietary intervention may be useful in treatment, from the study authors' point of view. The ketogenic diet is based on a low carbohydrate consumption and a high fat content, in order to stimulate ketosis, a metabolic process that occurs in the body when glucose levels are low.

In this process, the body produces ketone bodies to obtain energy, since the level of glucose (from carbohydrates) is low. These substances come from fat cells, which are destroyed and transformed into ketone bodies by the liver.

The idea of ​​analyzing whether the ketogenic diet could be useful in treating diseases such as schizophrenia came from the experience of Shebani Sethi, associate professor of Psychiatry and Behavioral Sciences at Stanford Medicine and first author of the study.

While working at an obesity clinic, Sethi saw a patient with treatment-resistant schizophrenia whose auditory hallucinations were reduced by adopting a ketogenic diet. From this, the researcher decided to study what was already available in the medical literature and discovered a long history of success in using this diet to treat epileptic seizures.

“The ketogenic diet has proven to be effective for treatment-resistant epileptic seizures by reducing the excitability of neurons in the brain,” said Sethi in press release. “We thought this treatment would be worth exploring in psychiatric conditions.”

How was the study carried out?

For the new study, Sethi's team followed 21 adults who have been diagnosed with schizophrenia or bipolar disorder who were taking antipsychotic medications and had some metabolic disorder (weight gain, insulin resistance, hypertriglyceridemia, dyslipidemia or impaired glucose tolerance).

Participants were instructed to follow a ketogenic diet, with approximately 10% of calories coming from carbohydrates, 30% from protein and 60% from fat. They also received keto recipe books and access to a healthcare professional.

The team tracked whether participants followed the diet well or not by measuring their blood ketone levels weekly. At the end of the study, 14 patients had fully adhered to the diet, six had partially adhered and only one did not follow the ketogenic diet. Throughout the research period, participants also underwent a variety of psychiatric and metabolic evaluations.

Before the trial, 29% of participants met criteria for metabolic syndrome, defined as at least three of five conditions: abdominal obesity, high triglycerides, low HDL cholesterol, high blood pressure and high fasting glucose levels. After four months of the ketogenic diet, none of the participants had metabolic syndrome .

Furthermore, on average, participants lost 10% of body weight , reduced waist circumference by 11% and had lower blood pressure, body mass index, triglycerides, blood sugar levels, and insulin resistance.

“Even if you're on antipsychotics, we can still reverse obesity, metabolic syndrome, insulin resistance. I think this is very encouraging for patients,” says Sethi.

Psychiatric Benefits of the Ketogenic Diet

The study also noted psychiatric benefits from adhering to the ketogenic diet. On average, the Participants improved psychiatric symptoms by 31% , evaluated on a scale that psychiatrically analyzes mental disorders. According to the research, three-quarters of the group showed clinically significant improvements, such as improved sleep and greater satisfaction with life.

“Participants reported improvements in energy, sleep, mood and quality of life,” said Sethi. “They feel healthier and more hopeful.”

Researchers believe that just as the ketogenic diet can improve the body's metabolism, it can also improve brain metabolism . According to Sethi, psychiatric illnesses, such as schizophrenia and bipolar disorder, can cause metabolic deficits in the brain, affecting the excitability of neurons.

“Anything that improves overall metabolic health is likely to improve brain health anyway,” Sethi said. “But the ketogenic diet can provide ketones as an alternative fuel to glucose for an energetically dysfunctional brain.”

The researchers believe that the study could help in the development of larger and more robust studies on how food can help in the treatment of psychiatric illnesses.