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Keto Diet & Schizophrenia

iStock-1389185416An interesting pilot study of ketogenic diets for mental illness was published recently in Psychiatry Research. The study was a single-arm trial with 23 subjects with schizophrenia or bipolar disorder plus metabolic abnormalities. Inclusion criteria were diagnosis of one of those conditions and currently taking psychotropic medications, plus being overweight or having obesity (based on body mass index) and having gained more than 5 percent of their body mass while using psychotropic medications to manage their mental health condition, or having at least one metabolic abnormality, such as insulin resistance, impaired glucose tolerance, elevated triglycerides, or dyslipidemia.

The protocol called for following a ketogenic diet intended to provide 10% of total calories from carbohydrate, 30% from protein, and 60% fat. Calorie counting was not required, but carbohydrate intake was advised to be no more than 20 grams per day (excluding fiber), primarily from limited amounts of non-starchy vegetables. Subjects attended a teaching session on proper implementation of the diet and were provided with a set of ketogenic cookbooks and recipes, a list of resources, and were in regular contact with health coaches to support adherence.

Subjects were considered compliant or semi-compliant if their blood ketone level was between 0.5 – 5.0 mmol/L at least 80 percent of the time they were measured (compliant), or 50-79% (semi-compliant). Adherent and semi-adherent subjects had significant reductions in body weight and BMI, waist circumference, visceral adipose tissue, HOMA-IR, triglycerides, and other biomarkers of metabolic health. All participants who met the diagnostic criteria for metabolic syndrome at baseline no longer met the criteria by the end of the four-month study, effectively reversing metabolic syndrome.

With regard to mental health, subjects experienced significant improvements in sleep, quality of life and life satisfaction, severity of mental illness and overall functioning. The study’s lead author noted that the improvements in mental health may be due to the improvements in metabolic function but also to the presence of ketones, which are known to be an effective fuel for the brain and nervous system.

This was a small pilot study without a control group, but it adds additional evidence supporting the use of ketogenic diets for mental health, as highlighted in a previous Research Forum article.

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