The Current Status Of The Ketogenic Diet In Psychiatry
Go to: Abstract Background The ketogenic diet (KD) has been used in treatment-resistant epilepsy since the 1920s. It has been researched in a variety of neurological conditions in both animal models and human trials. The aim of this review is to clarify the potential role of KD in psychiatry. Results The search yielded 15 studies that related the use of KD in mental disorders including anxiety, depression, bipolar disorder, schizophrenia, autism spectrum disorder (ASD), and attention deficit hyperactivity disorder (ADHD). These studies comprised nine animal models, four case studies, and two open-label studies in humans. In anxiety, exogenous ketone supplementation reduced anxiety-related behaviors in a rat model. In depression, KD significantly reduced depression-like behaviors in rat and mice models in two controlled studies. In bipolar disorder, one case study reported a reduction in symptomatology, while a second case study reported no improvement. In schizophrenia, an open-label study in female patients (n = 10) reported reduced symptoms after 2 weeks of KD, a single case study reported no improvement. In a brief report, 3 weeks of KD in a mouse model normalized pathological behaviors. In ASD, an open-label study in children (n = 30) reported no significant improvement; one case study reported a pronounced and sustained response to KD. In ASD, in four controlled animal studies, KD significantly reduced ASD-related behaviors in mice and rats. In ADHD, in one controlled trial of KD in dogs with comorbid epilepsy, both conditions significantly improved. Conclusion Despite its long history in neurology, the role of KD in mental disorders is unclear. Half of the published studies are based on animal models of mental disorders with limited generalizability to the analog Continue reading >>
Can A Ketogenic Diet Really Fight Depression? Low-carb, High Fat Foods Shown To Drastically Improve Mental Health
They say you are what eat, and we all know the difference a better diet makes to our complexion and our waistlines. But what about our heads? An increasing number of scientists are pointing to the Ketogenic diet - similar in nature to the low-carb, high-protein Atkins and Caveman meal plans, which have shown promising results in the treatment of depression and bipolar disorder. 'It's a very new field; the first papers only came out a few years ago,' Michael Berk, a professor of psychiatry at the Deakin University School of Medicine in Australia tells The Washington Post. 'But the results are unusually consistent, and they show a link between diet quality and mental health.' A Ketogenic diet typically restricts the intake of carbs to no more than 50g a day. A good rule of thumb is to follow the 60/35/5 rule in which 60 per cent of calories come from fat, 35 per cent from protein, and five per cent from carbs. Grass-fed meat, fish, dairy, nuts and avocado are top of the list in terms of foods that comply. Jodi Corbit, a 47-year-old mother from Catonsville, Maryland, had been battling depression for decades before adopting the Ketogenic diet in a bid to lose weight. To her surprise, she not only shifted several pounds, but also her lifelong depression. 'It was like a veil lifted and I could see life more clearly,' she explains. 'It changed everything.' Chow down: Although research on the mental benefits is still its early days, the Ketogenic diet has already been shown to drastically improve the symptoms of epilepsy, Alzheimer's and even cancer Dr El-Mallakh, a professor of psychiatry at the University of Louisville, believes there is a 'strong link' between Ketogenic eating and mental health. He authored a book on the subject, Bipolar Depression, and last year published t Continue reading >>
Atkins Diet 'causes Mood Swings And Depression'
Quick Links: Join our private community forum Join our facebook community Follow us on twitter Listen to Judy on NPR-affiliate WHDD-FM (click "Food for Mood") Subscribe to our Blog Read our Author Blog Sign up to receive our FREE one day meal Plan and Recipe of the Month (and receive a free one-day PDF sample of the diet when you sign up) Sign up for telephone consultation sessions Schedule a weight loss workshop for your community or organization The Serotonin Power Diet Health Correspondent, PA News Low carbohydrate regimes like the Atkins diet could lead to mood swings and depression and leave slimmers feeling like "an emotional zombie", researchers have claimed. The controversial high-protein, low-carb Atkins diet has prompted criticism from many doctors who fear it could increase the risk of long-term health problems such as kidney damage, high cholesterol and diabetes. More research in America has now suggested it could also affect mental health, leaving dieters feeling grumpy, tired, apathetic and restless. Dr Judith Wurtman and her colleagues, from the Massachusetts Institute of Technology's (MIT) clinical research centre, found that when you stop eating carbohydrates, your brain stops regulating serotonin. This chemical elevates mood and suppresses appetite, and eating carbohydrates naturally stimulates its production. Antidepressant drugs make serotonin more active in the brain and help regulate mood. But carbohydrates raise serotonin levels naturally, acting as a natural tranquilliser. The MIT research looked at serotonin levels in the brains of 100 volunteers who ate different diets, either with a lot of meat and other high-protein foods, or with more carbohydrates, found in breads and cereals. They found that the brain only made serotonin after a person ate Continue reading >>
Dear Mark: Depression Diet?
I occasionally get emails from readers who are interested in lifestyle changes that can either complement or replace their conventional treatments for depression. Since our post a few weeks ago on antidepressants, I’ve gotten a slew of emails asking me about the role of nutrition in mental health. In response I thought I’d devote a Dear Mark to the general question of diet and depression. Thanks to all who wrote in or commented on the boards or forum! It comes as no surprise that nutrition directly impacts brain performance just as it does the functioning of every other organ. Although the roots of clinical depression involve a complex (and theoretically contentious) mix of physiological, genetic and socio-emotional factors, the physical picture hones in on neurotransmitters, chemical messengers that travel between nerves in the brain. Of all the neurotransmitters, the key players in mood disorders are dopamine, norepinephrine and serotonin. When we talk about a diet that supports mental health, we’re essentially looking at nutrition that sustains both optimal neurological functioning and hormone balance. Although it’s not commonly discussed as such, depression is an inflammatory condition. Current research emphasizes the underlying role of inflammation as a cause for both depression itself and the neurodegenerative symptoms seen in those with depression. Researchers have found that people with clinical depression show elevated levels of inflammation biomarkers. Furthermore, risk factors for depression include conditions linked to inflammatory response such as low omega-3 levels, leaky gut, and late pregnancy/postpartum rise in cytokines. Conventional anti-depressant medications, not surprisingly, have anti-inflammatory effects. Of course, I support an anti-infl Continue reading >>
Quieting The Bipolar Mind: Can A Ketogenic Diet Stabilize Mood?
Disclaimer: Please note that I am in no way endorsing nutritional ketosis as a supplement to, or a replacement for medication. There is very little data actually supporting the use of a ketogenic diet as a treatment for bipolar, and a well-documented case where a bipolar patient on valporic acid developed full-blown mania with psychosis after starting a ketogenic diet (thanks to @neurocritic for pointing me to this report; read about it below). This post talks about the theory behind using keto for bipolar disorder and a few recorded clinical cases. Bipolar disorder is often described as a dizzying, sinister and emotionally draining roller-coaster ride. It is marked by dark periods of severe depression interspersed with mania or hypomania – insane energy levels, difficulty concentrating, distorted thinking, euphoria and thoughts that tumble around and around in the brain. To date there is no cure for bipolar disorder, but mood swings can be managed effectively with lithium or anti-seizure medication, such as valporic acid. While effective in many cases, these drugs unfortunately come with a price: in some women lithium may lower thyroid levels causing rapid cycling of depressive-maniac cycles; valporic acid may increase the level of testosterone in young women leading to disruption of menstrual cycles and excess body hair. Many drugs also suffer from the “rebound effect”, where suddenly stopping the medication may worsen bipolar symptoms. In many cases, using a lower drug dose may minimize side effects, but sometimes at the cost of decreased efficacy. What if there’s an alternative way –say, a diet – to stabilize mood in conjunction with drugs? Lucky for mood clinicians, there is in fact a successful pre-existing case: the use of the ketogenic diet to treat Continue reading >>
Is The Ketosis Diet The Most Powerful Aid For Depression?
The western world is in the grip of a terrible malaise. Depression has been earmarked by the World Health Organisation (WHO) as the fastest growing health problem right now and expects it to be that way for many years to come. But why? What gives? Do they know something we don’t? Or is it, in fact, that people just don’t really understand Depression and are blithely wandering into its clutches because they just can’t see it coming? Well, I obviously don’t have all the answers, but I’m going to tell you what I’ve learned over the years with my research into food and health matters. The first piece of information worth considering is the old quote “You are what you eat”. Or the version attributed to the “Father” of Western medicine “Let your food be your medicine and your medicine be your food”. Now, I remember my A-Level chemistry, and I was pretty good at it, and I remember that the bottom line is that you can’t make certain compounds if the ingredients for those compounds are not present in the reaction vessel. Your body is the reaction vessel in this instance, and therefore it stands to reason that if you don’t get enough, say, Iron in your diet, you will find your body exhibiting symptoms which are caused by a lack of Iron. Pretty simple stuff, right? Right. Except that during the whole time that Depression has been becoming the world’s number one disease, the ‘official line’ on dietary recommendations has stressed the importance of not eating too much fat. Low-fat carbs have been the order of the day, and we have probably all seen one version or another of that Special K woman on our screens literally thousands of times. She seems to be doing alright on it… what’s the problem? Well, my money is on the fats. It takes a bit of hea Continue reading >>
Gestational Ketogenic Diet Programs Brain Structure And Susceptibility To Depression & Anxiety In The Adult Mouse Offspring
Abstract The ketogenic diet (KD) has seen an increase in popularity for clinical and non-clinical purposes, leading to rise in concern about the diet's impact on following generations. The KD is known to have a neurological effect, suggesting that exposure to it during prenatal brain development may alter neuro-anatomy. Studies have also indicated that the KD has an anti-depressant effect on the consumer. However, it is unclear whether any neuro-anatomical and/or behavioral changes would occur in the offspring and persist into adulthood. To fill this knowledge gap we assessed the brain morphology and behavior of 8-week-old young-adult CD-1 mice, who were exposed to the KD in utero, and were fed only a standard-diet (SD) in postnatal life. Standardized neuro-behavior tests included the Open-Field, Forced-Swim, and Exercise Wheel tests, and were followed by post-mortem Magnetic Resonance Imaging (MRI) to assess brain anatomy. The adult KD offspring exhibit reduced susceptibility to anxiety and depression, and elevated physical activity level when compared with controls exposed to the SD both in utero and postnatally. Many neuro-anatomical differences exist between the KD offspring and controls, including, for example, a cerebellar volumetric enlargement by 4.8%, a hypothalamic reduction by 1.39%, and a corpus callosum reduction by 4.77%, as computed relative to total brain volume. These results suggest that prenatal exposure to the KD programs the offspring neuro-anatomy and influences their behavior in adulthood. Introduction The ketogenic diet (KD), a known treatment for intractable epilepsy, has been recently found efficacious in treating and/or managing a variety of other conditions; from type-II diabetes, to Alzheimer's disease and cancer (Veech et al. 2001; Van der Continue reading >>
Your Food And Your Mood: Carbs, Depression, And Cognitive Decline
We are all too familiar with the obesity and diabetes epidemics that plague our society. These are not the only epidemics we are facing. The United States spends about $215 billion annually on orthopedic surgeries, cancer is catching up to heart disease as the number one killer in the U.S., and we also suffer from chronically low moods and neurodegeneration as we age. According to the Centers for Disease Control and Prevention, the prevalence of antidepressants is up 400% when compared to the last couple decades, and Alzheimer’s disease costs this country $100 billion annually. That is not a typo - 400% and $100 billion. Could it be that our current recommended dietary guidelines are a contributing factor to this epidemic? The answer is most definitely yes. Disclaimer: I do not think that diet is the only underlying issue here. We are chronically overstressed, sleep deprived, vitamin D deficient, sedentary, and tend to spend a lot of time alone. Those are all contributing factors to the decreased mood seen in this country. However, for today we are going to focus on nutritional aspects that are major contributing factors. The Possibilities of Eating Low Carb We are encouraged by the USDA to eat a diet high in carbohydrates and low in fat. A study performed in 2012 and published in the Journal of Neurobiology and Aging put 23 older adults on a six-week diet that was either low carb or high carb. Although depressive mood was unchanged, there were reductions in weight, fasting glucose, waist circumference, and fasting insulin, as well as improvements in the verbal memory test of the low-carbohydrate group.1 This study lasted only six weeks, yet showed increased cognitive ability for an older population with mild cognitive decline. What would happen if we ate like this al Continue reading >>
Low-carb Diet = Depression??? Not So Fast!
I’ve noticed a few blogs on the internet recently and posts within our Community from people asking about the effects of Atkins on their sleep or whether doing Atkins would increase their risk of depression. I’ve addressed this topic before, but I thought it would be a great time to revisit it. One study that was well publicized in the past followed a group of adults who were separated into two weight-loss groups: a very low-carb plan and a restricted-calorie, moderately high-carb plan. Both groups lost about the same amount of weight over a year—30 pounds. But, according to the researchers, the low-carb group reported higher levels of anger, depression and confusion vs. the higher-carb group. The researchers suggested a link to better serotonin (a neurotransmitter involved in mood) synthesis with the higher-carb group while the low-carb group had lower levels of serotonin. Concluding that higher carbohydrate intake can increase serotonin concentrations in the brain, while fat and protein reduce concentrations. But it’s just not that simple. Even the researchers suggest that more studies need to be done to support this theory. Let’s start with this indisputable fact: The body needs tryptophan to make serotonin. No one denies this—tryptophan is an essential amino acid, and we need it for all sorts of things, including making serotonin. Tryptophan is a good guy. But no one knows just how much is needed; nor does anyone know exactly how much serotonin we need to make in order to “not be depressed”. What we do know: Depression is a function of an Internet-like maze of interrelationships between serotonin, dopamine, beta-endorphins and other neurotransmitters like norepinephrine and epinephrine. The making of any of these chemical messengers can be influenced Continue reading >>
Ketosis For Depression
Depression is so common these days that it seems hard to meet anyone who hasn’t experienced it in some degree. While this has perhaps become the new normal, it doesn’t need to be. Our eating choices not only affect our physical health but our mental health as well—so if you’ve been wondering whether the ketogenic diet can positively impact your emotional state, read on for the use of ketosis for depression. Diet and Depression It’s no secret that most people are overworked, under-rested, and living on a poor diet. It’s also no coincidence that the modern advice to eat a diet high in carbohydrates, low in fat, and with constant snacking or small meals throughout the day has coincided with a rise in diabetes, obesity, and mental issues like anxiety and depression. Let’s take a look at why this difference in diet could be causing these problems—and how ketosis and a ketogenic diet can help. Ketogenic Nutrition and Depression Most of us can agree that a high intake of sugar has a negative impact on mood. Just think of the sugar highs and crashes that result from eating high-carb foods. What follows is feelings of crankiness, low-energy, and maybe even depression. Now, think about how a steady intake of fats from a ketogenic diet could have a positive impact on mood and endorphin levels. Many people who start eating keto have come from a background of eating the Standard American Diet and not exercising enough. Starting a ketogenic diet, removing high-carb refined foods, losing weight, and eating whole foods is bound to help with mood and make you happier. This alone could have benefits for those with depression. In addition, there are some interesting links between ketones and many conditions of the brain similar to depression, including epilepsy and Alzheim Continue reading >>
Keep Yourself In Ketosis
When talking about a Grain Brain lifestyle, and the very similar ketogenic diet, it’s frequently mentioned that we are aiming to keep our bodies in ketosis. However, if you’re new to my work, it may be that you’re not exactly sure what ketosis is, or why we should be worrying about getting our body into this state. Allow me to explain. Ketones are a special type of fat that can stimulate the pathways that enhance the growth of new neural networks in the brain. A ketogenic diet is one that is high in fats, and this diet has been a tool of researchers for years, used notably in a 2005 study on Parkinson’s patients finding an improvement in symptoms after just 28 days. The improvements were on par with those made possible via medication and brain surgery. Other research has shown the ketogenic diet to be remarkably effective in treating some forms of epilepsy, and even brain tumors. Ketones do more than just that though. They increase glutathione, a powerful, brain-protective antioxidant. Ketones facilitate the production of mitochondria, one of the most important actors in the coordinated production that is the human body. And that’s just the tip of the iceberg. Our bodies are said to enter ketosis at the point when blood sugar levels are low and liver glycogen are no longer available to produce glucose as a fuel for cellular energy production. At this point, not only is the body doing the natural thing, and burning off fat, it’s also powering up the brain with a super efficient fuel. We can jump start ourselves into ketosis with a brief fast, allowing our body to quickly burn through the carbs that are in our system, and turn to fat for fuel. A ketogenic diet is one that derives around 80% or more of of its calories from fat, and the rest from carbs and prote Continue reading >>
Where Did My Appetite Go?
It’s the flip side to being hungry all the time: what on earth do you do when your appetite just isn’t showing up to play? When you count up your food and find you’re eating almost nothing – not because you’re trying to starve yourself, but because you just aren’t hungry for it at all. You don’t even want to eat. This can be great for weight loss, but it can also be pretty scary to experience without knowing why, and you might be wondering whether you’re accidentally depriving yourself of necessary nutrients on such a tiny amount of food. So why could this be happening? Ketosis Ketosis is a metabolic state where your body runs primarily on fat for energy, instead of carbohydrates. You achieve ketosis by eating a very low-carb diet. Whether you were intending to eat a ketogenic diet or not, if you don’t make an effort to eat any tubers or fruits, you might end up accidentally taking Paleo in a ketogenic direction. And one of the best-known side effects of ketosis is loss of appetite. There’s nothing necessarily wrong with this – it’s one of the reasons why ketogenic diets can be so great for weight loss. If you want to lose weight or don’t mind the appetite loss, then just sit back and enjoy the hunger-free ride! On the other hand, if you weren’t trying to lose weight, this can be a problem. For an athlete going Paleo to improve the health, for example, a ketogenic diet can be a disaster: suddenly, they aren’t eating enough to fuel their workouts, and performance goes down the drain. The fix for this is simple: try adding some more safe starches into your diet and see how you feel. You might find that your appetite comes back all on its own. Hunger as Fatigue Another potential cause for a loss of appetite is that you are hungry; you just don Continue reading >>
Can A Ketogenic Diet Help Treat Bipolar Disorder?
Bipolar disorder can disrupt every part of your life, including your job and your relationships. Medicine and talk therapy can help control the severe high and low mood swings, depression, and mania symptoms. You might have also considered trying alternative therapies, like diet changes. Although changing your diet won’t cure bipolar disorder, there is some evidence that certain food choices can help. One diet in particular, the ketogenic diet, has the potential to benefit people with this condition, according to limited research. The ketogenic diet has been around since the 1920s. It’s a high-fat, low-carbohydrate diet that mimics the state your body would go into if you were fasting. Normally, carbohydrates, namely glucose, supply your body and brain with energy. Glucose is the brain’s preferred source of fuel. When you cut carbs from your diet, fat takes over as your body’s primary energy source. The liver breaks down fats into substances called ketones, which are naturally higher in energy than carbohydrates. Ketones travel through your bloodstream to fuel your brain. There are two variations of the diet: On the classic ketogenic diet, you eat a ratio of 3:1 to 5:1 fats to protein plus carbohydrates. In other words, three to five times the amount of fat compared to protein and carbs combined. The bulk of your diet is made up of fats from foods like fish, such as sardines and salmon, butter, red meat, avocado, chicken, eggs, cheese, coconut milk, seeds, and nuts. Most of your carbs come from vegetables. On the medium-chain triglyceride (MCT) diet, you get about 60 percent of your total calories from a type of coconut oil. You can eat more protein and carbs on the MCT diet than you would be able to on the classic ketogenic diet. Research over the years has fou Continue reading >>
5 Compelling Reasons To Stick With A Ketogenic Diet
Chances are if you’re like me, you can come up with a million reasons not to do something healthy. Wouldn’t it be cool if you could come up with a million reasons to change your life for the better? Well, it won't be a million. It’ll be five, and it’ll be about the ketogenic diet. The ketogenic diet is helping people all over the world lose weight, get healthy and feel better. However, like with any lifestyle change, you’re going to experience some resistance. If you’re only armed with one reason to do something, you could get overwhelmed by the horde of self-sabotage that lurks in the corners of our brains. That’s why, for me, it’s important to come up with a smorgasbord of good reasons to keep doing something healthy. If the only positive I was getting from the ketogenic diet was simply weight loss, I think I could talk myself out of it just to indulge in the fleeting pleasures of an afternoon muffin. But armed with multiple, interesting and cool benefits of the ketogenic diet, I can keep those harlot muffins where they belong: in apocalypse-proof plastic wrapping, next to the rack of children’s sunglasses near my drugstore checkout line. Smile, Baby! The ketogenic diet is low-carb and very, very low in sugar. Sugar and refined carbs are the main culprits behind tooth decay, causing certain bacteria in your mouth to overfeed and release excess acid, which causes cavities. The absence of sugar and carbs keeps these bacteria from going bananas, and as a result, you have a much slimmer chance of developing cavities and gum disease. You might think that not getting cavities is not really that great of a reason, but have you paid for a cavity as an adult? It costs more than taking an entire family to Disneyland. I’d personally prefer to go on Space Moun Continue reading >>
Do High-fat Diets Cause Depression?
Fat-Phobia Strikes Again Earlier this month, the following headline showed up in my inbox: HIGH-FAT DIET LINKED TO ANXIETY, DEPRESSION It was distributed by Medscape (a widely-read e-news source geared towards medical professionals), as well as a variety of other media outlets, including Science Daily. The study itself 1) was published in the British Journal of Pharmacology and is entitled High fat diet-induced metabolic disorders impairs serotonergic function and anxiety-like behaviours in mice. We have been (wrongly) told for decades by public health officials that dietary fat is unhealthy, so we tend to take articles that support this belief at face value, without question. But before you clear your cupboards of all fatty foods, hoping for eternal happiness and tranquility, let me tell you why the results of this MOUSE study need not cause you any additional depression and anxiety. Of Mice and Mental Health Researchers fed one group of mice a low-fat chow and another group a high-fat chow. After twelve weeks, the mice eating high-fat chow had gained more weight. They had also developed high blood sugars, high insulin levels, and glucose intolerance. Sixteen weeks into the study, these mice also showed more signs of emotional distress. Poor meeces. Furthermore, when the high-fat mouse group was treated with the antidepressant Escitalopram (brand name Lexapro), the antidepressant failed to work. The study’s authors concluded that high-fat diets may lead to type 2 diabetes, and that type 2 diabetes may then lead to depression and anxiety symptoms which respond poorly to antidepressants. Hmmm. As a psychiatrist with a special interest in nutrition, I understand how important dietary fat is to the health of the brain, and I know that fat doesn’t cause type 2 diabetes. Continue reading >>