Pilot study shows ketogenic diet improves mental illness
med.stanford.edu
med.stanford.edu
Any person that loses 10% their body weight through a diet is going to feel much better.
This seems... handwavey at best, do you know of any concrete ingredients with proven negative effects on the neurological system or is this pure conjecture?
The complex people have around weight I find really strange.
I'd be surprised if most of the mental health effects don't simply follow from the realisation that you are in control of your own weight.
Feeling powerless is pretty shit.
If you're obese, changing composition will likely add many health benefits, and very often the overall weight of the person shifting said composition will be lower because they were carrying a lot of fat, and only added a reasonable amount of muscle if they took up exercise.
Also, the vast majority of body builders are in “overweight”. Most muscle heavy gym goers should still be in normal BMI, or maybe the low end of overweight at a 10-15% body fat.
Should optimally be <0.5.
All in one weight in itself doesn't mean much in isolation. That's why you have people with a high BMI that are healthier than people with a "normal" one.
>An athlete at 240 lbs
As a contrived example, somebody this big (athlete or not), is probably at an increased risk of sleep apnea. I know of some competitive athletes (with visible abs, no less) that were surprised to learn they have sleep apnea. After a CPAP they felt better. Alternatively, they could probably have lost weight (but no longer be as competitive in their chosen sport.) Some of the risk factors (gender, neck circumference) aren't the typical proxies we use to subjectively assess health as a layperson.
>That's why you have people with a high BMI that are healthier than people with a "normal" one.
This can be true, but it is not generalizable. Last I heard, something like 1% of people with a high BMI would fall into this camp.
Like, at some point, dying, lower heart rate, loosing hair, being cold, your weins collapsing, body eating own muscles.
https://www.hsph.harvard.edu/nutritionsource/healthy-weight/
I suppose they could lose 10% through caloric restriction, but that wasn't part of this study.
Additionally, when you walk or run you don't place only and exactly the force of the weight of your body down. Each foot is loaded with an impact and the forces are distributed up the leg. What your knee experiences is a dynamic and spiky load.
. . . "Our results indicate that each pound of weight lost will result in a 4-fold reduction in the load exerted on the knee per step during daily activities. Accumulated over thousands of steps per day, a reduction of this magnitude would appear to be clinically meaningful. " . . .
Remember that pounds is a unit of force - not mass.
There's the set of "tech neck" images (example https://www.vital-balance.com/en/tech-neck/ though many more can be found) where it shows what the force on the neck is from the head. At 0°, it's 10-12 lbs of force down. If you've got your head tilted at 45° looking at a phone, the infographic says that its 49 lbs of force on the neck.
>There is increasing evidence that psychiatric diseases such as schizophrenia and bipolar disorder stem from metabolic deficits in the brain, which affect the excitability of neurons, Sethi said. The researchers hypothesize that just as a ketogenic diet improves the rest of the body’s metabolism, it also improves the brain’s metabolism.
I wouldn't be so quick to look for the most reductive/simple answer. Drastic dietary changes can have a huge impact on the microbiome, which can in turn lead to substantial changes in all kind of signaling between the gut and brain (in terms of hormones, immune molecules, neurotransmitter precursors, and much more). There may also be implications for cellular metabolism.
As the quote above touches upon, many mental health disorders may have a component of disruptions to metabolism and energy balancing on the cellular level. Possibly including ADHD, autism, treatment resistant depression, and OCD, in addition to schizophrenia and treatment resistant epilepsy.
I lost 10kgs twice in my life; the first time with a high carb, low fat diet and the second one with a no carb, high fat diet. Roughly same weight interval 84kg->70kg and roughly the same timeline (I was aiming at -1kg per week).
The high carb diet was tough: I was hungry all the time and I had to count calories precisely. Mentally I felt roughly like I did before the diet. Mostly tired. I didn't do much adjusting to my diet, I just had less food than before in order to create a caloric deficit.
The no carb diet was easy: I was never hungry, I had mental clarity for the first time in my life. After the occasional sleep deprivation I was feeling much better than before. I started eating twice a day with no snacks, then migrated to one meal per day with no hunger. Adjusting to the new diet came with some mistakes (eg. balancing elecrolytes to get the optimal level of energy) but after fixing them I was much better than before.
I can confirm that for this N=1, both clean vegetarian and carnivore diets are a large improvement over the standard American diet health wise, but the later has been much more sustainable.
I think this is why there is so many arguments about one or other, people get fired up over veg v carnivore.
Because they are both better than the Standard American Diet.
It is really important for people to note their starting position. If they were from Standard diet, almost anything is improvement.
Just like someone can be a vegan but is eating vegan oreo's, then that is not healthy. Or carnivore and just downing ribs all day.
Seems like just less processed is the best.
That pattern has been very successful for me. Beef short ribs are my favorite food now, and I have them for my main meal of the day (breakfast) on most days. I'm eating a plate of them as I type this. On that diet I've gone from morbidly obese to merely overweight, my diabetes is in remission, and my IBS has become manageable. The duration of the satiety from this meal is very high, so I'm not at all tempted to try to down them all day. I was a binge eater on carbs.
I wonder why you consider ribs to be carnivore junk food? Is it the fat? On any low carb program you're practically obliged to replace carbs with fat for energy. If it's the saturation of the fat, carnivores like me tend to disagree that it's unhealthy. Of course that doesn't work very well if they're covered in sugary BBQ sauce, but my breakfast has just three ingredients: ribs, salt and butter.
But you are correct. If it is just salt and butter, then ribs is a low processed food and probably not even as bad fat wise as other cuts. Probably also not the most fatty either.
Maybe a better carnivore 'junk' food example is like someone making a 'lasagna' with just layers of hamburger and a layers of cheese. So it is just all hamburger and cheese slop.
I've done both keto and vegan. And lost weight with both.
At the moment, I'm not sure I can define which one is better.
When I finally tried the low residue approach of carnivore it relieved my symptoms by the next morning. As a result I've become skeptical that either fiber or carbs are health foods for me. I'm also much more skeptical of the epistemic capacity of nutrition research.
After sorting that out I added some psyllium fibre tablets and I'm mostly sorted.
I agree, taking extra fiber supplements can be bad, or overwhelm the gut. But you can eat vegetables, and get fiber, but at a lower volume of fiber before you get constipated.
I'm just on side that vegetables are important. And the carnivore diet people don't seem to get enough vegetables generally, and all the other nutrients in vegetables. Even thought, you can do Keto with low carb vegetables. It can be done. Thought difficult.
Also. Gluten. When I cut out Gluten, that also cut out a ton of carbs (no breads). If you just eat vegetables without grains, it is pretty low carb.
Maybe, by the time you eat just meat, or just whole plants, or even a combination of whole foods (meat and vegetables, minus grain), your are being much more healthy in general than the Standard American Diet.
really, just eating a whole baked potato can be considered low carb compared to someone downing oreo's.
Why don’t you think it’s unhealthy? Would you argue the reverse - that saturated fats are healthy?
https://pubmed.ncbi.nlm.nih.gov/18615352/
For a good popular treatments I recommend
https://www.nytimes.com/2002/07/07/magazine/what-if-it-s-all...
and
See how you made assumptions (not downing ribs) and watered down the analogy (oh it’s just not-SAD) in order to reach a different conclusion.
The “seems like” is a totally unrelated conclusion to the N=1 that GP was talking about.
I am a month in right now on tracking every calorie I eat as close as possible in a spreadsheet.
It astounds me what I thought I could eat and think I am still in a calorie deficit. I would even say I had become completely delusional from diet misinformation.
All these gimmicks to cause yourself to restrict calories is so suboptimal to simply counting.
I think counting calories is unpopular though exactly because not counting calories allows for a level of self delusional. You can then mentally be in this super position of at the same time believing to be on a diet without actually restricting calories. Of course you don't lose any weight but you are on a "diet".
This has been known for quite some time. https://pubmed.ncbi.nlm.nih.gov/19820013/
Though those labels were always suspicious to begin with, especially since the carb in the “low carb” meme seems to only cash out into refined grains, not beans or broccoli.
I have no study to back me up but I think all anecdotes and studies about weight-loss without self-denial is bound to get more push-back than normal. Weight-loss and fitness above a certain level is “supposed to” (we think) involve hard work and sacrifice. No doubt colored by the hard workers who pushed through and have now have built a minor identity around how their strong character compared to their former selves.
Control groups are not "whataboutism". If adding that kind of control showed keto was specifically helping these people, then that'd be great; but since the study doesn't seem to have done that, it's hard to be confident in the conclusion.
Instead, they gave the participants cookbooks, and assigned them a personal coach to help them plan and cook their meals and follow through with the diet change. Giving that kind of personal support to change habits and make more considered choices to someone with mental health challenges is bound to make them feel better, no?
Anyway in his book (or podcasts) there are many anecdotal but nevertheless fascinating cases of hopeless patients in total remission after a couple of months on keto therapy. It seems a lot of research is underway as well
Given this study design, I don't really find the results that surprising.
So this is important work. It'll also be interesting to see if it replicates and generalizes.
https://en.wikipedia.org/wiki/Brain-derived_neurotrophic_fac...
"All disease begins in the gut" – Hippocrates (460 – c. 370 BC)
I have celiac disease and before it was diagnosed my anxiety and depression was much worse. I even tried keto once and felt better, because I wasn't eating gluten for the first time in my life. I think there's a larger conversation to be had about how we develop auto-immune issues and food intolerances as we age, but we really don't see that as a regular thing to worry about. Nor do we really have the tools to see what foods we cannot handle well other than elimination diets, which is what keto seems to accidentally be for many people.
It’s weird enough how all science articles attract but-what-about-correlation knee-jerk comments. But diet articles also seem to attract anecdote wars.
Got a source on this by chance?
https://ncdalliance.org/es/news-events/news/red-meat-increas...
A diet high in red meat can shorten life expectancy, according to researchers at Harvard Medical School. The study of more than 120,000 people suggested red meat increased the risk of death from cancer and heart problems.
Substituting red meat with fish, chicken or nuts lowered the risks, the authors said. The British Heart Foundation said red meat could still be eaten as part of a balanced diet.
The researchers analysed data from 37,698 men between 1986 and 2008 and 83,644 women between 1980 and 2008.
They said that during the study period, adding an extra portion of unprocessed red meat to someone's daily diet would increase the risk of death by 13%, of fatal cardiovascular disease by 18% and of cancer mortality by 10%. The figures for processed meat were higher, 20% for overall mortality, 21% for death from heart problems and 16% for cancer mortality.
The study, published in Archives of Internal Medicine, said: "We found that a higher intake of red meat was associated with a significantly elevated risk of total, cardiovascular disease, and cancer mortality.
More at the national cancer institute:
"The magnitude of association between red and processed meat consumption and all-cause mortality and adverse cardiometabolic outcomes is very small, and the evidence is of low certainty."
Personally I've cycled through keto a few times. I will say that while it did not line up with my goals sufficiently (you cannot powerlift/bodybuild long term on keto - your body _needs_ exogenous glucose for that) I was way more clear-headed and alert despite being tired all the time (presumably that's more because of the workouts).
It's interesting though, I kind of wonder if this is a sort of paradoxical reaction as (relatively) mentally healthy people who I know tried it (e.g Atkins) had their moods significantly worsen.
Dieting is stressful?
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3625904/
It covers everything from basic biochemistry to unusual disease states, here's the diet-relevant bit:
> "Ketogenic diets are often unpalatable, which leads to poor patient compliance. Additionally, such diets raise blood cholesterol and free fatty acids, increase the risk of nephrolithiasis, and cause constipation (23, 116, 201). Therefore, Veech and Clarke developed and tested ingestible ketone ester compounds, which can rapidly generate ketoses exceeding 5 mM in rats and humans (37, 103, 195), while sparing the adverse consequences of high-fat diets."
Now these ketone esters are being marketed direct to consumers when they really should only be used under medical supervision as part of a coherent treatment program for specific issues:
https://www.businessinsider.com/ketone-ester-drinks-claim-ke...
For keto, the main thing you need to know is that if you are on high blood pressure or diabetes meds you can have dangerously low blood pressure or blood sugar on keto. Seriously, don’t try it without medical supervision lest you pass out in the bathroom. For anyone not on meds, you may need more salt than you’d otherwise have. Otherwise it’s fairly safe. There’s nothing harmful about ketones. They can help with epilepsy. Maybe your brain runs better on them without epilepsy, so it’s worth a shot to find out. Docs prescribe bipolar people seizure drugs and it works for some reason, so it’s not an unreasonable hypothesis.
Seeing these results, I made the same dietary change (although I am in decent shape and not overweight). I am seeing similar benefits.
Very small sample size.
but yeah, same outcome