A ketogenic diet consisting of low-carb, high-fat foods may ease the symptoms of serious mental illness and reduce weight gain and other side effects from the drugs used to treat it, new research shows. A clinical trial, led by researchers at Stanford Medicine, recruited 23 patients diagnosed with schizophrenia or bipolar disorder and instructed them to follow a diet consisting of 10%carbohydrates, 30% protein and about 60% fat.

The medications prescribed to treat serious mental illness can cause “major metabolic side effects,” such as insulin resistance and weight gain, researchers say, and all of the patients studied suffered from at least one of these conditions. After four months on a ketogenic diet, 79 percent of participants showed a “clinically meaningful improvement” in psychiatric symptoms. The study was small and relatively short, so more research is needed to determine if dietary changes can have a meaningful, long-term impact on patients with schizophrenia or bipolar disorder. But the findings are part of a growing body of research suggesting a powerful link between brain health and diet. The ketogenic diet has also been studied in the treatment of Alzheimer’s disease and epilepsy. Researchers theorize that the diet may improve psychiatric symptoms by correcting metabolic issues. “The working theory is that we’re providing energy to the brain that circumvents these metabolic deficits,” said Shebani Sethi, a clinical associate professor of psychiatry and behavioral sciences at Stanford Medicine and the lead author of the study. Sethi said researchers know a ketogenic diet can benefit the brain but how much the diet may help schizophrenia or bipolar, in particular, “is really just emerging.”

The facts

• Patients were told to reduce their carbohydrate intake to 20 grams per day; to eat one cup of vegetables per day and two cups of salad per day; and to drink eight glasses of water a day. Sethi said she encouraged patients to use avocado, coconut and olive oils, and to not be afraid of butter. They were not told to count calories. Patients continued to take prescribed medications and were assigned a health coach.
• To determine how well they were sticking to the diet, patients were monitored with weekly blood tests. Fourteen of the participants stuck with the diet and six were “semi-adherent.” One person was not adherent, and two more dropped out of the study.
• Participants improved an average of 31 percent on a psychiatric assessment of the severity of the mental illness, a rating called Clinical Global Impression scale.
• Those who stayed on the ketogenic diet lost — on average — 12 percent of their body weight, reduced their waist circumference by 13 percent and their visceral adipose tissue (the fat around organs) dropped by 36 percent.
• Before starting the diet, 29 percent of the participants had at least three of the five markers for metabolic syndrome — a cluster of conditions that together raise the risk for heart disease, diabetes and other chronic diseases. After four months on the diet, none of the participants had metabolic syndrome. (Washington Post)