A new Ohio State University pilot study suggests that a ketogenic diet might also help with symptoms of major depressive disorder (MDD) in young adults.
The findings, published in Translational Psychiatry, hint at a potential new frontier in “metabolic psychiatry,” where nutrition plays a direct role in mental health care.
While antidepressants and therapy remain the benchmarks of care, they don’t necessarily work for everyone. And side effects like weight gain, insomnia, and nausea usually threaten adherence.
This pool of patients who find themselves left behind by the prevalent care models, has prompted researchers to explore alternative approaches to treatments.
“We have a treatment gap in that we have more students suffering from mental health concerns than can feasibly receive professional treatment,” co-author Ryan Patel, DO, a psychiatrist in Ohio State’s Office of Student Life Counseling and Consultation Service, said. “There is a need for finding ways of helping students on a large scale. And nutrition is one way we can do that.”
One promising new lead has emerged from an unlikely place. The ketogenic diet (KD), a low-carb, high-fat regimen that shifts the body into “nutritional ketosis,” burning fat instead of glucose as its primary energy source. Beyond its established benefits in helping epilepsy patients, small case studies have hinted that KD might curb depression symptoms, possibly by lowering inflammation, improving metabolic health, and boosting levels of brain-derived neurotrophic factor (BDNF).
Methodology
The Ohio State team recruited two dozen students (average age 24) with clinically confirmed MDD who were already receiving standard counseling and/or medication. Over the following 10 to 12 weeks, participants adopted a well-formulated ketogenic diet (WFKD) that included extensive coaching and partial food provision. They tracked daily blood ketone levels and attended regular check-ins. They also completed a pair of standard depression assessments: the Patient Health Questionnaire (PHQ-9) and the Hamilton Rating Scale for Depression (HRSD).
Of the 24 students, 16 finished the program. And most of them maintained nutritional ketosis for nearly three-quarters of the intervention period.
Perhaps most importantly, depressive symptoms fell sharply. PHQ-9 scores dropped by 69% while HRSD scores tumbled 71%. Improvements often appeared within the first two weeks.
And by the end of the study, no participant scored in the moderate or severe depression range. Global well-being scores nearly tripled, and none of the students reported worsening symptoms.
“The average effect size for medications and counseling after 12 weeks is about 50%, and we saw a substantially greater result,” he said. “That is an impressive finding, that across the board, in this real-world setting, everybody got better, and across the board, our participants did not need more treatment or emergency intervention.”
Benefits Beyond Mood
The new diet did more than improve the participants’ moods. Students lost an average of five kilograms (about 11 pounds), with fat mass reductions of around 13%. Serum leptin levels dropped by more than half, while BDNF levels climbed 32%.
Cognitive testing revealed improvements in memory, processing speed, and executive function. This, the authors insist, suggests the diet might also boost brain performance in depressed individuals.
Adherence, Safety, and Meaning
Most participants tolerated the diet well. While seven of the eight participants whole dropped out of the study seemed to be unrelated to the diets. It’s also worth noting that minor side effects – such as headaches and muscle cramps – cropped up early on, but resolved themselves with electrolyte support. Most importantly, the researchers failed to document any serious adverse events.
Admittedly, attrition appeared to be higher than in some similar studies, which the researchers suggest could reflect the challenges of sustaining strict dietary changes during an academic semester. Still, most of the students maintained ketosis consistently and even expressed satisfaction with the support they received.
The study shore up the argument that metabolic health and mental health are intertwined. Insulin resistance, obesity, and systemic inflammation all share links to depression. By addressing these pathways, dietary interventions could possibly bolster conventional therapies.
Despite some caveats, the findings underscore a more fundamental shift toward incorporating lifestyle interventions into psychiatric care. “Metabolic psychiatry” is gaining traction as evidence mounts that targeting inflammation, hormones, and energy metabolism can help improve mood disorders.
For students and clinicians alike, the idea that food could help fight depression is both intuitive and revolutionary. But whether this pilot sparks a larger movement remains to be seen. For now, at least, this study offers hope – and a reminder that mental health might sometimes start on the plate.
Further Reading
Ketogenic Diet Shows Promise for Bipolar Disorder
Breaking the Cycle of Depression and Obesity
Can Physical Changes – Like a Keto Diet – Help Mental Illness?
