Ketogenic Diet Intervention on Metabolic and Psychiatric Health in Bipolar and Schizophrenia: A Pilot Trial.

Terence Ketter, Eric Westman, Laura Saslow, Shebani Sethi, Blair Richards, Ronald M Krauss, Farnaz Hooshmand, Diane Wakeham, Julia Bjornstad

Journal: Psychiatry research 2024;335():115866

PMID: 38547601

Abstract

The ketogenic diet (KD, also known as metabolic therapy) has been successful in the treatment of obesity, type 2 diabetes, and epilepsy. More recently, this treatment has shown promise in the treatment of psychiatric illness. We conducted a 4-month pilot study to investigate the effects of a KD on individuals with schizophrenia or bipolar disorder with existing metabolic abnormalities. Twenty-three participants were enrolled in a single-arm trial. Results showcased improvements in metabolic health, with no participants meeting metabolic syndrome criteria by study conclusion. Adherent individuals experienced significant reduction in weight (12 %), BMI (12 %), waist circumference (13 %), and visceral adipose tissue (36 %). Observed biomarker enhancements in this population include a 27 % decrease in HOMA-IR, and a 25 % drop in triglyceride levels. In psychiatric measurements, participants with schizophrenia showed a 32 % reduction in Brief Psychiatric Rating Scale scores. Overall Clinical Global Impression (CGI) severity improved by an average of 31 %, and the proportion of participants that started with elevated symptomatology improved at least 1-point on CGI (79 %). Psychiatric outcomes across the cohort encompassed increased life satisfaction (17 %) and enhanced sleep quality (19 %). This pilot trial underscores the potential advantages of adjunctive ketogenic dietary treatment in individuals grappling with serious mental illness.

Copyright © 2024. Published by Elsevier B.V.

Address: Metabolic Psychiatry, Dept. of Psychiatry and Behavioral Sciences, Stanford Medicine, Stanford, CA, USA. Electronic address: [email protected].; Metabolic Psychiatry, Dept. of Psychiatry and Behavioral Sciences, Stanford Medicine, Stanford, CA, USA.; Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, USA.; Department of Medicine, Duke University Medical Center, Durham, NC, USA.; Department of Pediatrics and Medicine, University of California-San Francisco, San Francisco, CA, USA.
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