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A groundbreaking pilot study led by researchers at Stanford Medicine has unveiled the potential of a ketogenic diet in improving both metabolic health and psychiatric conditions in individuals with serious mental illnesses like schizophrenia or bipolar disorder. The findings, published in Psychiatry Research on March 27, suggest that dietary interventions could offer a new approach to managing mental illness alongside standard medications.
Dr. Shebani Sethi, associate professor of psychiatry and behavioral sciences at Stanford Medicine and lead author of the study, expressed optimism about the promising outcomes of the research. “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,” said Sethi, who is board certified in obesity and psychiatry.
The study, conducted over four months, followed 21 adult participants diagnosed with schizophrenia or bipolar disorder, all of whom were taking antipsychotic medications and experiencing metabolic abnormalities. These abnormalities included weight gain, insulin resistance, and other metabolic issues commonly associated with antipsychotic treatment. Participants were instructed to adhere to a ketogenic diet comprising approximately 10% of calories from carbohydrates, 30% from protein, and 60% from fat.
The results were striking. By the end of the trial, participants experienced significant improvements in both metabolic health and psychiatric symptoms. Notably, none of the participants met the criteria for metabolic syndrome after four months on the ketogenic diet, compared to 29% at the beginning of the trial. On average, participants lost 10% of their body weight, reduced waist circumference by 11%, and exhibited improvements in various metabolic markers.
Equally significant were the psychiatric benefits observed during the study. Participants reported a 31% improvement on a psychiatrist rating of mental illness known as the clinical global impressions scale, with three-quarters of the group showing clinically meaningful improvement. Additionally, participants reported better sleep, mood, energy levels, and overall quality of life.
Dr. Sethi highlighted the potential of metabolic interventions in addressing the complex interplay between metabolic health and mental illness. “There is increasing evidence that psychiatric diseases such as schizophrenia and bipolar disorder stem from metabolic deficits in the brain, which affect the excitability of neurons,” Sethi explained. The ketogenic diet, by providing ketones as an alternative fuel source to glucose, may help improve brain metabolism and alleviate symptoms associated with energy dysfunction.
The study’s success has prompted plans for larger, more robust studies to further explore the therapeutic potential of dietary interventions in treating mental illness. Dr. Sethi emphasized the importance of addressing the underserved population of patients with serious mental illness and metabolic syndrome, noting the urgent need for novel treatment approaches in this vulnerable group.
The groundbreaking research underscores the transformative potential of metabolic psychiatry and opens new avenues for personalized, holistic approaches to mental health care.
The study was supported by the Baszucki Group Research Fund, Keun Lau Fund, and the Obesity Treatment Foundation, with contributions from researchers at the University of Michigan, the University of California, San Francisco, and Duke University.
