Serious mental illnesses such as schizophrenia and bipolar 1 disorder can have a major effect on a person’s daily life.
People living with these conditions may experience hallucinations, delusions, changes in mood, difficulty thinking clearly, and problems with memory and concentration. Medicines can help reduce many symptoms, but they do not work equally well for everyone.
Many patients also continue to struggle with depression, poor thinking skills, weight gain, diabetes, and other metabolic problems linked to both the illness and some psychiatric medicines.
Because of these challenges, scientists have been searching for new ways to improve both mental and physical health. One approach receiving growing attention is the ketogenic diet.
This eating plan is very low in carbohydrates, moderate in protein, and high in healthy fats. By greatly reducing carbohydrate intake, the body begins burning fat for energy instead of sugar.
This process produces molecules called ketones, and the body enters a state known as ketosis. The ketogenic diet has been used for many years to treat certain types of epilepsy, and researchers are now exploring whether it could also benefit people with brain and mental health disorders.
A new study from the University of California, San Francisco has added important evidence to this growing area of research. The study, published today in Schizophrenia Bulletin, is the first randomized controlled trial to examine a ketogenic diet in people with schizophrenia-spectrum disorders or bipolar 1 disorder with psychosis.
The researchers enrolled 58 adults, and 47 completed the first month of the study. During this period, one group followed a ketogenic diet while the other continued their usual diet. After the first month, participants were offered the opportunity to continue the ketogenic diet for another four months. Twenty-five people chose to remain in the study.
The researchers found that the diet was practical for most participants. During the first month, 83% of daily tests showed participants had successfully remained in ketosis. During the longer four-month period, this increased to 94%. Importantly, no serious side effects related to the diet were reported.
After just one month, people following the ketogenic diet showed clear improvements in several measures of metabolic health compared with those eating their usual diet. They had healthier blood sugar levels, and people with higher ketone levels also tended to report fewer symptoms of depression.
The researchers found that these benefits could not be explained by weight loss alone, suggesting that ketosis itself may have played an important role.
The longer follow-up produced even more encouraging results. Participants who continued the diet for four months maintained their metabolic improvements while also showing significant reductions in symptoms of schizophrenia and depression.
They also performed better on tests of thinking and memory. These improvements are especially important because many current psychiatric medicines help control psychosis but have only limited effects on cognitive problems and mood symptoms.
Lead researcher Dr. Judith M. Ford said the improvements in thinking ability and emotional well-being were among the most important findings. However, she also emphasized that this was still a relatively small study. Larger and longer clinical trials are needed before doctors can recommend ketogenic therapy as a standard treatment for serious mental illness.
The researchers also noted that one month may not be long enough to fully measure the diet’s mental health benefits. Many of the strongest improvements appeared after four months, suggesting that longer treatment may be necessary to see the full effects.
Although these findings are promising, people should not start a ketogenic diet without speaking with their healthcare team. The diet can be difficult to follow and may not be suitable for everyone, especially people with certain medical conditions or those taking specific medicines. Medical supervision can help ensure the diet is balanced and safe.
Overall, this study provides encouraging early evidence that improving the body’s metabolism may also improve brain health in some people with serious mental illness.
If future large clinical trials confirm these findings, ketogenic therapy could become an important addition to existing treatments, helping patients improve not only their psychiatric symptoms but also their physical health and quality of life.
The research was published in Schizophrenia Bulletin.
Overall, this was a well-designed randomized controlled trial, which is considered one of the strongest types of medical research. The study showed promising improvements in both physical and mental health, but the number of participants was still small, especially during the four-month extension, which did not include a control group.
Because of these limitations, the results should be viewed as encouraging rather than conclusive. Larger, longer studies involving more diverse patients will be needed to confirm whether the ketogenic diet is truly an effective and safe long-term treatment for schizophrenia-spectrum disorders and bipolar disorder.
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Source: University of California, San Francisco.
