Keto: From metabolic disorders to mental health

Schizophrenia and bipolar disorder are debilitating mental health disorders.

Almost five percent of American adults will be diagnosed with bipolar disorder at some time in their lives — that’s one in every 100 people. You, a friend or a family member may be one of them. Slightly fewer will be diagnosed with schizophrenia.

Mood swings, delusions, agitation, anxiety, depression, suicidal thoughts, insomnia, reckless behavior, and other symptoms tear through patients’ lives like a tornado, destroying relationships, ruining careers and in some cases, taking lives.

Most people with these conditions need antipsychotic medication to keep their lives on track. But the side effects can be unhealthy, and distressing enough that many patients stop taking their medication.

Now, there’s research pointing to a promising way to help them…

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Metabolic psychiatry: eating for brain health

As a medical student, Dr. Shebani Sethi worked in an obesity clinic. There, she saw a patient with treatment-resistant schizophrenia whose auditory hallucinations were reduced while on a ketogenic diet.

So she dug into the existing research. There wasn’t much about the diet’s effect on schizophrenia, except for some decades-old case reports.

But she did find plenty of literature on the success of using the keto diet to treat epileptic seizures — and she made a connection…

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

Now a board-certified doctor in both obesity and psychiatry, Dr. Sethi has coined the term metabolic psychiatry, a new field that approaches mental health from an energy conversion perspective.

In a four-month trial, her team followed 21 adults who were diagnosed with schizophrenia or bipolar disorder, who were taking antipsychotic meds and who had a metabolic disorder such as obesity or insulin resistance.

The participants were instructed to follow a ketogenic diet. Only about ten percent of their calories came from carbs, with 30% from protein and 60% from fat.

Dr. Sethi shared keto-friendly meal ideas with the participants. They were also given keto cookbooks and access to a health coach.

Keto improved physical AND mental health

The results of this four-month trial speak for themselves, both in terms of physical and mental health:

• Before the trial 29% of participants had three of the five conditions that define metabolic syndrome: abdominal obesity, high triglycerides, low HDL (“good”) cholesterol, high blood pressure, and high fasting glucose levels.
• After four months on the ketogenic diet, none of the participants had metabolic syndrome.
• On average, the participants improved 31% on a psychiatrist rating of mental illness known as the clinical global impressions scale, with three-quarters of the group showing clinically meaningful improvement.
• Overall, the participants also reported better sleep and greater life satisfaction.

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

The researchers hypothesize that just as a ketogenic diet improves the rest of the body’s metabolism, it also improves the brain’s metabolism.

“Anything that improves metabolic health in general is probably going to improve brain health anyway,” Dr. Sethi said. “But the ketogenic diet can provide ketones as an alternative fuel to glucose for a brain with energy dysfunction.”

Ketones are chemicals that the liver produces when it breaks down fat for energy instead of carbs.

These findings confirm past research showing that a ketogenic diet can reduce brain inflammation.

Want to go ketogenic?

The keto diet is very restrictive, so it’s not for everyone. If you’re being treated for a mental illness and want to try it, be sure to talk to your doctor and never go off any medication without consulting them.

If you’re someone purely interested in following the diet to improve your metabolic health, you may want to ease into it. In that case, there’s an alternative diet that offers similar benefits, but with more flexibility.

It’s called the satiating diet and includes foods that are proven to reduce hunger, increase metabolism, balance blood sugar and provide other health benefits.

Sources:

Pilot study shows ketogenic diet improves severe mental illness — Science Daily

Ketogenic Diet Intervention on Metabolic and Psychiatric Health in Bipolar and Schizophrenia: A Pilot Trial — Psychiatry Research