We are seeing more and more research coming out regarding ketogenic diets and their potential utility for treating mental health symptoms. In full transparency, I have been suspicious of such a restrictive diet in the past but as I continue to learn through training with fellow psychiatrist and ketogenic diet expert, Dr. Georgia Ede and as more research continues to emerge, I shift to more curiosity. Let's dive in!
Metabolic Psychiatry
The whole premise of the ketogenic diet for mental health is based on the growing recognition that conditions that affect the nervous system and brain have at least some contribution from metabolic dysfunction in the body.
Metabolic psychiatry explores the interplay between our metabolism and mental health. This approach considers how metabolic dysfunctions, such as insulin resistance, inflammation, and oxidative stress, contribute to psychiatric disorders. Rather than treating symptoms, we are looking at underlying causes. Understanding and addressing these metabolic issues can lead to novel and effective treatments for mental health conditions such as bipolar disorder, schizophrenia, dementia, and depression.
The connection between metabolism and mental health :
Neurotransmitter Imbalances: Proper metabolism is crucial for the synthesis and regulation of neurotransmitters such as serotonin and dopamine. Metabolic dysfunctions can disrupt these processes, leading to imbalances that negatively affect mood, cognition, and behavior.
Inflammation: Chronic inflammation, often driven by metabolic issues such as insulin resistance, can impact brain function. Inflammatory cytokines can interfere with neurotransmitter pathways and contribute to mental health symptoms.
Oxidative Stress: Oxidative stress damages brain cells, proteins, lipids, and DNA. Metabolic disturbances, particularly those involving glucose metabolism, can increase oxidative stress, compromising brain health and leading to mental health disorders.
Insulin Resistance: Insulin resistance can lead to the brain struggling to utilize glucose efficiently. This condition is linked to various psychiatric and neuropsychiatric disorders, including depression, bipolar disorder, schizophrenia, and Alzheimer's disease.
Can Keto Help with Mental Wellbeing?
A ketogenic, or keto, diet in essence switches the body's primary fuel source from glucose to ketones, which provides the brain with a more stable and efficient energy source. This includes any way of eating that lowers insulin levels enough to switch on fat burning and generate clinically meaningful levels of ketones in the blood. Ketones can meet 60% of the brain's energetic needs and the rest of the energy can come from glucose made in our brains - it does not have to come from diet.
By lessening the glucose levels in our brains, ketogenic diets decrease inflammation, reduce oxidative stress, and can shift the neurotransmitter production pathway back on track. This all impacts brain function and mental health symptoms.
Evidence for Keto Diets in Psychiatry
We have the most evidence currently to support the use of ketogenic diets for bipolar disorder with promising trials completed and/or underway for autism spectrum disorder (not surprising considering oxidative stress tends to be elevated in those with autism), alcohol use disorder, depression, and eating disorders. There are also researchers looking at ketogenic diets for treatment of PTSD, anorexia (UCSD), and psychosis.
An important note, is that there is often a knee-jerk reaction that ketogenic diets are too restrictive and unsafe; however, if done under medical supervision and with careful consideration of who may be a good candidate, the ketogenic diet can be very helpful tool that uses as a food as medicine first ethos - rather than pills.
It's crucial to work closely with a medical professional trained in ketogenic diets rather than attempting it independently. Certain lab tests need regular monitoring, and it may be unsafe or contraindicated for individuals with specific medical conditions.
We provide medically supervised ketogenic diet guidance as a treatment for mental health symptoms. Learn more about becoming a patient at Driftless Integrative Psychiatry here.
A kind reminder: This blog post is designed as a general guide. This is not a substitute for personalized medical advice, nor is a patient-physician relationship established in this blog post.
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