Can a New Diet Help People With Schizophrenia?

Source: Unsplash/Travis Yewell

Gut-brain health has become a trend in recent years. There’s no denying the benefits of eating healthy food and its positive effects on the brain. The brain is an organ and is affected by what goes into it, so it would make sense that diet can affect one’s brain health.

The rise in attention to metabolic dietary changes has now leaked into discussions of serious mental illnesses like schizophrenia. In fact, I only discovered this recent treatment option by watching Lauren Kennedy, a schizophrenia YouTuber, describe how the ketogenic diet was helping put her schizoaffective symptoms in remission.

A scientist always knows that we can’t rely just on anecdotal information to make general conclusions. But apparently, metabolic dietary interventions have been studied in people with schizophrenia. What does one of those studies say?

The Study

The research on specific dietary interventions for schizophrenia specifically is still a relatively new field. In fact, only one center in the whole world has established itself in the "Metabolic Psychiatry" research field, and it resides at Stanford University, headed by Shebani Sethi, a researcher there.

A new study from that center, published in May of this year in Psychiatry Research, put ideas about the effect the ketogenic diet could have on mental illness to the test. The results showed promising treatment outcomes for dietary interventions to treat schizophrenia and metabolic syndrome.

Researchers from Stanford, Duke, University of California-San Diego, and the University of Michigan-Ann Arbor did a pilot trial testing the effects of the ketogenic diet on five patients with schizophrenia and 16 patients with bipolar disorder. Patients were encouraged to stay on their current drug treatment regimen. The participants were over 18 years old, taking some form of psychotropic medications, were overweight, and had gained more than 5 percent of body mass while using their medications, with at least one metabolic condition like impaired glucose tolerance.

Participants learned about the ketogenic diet through a one-hour session about successfully implementing the diet. They were provided handbooks, cookbooks, resources, recipes, and an individual coach for the duration of the study. The patients were instructed to meet with their coach every week in the first month, every other week in the second and third months, and once in the fourth month.

Psychiatric tests, metabolic assessments, diagnostics tests, bloodwork, and demographic information were taken as a baseline at the beginning of the study.

The researchers measured for body weight composition, a comprehensive metabolic panel, fatty acid profile, advanced lipid testing, and other metrics. At each visit, each person had their waistline circumference, blood pressure, blood ketones level, weight, heart rate, and body composition measured.

Twenty-nine percent of the cohort met the criteria for having metabolic syndrome, including abdominal obesity, elevated triglyceride levels, low HDL cholesterol, elevated blood pressure, and elevated fasting levels.

A hallmark features of the ketogenic diet is that it consists of 10 percent carbohydrates, 30 percent protein, and 60 percent fat, without the need to count calories, and limit carbohydrate intake to 20 grams (outside of fiber) per day. The participants were instructed to eat one cup of vegetables per day, two cups of salad per day, and eight glasses of water every day.

Outcomes

The results were positive in both physical and mental health. By the end of the study, none of the patients met the criteria for metabolic syndrome. Average weight decreased by 10 percent, waist circumference was reduced by 11 percent, systolic blood pressure was reduced by 6.4 percent, fat mass index was decreased by 17 percent, and BMI was reduced by 10 percent.

There were changes to psychiatric issues, too. Mental health was judged to improve by an initial rate of 33 percent to 75 percent at the end of the study. Baseline symptoms of mild or greater severity showed a 79 percent improvement. The severity of mental illness symptoms in bipolar patients showed improvement in 69 percent of patients. Those in the recovery state increased from 38 percent to 81 percent by the end of the study.

This dietary intervention also showed positive benefits in patients other than mood and symptom severity. Patients reported having higher life satisfaction, enhanced overall functioning, and improved sleep quality.

Conclusions

There are many benefits to using a dietary intervention over drug or even exercise interventions. While exercise, for example, helps in many areas of health, metabolic symptoms like high blood sugar levels might not be affected. Drug treatments, meanwhile, only target a few specific things (like high blood pressure medication, drugs for diabetes, and more)—leaving the patient with a cocktail of pills.

Ketogenic Diet Essential Reads

New Study: Serious Mental Illness Improves on Ketogenic Diet

The Benefits and Risks of a Ketogenic Diet

A diet, like the ketogenic diet, as the authors argue, helps with an array of metabolic and psychiatric symptoms.

This was a pilot trial, and the authors note some limitations of their sample. The number of participants was small, aspects of life such as socioeconomic status were not assessed, and there was no control cohort with which to compare results. Typically, clinical studies with targeted groups like those with mental illness are compared alongside healthy controls, which can help determine if the intervention is really helpful.

An intervention like a diet affects an individual with an array of symptoms. These results still show promise. Metabolic psychiatry is a brand new field of study that can be used as another line of treatment for people with severe mental illness.