Can Physical Changes – Like a Keto Diet – Help Mental Illness?

For anyone struggling with mental illness, the normal treatment – starting with antipsychotics – carries risk. The mental benefit can come with a physical price, whether it’s fluid retention, sedation, or even excessive weight gain. It can be enough to push some patients to quit the meds.

But maybe it doesn’t have to bet that way. A new Stanford Medicine study reveals that a ketogenic diet can boost metabolic health, which helps counter the frustrating side effects of standard medication.

The results, appearing in the latest Psychiatry Research, suggest that a dietary shift can help ease mental illness

“It’s very promising and very encouraging that you can take back control of your illness in some way, aside from the usual standard of care,” Shebani Sethi, MD, the lead author and associate professor of psychiatry and behavioral sciences at Stanford, said.

Managing a Keto Diet

The study conducted a four-month intervention – based on a low-carb keto diet – with more than 20 participants who’d received a bipolar or schizophrenia diagnosis and “were either overweight or met criteria for metabolic abnormalities such as insulin resistance or impaired glucose tolerance.”

The researchers told the participants to follow a keto diet, with about 10 percent of the calories from carbohydrates, 30 percent from proteins, and 60 percent from fats. The researchers also advised against counting calories.

Sethi and the other researchers also shared keto diet meal ideas, which included providing the participants with keto cookbooks and a health coach.

The research team tracked how well the participants followed the keto diet by checking blood ketone levels every week. By the end of the trial, two-thirds of the participants stuck with it and six remained semi-adherent. Only one participant failed to stick with the diet.

Promising Results

The results offered compelling evidence of the potential benefits of ketogenic dietary therapy. Some of the important results the researchers reported include:

• 79 percent of participants showed clinically meaningful psychiatric improvement – one-point or greater change on the Clinical Global Impression scale (CGI).
• Three-quarters of participants achieved recovery or a recovered state by the end of the study – based on a Clinical Mood Monitoring Scale (CMM).
• All of the participants who met the criteria for metabolic syndrome made it into remission by the end of the study.
• And all of the “fully adherent participants” achieved a recovered state at the study’s conclusion.

The researchers also noted measurable drops in weight, body mass index (BMI), waist circumference, and visceral adipose tissue across the board. Additionally, they saw advances in insulin sensitivity, quality of life, and sleep.

“We’re seeing huge changes,” Sethi said. “Even if you’re on antipsychotic drugs, we can still reverse the obesity, the metabolic syndrome, the insulin resistance. I think that’s very encouraging for patients.”

Exploring a Long-Suspected Connection

Sethi, board-certified in obesity and psychiatry, has been intrigued about a possible connection between the two since her days as a medical student.

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

A growing body of evidence has emerged that show that psychiatric disorders such as schizophrenia and bipolar disorder originate from metabolic deficits in the brain, Sethi said.

Sethi and her team approached this project with the theory that “just as a keto 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,” Sethi said. “But the ketogenic diet can provide ketones as an alternative fuel to glucose for a brain with energy dysfunction.”

She concluded that there are several factors at play and that she launched this small pilot study to help guide more exhaustive research in the future.

Further Reading

Valproate and Weight Gain: A New Look at an Old Problem

Does the Onset of Efficacy for Agitation Vary Depending on the Administration Route of Antipsychotics?

Urinary Incontinence: A Rare Adverse Effect of Olanzapine