Mental Illness: The Power of Food

Mental health, physical health, and diet all interact.

But medicine has long operated as though medications were the main medically approved interventions.

But food, exercise and even clean fresh air, all matter.

A pilot study shows that mental illness responds to dietary intervention.

It’s about ketogenic diet interventions. That limits carbs. Not for life, but for a “healing” period to create reversal or improvement of the condition.

And then not go back to lots of processed carbs, yet again.

A ketogenic diet shows promise in reducing symptoms of bipolar disorder and schizophrenia and even reversing metabolic syndrome. (It’s long been known to help seizures).

But a ketogenic diet is not a long-term diet.

Gut wall cells, enterocytes, need “gut food”. This comes with short chain fatty acids. That come from carbs. Healthy carbs.

Thus, a ketogenic diet can be used to treat mental issues. But after improvement, healthy non-processed carbs should be added back. In moderation.

Participants, in this ketogenic pilot study, who adhered to the high-fat, low-carb diet experienced a 30% reduction in psychiatric symptoms and an average 10% reduction in weight. 

"We're seeing huge changes," first author Shebani Sethi, MD, of Stanford University in Stanford, California said in a press release. "Even if you're on antipsychotic drugs, we can still reverse the obesity, the metabolic syndrome, and the insulin resistance. I think that's very encouraging for patients."

New theories of psychiatric illness consider the cause, in part, to come from “brain tissue on fire”. Or brain inflammation and altered metabolism.

• A keto diet for interventional periods, is neuro-protective.

• Avoiding processed carbs reduces inflammation and oxidative stress. 

This pilot study included 21 participants with schizophrenia (n = 5) or bipolar disorder (n = 16) who were aged 18-75 years.

All were currently taking psychotropic medications.

Participants were overweight (body mass index [BMI] ≥ 25) and had gained more than 5% of their body mass while taking psychotropic medication, or they had at least one metabolic abnormality, such as insulin resistance or dyslipidemia. 

Their keto diet included 10% carbohydrate, 30% protein, and 60% fat. 

Investigators monitored blood ketone levels at least once a week.

Participants were considered “keto-adherent” if their levels were 0.5-5 mM for 80%-100% of the times they were measured.

Health coaches checked in with participants for about 5-10 minutes each week to answer diet-related questions. (When was the last time your doc recommended a health coach?)

The study went on for 4 months, so this seems to be a good therapeutic dietary trial period time.

By the end of the trial, 14 patients had been fully adherent with the diet, six had been semi-adherent, and only one had been non-adherent.

Higher ketone levels, suggesting greater adherence, correlated with better metabolic health.

Overall, 43% of participants achieved recovery as defined by the Clinical Mood Monitoring Form criteria: 50% of the adherent group and 33% of those who were semi-adherent.

Mental health and physical health are interconnected.

Ultra-processed foods are unhealthy. They promote brain issues. And mood issues.

In all of us.

Also… especially kids.

I go into the homes of some close friends, smart folks, with at least one child with a severe illness. Often there are bags of processed chips, snack foods, sugary things.

When I ask how come, they often respond, “We’ve tried. It’s too much work to get them to eat otherwise. We can’t handle the crying, the fights, the refusals.”

The parents give up.

Ultra-processed foods stay in the house.

Their kids stay ill.

Even if you eat organic chips or boxed cereals, it’s still extremely processed.

We have gotten out of the habit of eating whole foods. Of cooking for ourselves.

We are losing control of the kitchen.

We often let kids, especially very ill kids with psychiatric diagnoses, run their own diets.

Can’t we just say, in my house you get this or you don’t eat?

But as soon as kids are a bit older, if you didn’t do this earlier on, it can be constant battles.

When did it begin that parents do not want to parent?

On so many levels this creates kids with potentially so many more issues, from brain to behavior to learning.

I was having eggs one morning in one of my favorite coffee dive places, and the small but sunny restaurant was filled with about 50 adults. Trying to enjoy their food.

One table had 6 adults and one small girl. She had doughnuts on her plate.

She was yelling, screaming, walking over to other tables and touching other people’s food. Getting up on empty tables. But no adult did anything.

In a time of fear to do anything, the store owners nor myself did anything.

We are all scared to take action.

Maybe someone will pull out a gun?

But everyone’s breakfast was ruined by this one small girl.

She would create chaos for everyone else. Only to return back to her table and adults to munch on more sugar.

Of course she is not an example of psychiatric illness. But an example of how adults have often now given up control.

Kids need healthy tough love. This includes food.

Food matters.

Discipline matters.

To avoid disease. Also, to be part of disease treatment.

Mental and physical intertwine.

What do you think?

During Covid there were two huge studies that showed that eating merely one more veggie meal a week statistically reduced the incidence of having severe Covid.

I spoke about this on my podcast. But my podcasts kept getting banned.

Oy.

Where have all the parents gone?

Where are the docs that bring up food not in an ancillary manner, but as a focus? Or recommended health coaches that help?

Knowledge is power… if lived.

Dr. B.

Reference:

Ketogenic Diet Intervention on Metabolic and Psychiatric Health in Bipolar and Schizophrenia: A Pilot Trial. Psychiatry Res. 2024 May;335:115866