Keto diet linked to short-term symptom relief in treatment-resistant depression

A study has found that the ketogenic diet — high fat and low carbohydrates — may help with treatment-resistant depression. Participants in the study showed symptom improvement during the six-week trial, although after another six-week follow-up, symptoms diminished, suggesting the diet may only be effective in the short run.

Treatment-resistant depression occurs when symptoms do not improve after trying at least two different trial medications, usually between six and eight weeks each.

The ketogenic diet shifts the cellular energy metabolism from glucose to ketones and has previously been proposed as a treatment for various psychiatric disorders, including depression.

Ketones impact neurotransmitter, inflammatory, metabolic, and gut-brain axis pathways, which the British researchers state are relevant to metabolic hypotheses of depression. However, the research on ketogenic diets for psychiatric disorders is still in an early stage.

The study, published in JAMA Psychiatry, included 88 participants and randomly assigned them to either the intervention group following a ketogenic diet or the control group following a phyto diet (with extra fruit and vegetables) for six weeks.

Short-term solution?

Both diets showed improvement in depressive symptoms, but the keto diet showed slightly greater improvement at the six-week check. The diets were supplementary to medications for depression.

The study found that the participants who suffered more severe depression seemed to benefit the most from the keto diet.At week 12, the difference between the dietary groups was not statistically significant. Therefore, the scientists stress that the effects may only be prevalent in the short term.

They found that the participants who suffered more severe depression seemed to benefit the most from the keto diet. However, the study did not pinpoint which depressive symptoms improved; instead, it used a Patient Health Questionnaire-9 score to assess overall improvement.

Meanwhile, weight loss has previously been associated with easing depressive symptoms in prior studies, the researchers note.

To ensure weight loss did not occur and did not impact the results, participants received snack portions based on their individual energy targets. Their weight was monitored, and if it changed by 0.5 kg over two consecutive days, the portions were adjusted.

A prior study found that 16 US college students who followed a well-formulated ketogenic diet for at least ten weeks experienced a 70% decrease in both self-reported and clinician-rated depression symptoms.

Long-term effects of keto have also been studied. It raised the important question of its safety and efficacy for improving metabolic health over a longer period, and found that the diet can potentially have dangerous effects on metabolic health, including how the body processes fats and carbohydrates.