Patients say keto helps with mental illness. Science is racing to understand why
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It's difficult to describe how massively my life changed when I started keto.
Like the subject of the article, I've had Bipolar (1 in my case, they didn't specify their version) for most of my life, since way before it's supposed to manifest in late adolescence. I was misdiagnosed here and there since I was a very young child, but I finally got on the right treatment plan at 20 years old.
The maintenance of that treatment plan has been taking a medium dose of Lamictal, an epilepsy drug, daily. It worked damn well compared to the regular mania, often culminating in psychosis and occasional full-on can't-even-hold-a-job levels of suicidal depression, but within a week of full-blown ketosis, I was a new person.
I found out about it through some documentary disguised as "In Defense of Fat" or something similar, and I was fascinated by the epilepsy cure thing. I had always known there was a connection between my condition and epilepsy, given that I was on seizure drugs and often experienced what I figured were mini-seizures (often described as brain zaps, I think).
I couldn't find any information on links except a few random, very weak studies, and sorta just told everyone who naysayed me to fuck off cuz it works for me. I lost 20 lbs of excess covid weight as a very nice side-effect, but I can safely say this is the most effective treatment I've ever experienced for my condition (of the many, many I've tried) and I feel like I have superpowers in comparison.
It is very obvious if I get kicked out of ketosis now after a few days or so. I've done it purposefully on vacations or just random cheat times. After a while I feel worse in the head, body, and soul. I make dumb or impulsive decisions (like my old self), or am grumpy in a way I haven't been since starting. I start to have awful dreams again and wake up my wife sleep-talking in distress, and am tired all the time like the old days.
It's certainly not the easiest diet to adhere to, it's also surely not the best for the environment unless you're really strict in specific ways like some, and it's potentially disruptive socially, but it's a lifestyle choice that has given me personally a truly new and improved life that I don't ever want to or plan to return from.
I'm able to sustain keto when using Huel Black (17% carbs), but your mileage may vary.
And Huel is both vegan and sustainable.
(I'm not affiliated, just a user)
It varies though and I use keto-sticks to check what level I'm at. And like you say, depends on daily activity.
I'm not a fan of vegan food in general (hard to get tasty), Huel is what I can tolerate.
If you're talking about B12, they use Cyanocobalamin which is produced by bacterias - Wikipedia page: https://en.wikipedia.org/wiki/Cyanocobalamin#Production.
Thing is that if you over-do it and have too high keto-levels, you can get poisoned by it and that certainly have a high level of stress on the body. (The old man points this out in your video)
Also, if you don't eat often enough, you may not trigger insulin and thus won't get hungry at all and get to little calories (thus dropping in weight).
You mean using a breathalyzer? I did not find them to be very consistent.
You know what likes keto even more? Your heart. There are studies and research of fatty acids being able to reverse heart disease, and them being incredibly more efficient fuels than glucose is. N=1 placebo, but I certainly feel my heart (in an overweight body) pumping better and with less effort 1+ weeks into very low carb.
Adaptation takes a while because our mitochondria are dysfunctional due to standard diets being so high in glucose. Fatty acids are the better fuel for muscles, and mitochondria in general.
I don't want to dismiss your personal experiences, but I think that's the wrong conclusion to draw.
Common mental illnesses - particularly depression and anxiety - have incredibly high placebo response rates. Everything looks like a promising treatment for depression in an uncontrolled trial. You can pick practically any intervention - including literal sugar pills - and get ~40% remission rates in an open-label pilot study. Many thousands of potential treatments supported by plausible theories, anecdotal accounts, case reports and small uncontrolled trials have fallen flat as soon as they were tested rigorously. The base rate suggests that the chance of a keto diet (or any other intervention with this level of evidence) being an effective treatment for depression is on the order of 0.1%.
If keto works for you then you should stick with it. The problem is that it's overwhelmingly likely to be no more effective for other people than a low-fat diet or a low-GI diet or sugar pills or faith healing. Articles like this one do a huge disservice to patients, because they completely neglect the base rate and perpetuate a cycle of hype and disappointment that can ultimately lead to distrust and despair.
If society wants to determine if X is generally an effective treatment for Y, there need to be robust experiments that involve multiple people as subjects.
If, however, one guy feels a lot better doing X, and feels worse they stop doing X, then sure, that person should probably keep doing X. Why does X work for that person? Who knows?
You have zero proof & did zero research on this person, yet trying to put someone who down sees profound benefit with the good old: "it's just placebo".
Just because there is no direct studies backing it up yet doesn't mean there isn't real effect. Could be keto, could be lack of certain starches or other foods, could be the focus & rhytm, whatever it is let's not discourage someone who is having a great practical benefit.
In this case there is literature & studies on epilepsy and keto, and OP was on put on epileptic medicine & describes a link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6361831/
Proof of what? I fully accept that this guy finds keto really helpful and I have made no effort to dispute that. There is a world of difference between "a thing that some people find helpful" and "an evidence-based clinical intervention".
>Just because there is no direct studies backing it up yet doesn't mean there isn't real effect.
The entire point of my comment is that the chance of there being a "real" effect (i.e. greater than placebo) is extremely low. That isn't the same as saying "this is definitely, 100% bogus".
You do know things can be effective without evidence-based clinical trials?
Just because there isn't any clinical trial done on it, doesn't mean it defaults to a placebo effect. What makes this case even more convincing is that there is literature on Epilepsy and keto, and OP was on put on epileptic medicine before: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6361831/
Everything new, and old but unprofitable, lack clinical trials. Clinical trials are extremely hard and expensive. Especially on complicated issues with hard to control variables: for instance mental issues with similar symptoms might have different causes.
Clinical trials are trying to prove what works safely for a large group, that's it, nothing more.
As someone who has allergies and a ton of symptoms that were alleviated by cutting out foods, it is really tiresome to hear that it is placebo or it is psychosomatic. Before I knew it was allergies and had the test in hand, I just had to grin and nod along when someone said my chronic sinus headaches were essentially make believe. Now I have a piece of paper that confirmed just about every food I had cut out or naturally avoided.
You are clearly not familiar with the research in this area. People dealing with mystery symptoms that are cleared up by cutting out certain foods will generally be. Maybe hold off on telling them it is placebo?
1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6606425/
As I am writing this, I am going through something like this. Over a longer period of time I have made myself believe that it is related to what/when I eat etc. If you can, could you share what were the triggers for you?
Regarding placebo - they do touch on this in the article. I have pretty high confidence it’s not placebo for me. But that’s the point, we just don’t know yet and all I’m saying is I’m glad we will soon know more based on my experience.
To partake in a study you need to get out of the house, go somewhere new, talk to new people a few times, do something new, get some daylight, etc. Those are all things we know has a positive effect on depression.
Big part of treating depression is to make people do those sorts of things, despite their bodies and mind screaming stay in bed, it's not worth it.
In my experience, both long term, major depressive disorder and generalized anxiety disorder only substantially improve through understanding, which of course is realized in at least 2 ways: experience and/or therapy.
We can say with some certainty that antidepressants' effectiveness is questionable, at best, long term, but of particular interest for effective indication would be any number of psychoactive substances, which routinely make headlines for this type of treatment but remain taboo for some still yet to be resolved reasons.
Of course this ultimately boils down to personal choices, but attitudes towards drugs will change before we see any real progress in this area, I'm afraid.
My lifestyle changed once I got a live-in partner. I need to get back on it.
When you eat carbs, your blood sugar rises. At first it fuels your muscles, then at some point your body has to release insulin to protect itself, keeping your blood sugar low using fat storage. Later, the blood sugar will crash, leading to a lack of energy and brain fog.
There are some hacks in the book to help with this, like walking after eating (muscles take up more of the spike), or eating in order (fiber first to moderate blood sugar, followed by protein/fat, and finally any carbs)
I think a keto diet probably has the same effects, as a consequence of removing simple carbs from your diet.
It might be better to understand this all holistically and manage it with decent nutrition, not just cutting out all <x>.
Another benefit of starting with fiber, is that your body will begin processing it and sending signals of satiety earlier than if you started carbs. Another hack I suppose is waiting 10 minutes between courses in your meals. Giving your body time to digest can help you feel fuller and prevent overeating. Especially when you grew up with the "clean your plate" form of parenting, learning to break that habit and stop when you're actually full can be a game changer for managing weight and body composition.
Some restaurants "traditionally" bring out bread or chips while you're waiting for the food (even the appetizers) to arrive.
And in most restaurants, many appetizers are not plant-based.
But doing regular Huel Black sizes (2-3 Scoops) 2x/day and I'll easily be within keto, sometimes it's too little energy though so I combine it with 2 eggs (organic).
These days I only eat after 5pm. My body is so used to it that I don't really get hungry during the day. Even if I go to gym in the morning. Do I notice a difference if I change my eating schedule or diet? Absolutely. If I eat during the day, I tend to want to eat more during the day. If I eat a lot of carbs and junk food, I tend to want to eat more. Also I feel like shit and my skin looks horrible. I think somewhere in all this mess there are mental health concerns as well, but I can't really quantify them in a meaningful way.
I noticed it is closely related to habit. When travelling I usually eat breakfast, lunch and dinner while I usually skip breakfast and sometimes lunch outside of travel. After travelling is done I feel a hunger pang in the morning where I would have taken breakfast as my body starts to "expect" it. Few days after ignoring it, it goes away...
Another case point for each' uniqueness - you mention you just drink black coffee on empty stomach. On university one of my classmates went through mandatory military service back then and he did exactly this. He utterly and forever destroyed his stomach lining (as per doctor's findings it was due to that coffee habit, even sugar or milk would help but he didn't know) and till end of his days. Tons of basic food that would make him cramp painfully or shit badly for hours. That he achieved within 1 year while you did 20 years of same seemingly without any issue.
This doesn't mean much. It's not like the doctor put your classmate under a "causo-scope" and that indicated beyond any shadow of a doubt that it was the black coffee which caused the issue.
It's more like the doctor performed tests for a few things it could be and when found no other alternative explanation he just said something. At best the doctor was thinking about a study showing correlation between black coffee drinking and stomach problems. At worst he just propagated some old wives tale.
This is no dig on the doctor. And certainly no opinion on what caused your classmate's problem. It's just sometimes the answer is that we do not know and cannot know. And the "as per doctor's findings" makes it sound more authoritative than it truly is.
That's exactly why I said "many people could", not "everyone will".
https://www.theguardian.com/lifeandstyle/2016/nov/28/breakfa...
so the question isn't "keto is the cure-all so why don't you do it?" but "the ketogenic diet results in curious effects, so what part of the diet affects which issues and why" and "how do the effects of the ketogenic diet differ from (pure weight-loss effects of) other diets"?
Polyunsaturated fat has a big tendency to exacerbate mental issues, for a variety of possible reasons but a big one likely being that it can result in chronic systemic inflammation.
So don’t make the mistake of thinking “animal fat = saturated fat” like I did, and ending up triggering a major depressive episode. Ruminants (cows/goats/sheep) seem remarkably resistant to this accumulation even when fed shitty meal.
1) Feeding different gut microbes. Often, pathogenic fungi and bacteria feed on simple carbs, which are abundant in normal diets, and drive inflammation that causes mental and physical illness
2) Ketone bodies are an alternative fuel for the brain that does not rely on glucose uptake mechanisms, which are often impaired by (pre)diabetes, inflammation, shit sleep, etc. all of which are very common.
Depressed people dehydrate and starw themselves. Starwing people (including those with eating disorders) get depressed as result of starvation.
I got either underfed to the point of fainting, had to rely on expensive restaurant meals and questionable supplements, or had to spent an enormous amount of time on meal preparation.
So either I approached this in a completely wrong way or keto just isn't for "normal" folks like myself with busy schedules.
Not that there's anything wrong with being vegan! But it definitely a minority position.
That's like an omnivore saying they're occasionally vegan because not 100% meals contain meat or dairy?
If it was possible to combine keto, a meat-free diet, and intermittent fasting, without breaking the bank or breaking the body, that would be the dream.
It's your body going into emergency starving mode. It might be good to do every now and then, just like fasting, but it's not normal.
It's not easy for any type of diet and just a few carbs will kick you out of ketosis.
But especially for Vegan, then it's mostly nuts & avocado's you can eat.
Some people have negative knowledge on diets and how the body metabolises foods, yet are ready to share advice on the internet.
Scientific evidence is clear that a whole food, plant-based is the best diet. I mean, it also makes common sense to eat a balanced diet to get all the different macro and micro nutritients, minerals and vitamins.
The "carb is bad!" line is just wrong. Eating one or two slices if fresh, whole weat bread is not unhealthy, it's healthy! It contains a lot of fiber, protein, vitamins and minerals. But of course, eating frozen pizza is unhealthy because it contains jackshit. Carbs != Carbs.
So why do these intermittent fasting, keto and what not diets work? Well, because people just live a silver bullet and quick fix. And many companies and people make a lot of money by selling these alleged quick fixes to people in the form of ready-made meals, books, coachings and what not.
Nobody is getting rich if people would just eat fresh vegetables.
while you are _probably_ correct that a whole food-plant based, balanced diet is the best way, it just does not work for everyone the same way. some might have allergies and intolerances, some might have a microbial gut biome that doesn't do well on certain foods, some might have other medical conditions (i.e. diabetes) which influences things. for all of them, having a "balanced diet" that doesn't fuck them up means different things.
many of those "fad diets" are actually nothing but tricks to actually introduce something that resembles a balanced diet into the lives of people whose diets are critically off. keto doesn't work because people believe in quick fixes, it PROBABLY works because you can't subsist on dougnuts, frozen pizza and beer anymore. suddenly it's water, spinach, broccoli, carrots and nuts for snacking. for those people, "carbs are ok" doesn't just open the door to bread but also to cake.
furthermore, keto wasn't invented by a snake oil salesman to get rich quick, it's been used as a medical intervention for at least a hundred years.
if you had actually read the article it's precisely about the scientific support for "this fad diet" keto for its effects, which actually aren't well understood. it's clearly stated that there are actually benefits for some people suffering from certain mental illnesses. don't just discard that.
And of course, if you've got a gluten allergy regular bread won't work for you. I know that nutrition is not a one-size-fits-all thing.
But you also have to agree that there are many keto snake oil salesmen.
> keto doesn't work because people believe in quick fixes, it PROBABLY works because you can't subsist on dougnuts, frozen pizza and beer anymore.
Yes, that's better formulated than what I did in my comment.
thus critizicing one's diet is like saying: "your religion is trash", which is, not surprisingly, usually not taken well be the other.
in my experience, a healthy diet is mostly about two things: * restricting calories to reach a balanced CI-CO for a bodyweight in the healthy range * allowing caloric restriction without going insane
so it's technically less about the quality of the food (i.e. how healthy your meal ingredients are) and more about feeling satiated long enough to not go crazy from hunger pangs between meals. in practice, those two overlap a great deal: if your meals lack in certain nutrients you tend to become "hungry" - for those missing nutrients, but people on a "bad" diet just eat more of the usual stuff.
apart from that, people have different motives and preferences: there are bodybuilders who can happily scarf down the same prepared meals day in and out and would subsist on cardboard if possible as long as the macros are right. there are the foodies who'd rather starve than eat a meal that's not delicious. women may need other ingredients than men due to different hormone profiles. some people love the simplicity of drinkable meals that contain all the nutrients and don't care for solid food at all anymore, while for others that would be hell on earth.
the potato diet will not work for a gourmand. a low fat diet may not work for women who need certain essential fats more than men. a low carb diet might not work well for an athlete. etc.
This is clearly not backed by science. It's clear that humans need a certain set and quantity of micro nutrients, macro nutrients, minerals and vitamins.
Now, of course, food is not the only factor determining your health. So there are people who only eat french fries and smoke and live to be a hundred, and there are people who eat a balanced diet, work out every day and then die from cancer with 40. But it's all about probabilities. Eating a balanced, whole food diet decreaes your all-cause mortality. And this is not religion, this is science.
Now, of course, every body is different and not nutrition is complicated and not that well-understood on an individual level. And yes, if you have a allergies or other types of reactions to certain foods that are considered healthy in general, you should not eat them.
He didn't need an eating disorder on top of all the other issues he already had, but that's where he's ended up by consuming diet advice from the internet.
Also, no reason to ever worry about lack of anything (iron, vitamins, minerals, whatever), none of that is ever an issue.
https://github.com/cutestuff/FoodDepressionConundrum/blob/ma...
In fact, we also know typical keto ways of exiting the mental health benefits while remaining keto. Sort of traps.
There's many keto types which work. I'm not a believer in net-carbs. Carbs are carbs, limit all carbs to 30g or less per day.
No artificial sweeteners, they all suck. No honey, you don't eat the barf of anything else, why bees? Eggs and Cheese are your big tester of if you can handle those.
In my anecdotal experience, it's crazy how many sugar zombies exist in society. They are all depressed and think the world is ending. They think they are conscious, but they clearly arent, controlled by carb and other cravings.
Something like 80% of north america are zombies?
https://www.tandfonline.com/doi/full/10.1080/10408398.2021.1...
> Our results show that meat abstention (vegetarianism or veganism) is clearly associated with poorer mental health, specifically higher levels of both depression and anxiety.
I would disagree. Veganism is certainly possible, but 99% of vegans will not do what is necessary.
Vegetarianism is not different from veganism in this discussion.
For me it was enough to significantly alter the quality of life. You might not need the full keto, only the "autoimmune exclusion protocol", which can help after long time stress adaptations
Unless you have allergies: no, it'a not keto, no, it's not Atkins, no, it's not veganism: it's not eating crap.
> Not eating 2000+ extra calories of fast food every day has never put anyone in danger.
Adolescents need 2500 or more daily, depending on gender activity level etc.
It would not be healthy every day, but it was not even approaching whole day amount of calories.
It was not far off any other restaurant food calories content.
being slightly overweight might be fine, but most of the population isn't "slightly" overweight, they're clinically obese and are fat as fuck. As in, like 60% or more of the population is full-on overweight. the rest of the world is catching up quickly, too.
Plus, anorexia is not the only eating disorder there is.
Anorexia prevalence in females ranges from 0.3%-1.5% and for males range from 0.1%-0.5%. And it is raising. It happens to be the most deadly mental issue there is. Male mortality is higher, cause people associate it with women. That is not "trivially small".
While this is broadly true, I think it's also important to convey that the hormones involved also play a huge role. There are plenty of people who stay in a calorie deficit* and still gain weight because they spike insulin with a snack or a meal every two hours.
Keto works so well because it doesn't spike insulin as much, on top of the greater satiety signals sent by popular foods associated with the diet. Eventually you feel more full for longer and the insulin spike is further reduced from the omission of calories entirely.
*: By constantly spiking insulin, the body will down regulate your metabolism since it can no longer access stored fat deposits for energy. If your BMR is lowered, then technically you are burning less calories than you are eating. Assuming a person stops spiking their insulin, their BMR will rise back to "normal" levels when the body realizes that it has access to stored fat again.
There are "symptoms" for a lowered BMR, feeling cold being chief among them as lowering blood circulation is an easy way for the body to slow down. Mental fog is can be another sign as our brain is the most calorically demanding organ in our entire body.
This model of hormonal driven weight loss/gain is fairly new and just now being studied at scale. Hopefully as time passes, doctors will become better educated and can advise their patients on how best to structure their diet to make their bodies work for them instead of against them.
I highly recommend watching some lectures by Dr Jason Fung about the issue in depth. There are a few on YouTube that are 45+ minutes in length and describe the situation more thoroughly. The TL;DW though is this: if insulin levels are high, the body cannot release stored fat. Eating raises insulin. If you eat all the time, your body will always have high insulin levels and cannot release stored fat for energy and thus will look for other ways to equalize the calories in/out equation.
The fastest way to lose weight, is to simply not eat. It sounds so simple and obvious, yet we've lost sight of the plot in our modern world.
it works, but in short bursts.
maybe if you've got enough money for a professional cook and meal planner a la hollywood types or billionaires.
i could do it for ~3 months while cutting during my bodybuilding days, for example. no way i could do it for the next 50 years of my life.
Add "and regularly exercising" to the formula. Our bodies are not made to be sitting all day.
A lot of anecdotes about people switching to keto and feeling better, but not giving the context of what kind of food they were eating beforehand.
As I'm sure many of us know, a lot of software engineers (to be fair, this applies to most people as well) have very bad diets; buying fast food lunch every day, eating free snacks, etc.
I haven't eaten fast food in decades. Cutting gluten changed my life. Go on everyone, tell me how I'm a fraud.
The response should not be "surely they had crap diets" or "it's just placebo/it's just psychosomatic", it should be "uhm, I wonder why this is happening, let's investigate.
which is the whole point of the article, after all
So yes, people's experiences told by themselves are unscientific
(I'm not affiliated).
Lol. This typo could make it big time!
A large urea crystal finally dislocates from Mr. Jordan Peterson's biological urethra, and so he weeps for a white kid getting bullied somewhere. Master P signals the host, who allegedly is in ketosis too, for the recording to keep rolling, although, that goes without saying, he can't speak profoundly at the moment. With uberwill and force, simply not possible running on carbs, he bravely breaks through weltschmerz vocal chord spasms, faintly reaching peak insight for the audience: "It's not just a diet; it's a revelation of white genocide!"
Too bad keto does not help with spelling
I no longer limit my carbs, but when I eat carbs they come from rice and potatoes instead of wheat because I wore a CGM for two-week periods of time multiple times last year and the year prior and found that wheat was always the number one culprit spiking my blood sugar which would result in massive carb crashes, which overall affected my energy levels which snowball into negative second-order effects on my feelings of productivity and mood.
We didn't evolve around day-long snacking.
Our teeth be flat like for eat fruits and plants, not for tear meat. And our digestion system be long, cherry for fiber. Da kine sweet ono loa!
While this is true for some ape species, it is not true for the human or our ancestors in the Homo genus. [1, 2].
> Our teeth be flat like for eat fruits and plants, not for tear meat.
That is not true. Human teeth are specialized for an omnivore diet.
> The best evidence that humans are omnivores comes from the teeth. Humans have short canines that are a functional consequence of having an enlarged cranium and associated reduction of the size of the jaws. In other primates, the canines are comparatively longer than humans as they function as both defense weapons and visual threat devices. Interestingly though, both Gorillas and gelada baboons prefer vegetarian diets. Humans may have no need for long pointy canines as carnivores do for such use, particularly for capturing prey and threatening enemies. They do have canines that are pointy enough to serve the purpose of tearing meat. The molars and premolars, in turn, are used to crush food. [3]
1: https://en.wikipedia.org/wiki/Homo_habilis#Diet
> They do have canines that are pointy enough to serve the purpose of tearing meat.
But I asked you, how do you end up turning the above statement about the modern human into:
> I'd really like to see a human try to tear raw flesh off an animal with their canines. I am highly skeptical that would work at all.
I didn't suggest humans walked around tearing off raw meat. However, our ancestors probably did at some point.
Since our ancestors tamed the fire about 2 million years ago, we have started cooking using fire, which changed our anatomy.
Perhaps I just can't express myself.
There is nothing controversial here, unless you are wildly disagreeing with evolution.