Severe mental health conditions can pose challenges for both patients and healthcare professionals due to the metabolic side effects of antipsychotic medications. A recent pilot study conducted at Stanford Medicine suggests that a ketogenic diet, when combined with standard medication, may improve both metabolic health and psychiatric symptoms in individuals with severe mental illnesses. While these initial findings are promising, experts emphasize the need for more comprehensive research and recommend sticking to more sustainable dietary patterns.
Mental health conditions affect a large number of adults in the United States, including severe conditions such as bipolar disorder and schizophrenia. Antipsychotic medications are often essential for symptom management but can lead to metabolic side effects such as weight gain and insulin resistance, which can negatively impact individuals’ quality of life and sometimes lead to discontinuation of treatment. To address these challenges, Stanford Medicine explored whether a ketogenic diet could enhance metabolic and psychiatric outcomes for patients with severe mental illness through a pilot study.
The ketogenic diet, which is high in fats, low in carbohydrates, and moderate in protein, has previously shown effectiveness in managing various conditions including diabetes, obesity, and mental health disorders. The pilot study conducted at Stanford Medicine involved 21 adults diagnosed with bipolar disorder or schizophrenia who were taking antipsychotic medication and were overweight or had a metabolic issue. Most participants were female and white, with an average age of 43 years old. Participants were provided with instructions to follow a ketogenic diet with specific macronutrient ratios and received support and guidance to help with diet adherence.
Participants who strictly followed the ketogenic diet showed improvements in psychiatric symptoms and metabolic markers. Those who adhered to the diet experienced less severe psychiatric symptoms and improvements in metabolic health compared to the semi-adherent group. The study results showed significant reductions in body weight, BMI, waist circumference, fat mass index, and systolic blood pressure, along with improvements in metabolic markers such as visceral fat, inflammation, HbA1c, triglycerides, and insulin resistance. Psychiatric improvements were also notable, with a decrease in mental illness severity and improvements in overall functioning and sleep quality.
Healthcare professionals caution that while the ketogenic diet may show promise for improving mental health and metabolic outcomes in individuals with severe mental illness, further research is needed to validate these findings. Concerns about the long-term sustainability of the ketogenic diet, including potential nutrient deficiencies and alteration of gut microbiomes, need to be addressed. Sustainable, long-term dietary approaches such as the Mediterranean and plant-based diets, along with mindful eating and personalized nutrition, are recommended for broader health benefits. Larger, randomized controlled trials are needed to fully understand the ketogenic diet’s implications in psychiatric care. Despite the exciting potential of these findings, it is crucial to consult with a healthcare provider before making any changes to dietary or treatment approaches.
