4 Feb 2024

Will Stone: Can the keto diet improve our mental health?

From Sunday Morning, 11:10 am on 4 February 2024

The ketogenic (aka keto) diet gets hyped for weight loss, but scientists are now discovering it may also help alleviate the symptoms of bipolar disorder and schizophrenia.

Will Stone – a health and science reporter at NPR – chats to Jim Mora about what we know so far.

Boiled eggs and avocado

Photo: Ellen Bordal

One of the people driving research into the psychiatric benefits of the keto diet is Scotsman Iain Campbell. He lived with the symptoms of bipolar disorder for years until a low-carb diet he adopted to lose weight delivered an unexpected blessing, Stone says.

"One day he was looking out the window of the bus. And he suddenly realised he felt happier and more peaceful than he could remember feeling in years.

"He started to put the pieces together, realising that maybe it was this low-carb diet that had put him into ketosis (a metabolic state where the body switches from glucose as its primary energy source to ketones, which come from fat).

 "From there, [Campbell] went on to get a PhD in mental health and now he's one of the researchers leading this field."

Since 2016 Harvard psychiatrist Chris Palmer has also been on the case, after noticing two of his patients with serious schizoaffective disorder had remarkable improvements in their symptoms after trying the ketogenic diet.

In 2021, Palmer began working with Matt Baszucki, the son of tech entrepreneur David Baszucki (creator of the online game Roblox) who also saw dramatic changes to his bipolar symptoms and quality of life after going keto.

The family's nonprofit Baszucki Group now funds some of the clinical trials testing the diet's effect on bipolar disorder, schizophrenia, depression, eating disorders, alcoholism and PTSD.

It appears that physical issues common to people with psychiatric illnesses, such as increased inflammation and oxidative stress, could be linked to dysfunction in the mitochondria (the powerhouses of our cells), Stone says.

"A growing number of scientists believe there's a very strong link here and that if you actually resolve some of the metabolic problems – insulin resistance, obesity, hypertension – you may actually start to make progress on the psychiatric symptoms.

"The hope is that by providing an alternative source of fuel – the ketones are, in this case, an alternative to glucose – you may actually bypass some of the problems with the mitochondria and then have all these beneficial effects."

Health and science reporter Will Stone

Health and science reporter Will Stone Photo: Supplied

The classic ketogenic diet of roughly 90 percent fat with modified versions containing 60 percent or 70 percent fat clearly isn't going to be suitable for every person suffering from a mental illness, Stone says.

"You have to weigh the medical condition of the patient at the time versus the intervention. If the person is struggling with obesity and high blood sugar and all kinds of problems... that's where [recommending the keto diet] gets tricky."

People with low body weight may not be able to achieve the same effects either, he says.

"The key to the ketogenic diet is you have to have enough fat somehow involved to get into that ketosis state. And if you're, for example, a lean person who doesn't have a lot of fat in your body, you have to really make sure you're getting enough fat because your body doesn't have anywhere to draw that from."

For years now, there's been interest in the potential of the keto diet as a treatment for Alzheimer's, Parkinson's, MS and other neurodegenerative conditions.

"There have been no big revolutionary results although there have been promising some smaller trials. So I think the jury's still out on a lot of this and it will be interesting to see whether mental health actually kind of rises to the top, so to speak."

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