Does Keto Keep the "Crazy" Away?
Many people claim that very low-carb diets improve their mental health. But what does science say? Let's find out.
Run a search in the T Nation archives and you'll find a dozen articles about very low-carb ketogenic diets. Some experts think they're great, some don't, and most see both the benefits and drawbacks.
When talking about keto, we're usually concerned with fat loss and its effects on muscle building. But that's not why many people are interested. Instead, they want to do it to improve their mental health. Many claim it does just that. But does it? What does the research say, and how can we make it work better?
The Studies
Most of the research so far has focused on major mental illnesses, usually when traditional treatments have fallen short.
A pilot study conducted by Stanford Medicine found that 79% of participants showed clinically meaningful psychiatric improvement after four months of keto dieting. These folks were suffering primarily from bipolar disorder and schizophrenia. Improvements were observed in mood, cognition, and overall mental stability.
How does keto do that? The researchers theorize that keto shifts the brain's primary fuel source from glucose to ketones, which may stabilize neuronal activity and improve brain metabolism. This metabolic shift is linked to reduced inflammation, better energy regulation in the brain, and potential neuroprotective effects. Several of the participants described keto as "life-changing" and said they'd never felt better.
As a bonus, every participant with metabolic syndrome was in remission by the end of the study. As a reminder, metabolic syndrome is a cluster of conditions including abdominal obesity, high blood pressure, elevated fasting blood sugar levels, high triglycerides, and low levels of HDL ("good") cholesterol.
Likewise, a retrospective analysis published in Frontiers in Psychiatry evaluated the impact of keto on people with treatment-resistant mental illnesses, including major depressive disorder, bipolar disorder, and schizoaffective disorder. The study involved 31 inpatients who adhered to a keto diet limited to 20 grams of carbs per day.
Significant reductions were observed in depression severity. For those with schizoaffective disorder, psychosis symptoms improved notably. As with the previous study, participants also showed improved metabolic markers, including weight loss, lower blood pressure, improved blood glucose levels, and reduced triglycerides.
But Would Other Diets Do the Same Thing?
To really assess keto's effects on mental health, we'd need several controlled studies comparing keto dieting to other diets that lower inflammation. Since mental health is closely related to brain inflammation, would any inflammation-zapping nutrition strategy improve mental health? We don't know yet, but we can say that keto helps.
Improving Keto for Mental Health
To improve keto's ability to balance mental health, we want to correct any nutritional deficiencies and add some complementary supplements to further reduce brain inflammation.
1. Fish Oil
Most keto dieters adopt a meat-heavy plan and use nuts, seeds, and certain oils to bump their fat intake. This could lead to an imbalance of omega-3 and omega-6 fatty acids, which promotes inflammation. Omega-3s help balance this ratio by reducing inflammation and promoting brain health.
Keto diets rely heavily on ketones for brain fuel, and omega-3s, particularly DHA, are crucial for maintaining brain structure and function. Supplementing omega-3s enhances cognitive benefits.
In addition, during the keto-adaptation phase, the body experiences metabolic stress while shifting from glucose to ketones. Cortisol helps facilitate this adaptation, but sustained high levels can occur. Fish oil helps keep excess cortisol under control. DHA and EPA also support brain health by improving membrane fluidity and neurotransmitter function. This helps the brain respond to stress more effectively, reducing the need for excessive cortisol secretion.
If your keto plan isn't heavy in sardines and salmon, take bioactive fish oil. Flameout DHA-Rich Fish Oil (Buy at Amazon)contains more than enough omega-3s, including 2000 mg of DHA.
2. Electrolytes, Especially Magnesium
A keto diet depletes electrolytes due to water loss during the initial stages. This is partially what causes "keto flu." So salt your foods liberally and consider taking a potassium supplement.
Keto diets often have low levels of magnesium due to restricted food choices (low or no intake of grains, fruits, and legumes). Adding pumpkin seeds and spinach helps but magnesium supplements are still a good idea.
Magnesium helps regulate glutamate (an excitatory neurotransmitter) and GABA (an inhibitory neurotransmitter), ensuring balanced brain activity and reducing stress and anxiety. Magnesium is also essential for ATP production, the primary energy source for neurons. Brain cells require significant energy to maintain cognitive function.
By itself, magnesium was shown in several studies to fight off depression, plus it helps with sleep, a struggle for many keto dieters.
To correct any deficiencies, take 400 mg of chelated magnesium daily. Elitepro Vital Minerals (Buy at Amazon) contains this amount in its most absorbable form.
3. Antioxidants
Keto diets often lack antioxidant-rich fruits. Several studies like this one show that people who consume plenty of fruits and veggies are much less likely to experience depressive symptoms.
Aside from antioxidants, plant nutrients play a role in neurotransmitter synthesis, including serotonin and dopamine, which regulate mood. And bioactive polyphenols (found mostly in berries and leafy greens), enhance brain plasticity and improve brain signaling.
Fruits and veggies also support a healthy gut microbiome by feeding beneficial bacteria. These bacteria produce short-chain fatty acids and other metabolites that communicate with the brain, influencing mood and reducing depressive symptoms.
Balance your keto diet by taking Biotest Superfood (Buy at Amazon). It contains 18 whole-food extracts of fruits, berries, and vegetables, and it only has two grams of carbs per serving, so it won't kick you out of ketosis.
Obligatory Note
The studies above were well-supervised by mental health experts. While keto looks hopeful for improving mental health, consult your doctor, and don't ditch your meds just yet.