The Ketogenic Diet and Mental Health
Inflammation is one of the most powerful factors which determines health and illness. Levels of inflammation in the body are very strongly influenced by dietary choices. In my holistic practice of psychiatry, one of the most important conversations which I have repeatedly with my patients, is the fundamental importance of following a non-inflammatory diet. This conversation must be had repeatedly, because diet is one of the very hardest things for most people to change.
For optimum health, I believe that a Ketogenic Diet, one that is high in fat, adequate in protein and low in carbohydrate, exerts the most anti-inflammatory effect. This combination changes the way energy is used in the body; instead of deriving energy from carbohydrates which convert to glucose, energy is sourced from fats which convert in the liver into fatty acids and ketone bodies. An elevated level of ketone bodies in the blood, a state known as ketosis, is correlated with myriad health benefits. In contrast, elevated levels of glucose leads to inflammation, insulin resistance and accelerates aging.
Research on the impact of a ketogenic diet for Cancer, Autism, Alzheimer’s Disease, ALS, Parkinson’s Disease, Traumatic Brain Injuries, Sleep Disorders, Headaches, Bipolar Disorder, Diabetes and Cardiovascular Disease is emerging, and I anticipate that we are going to be hearing much more about its health benefits and novel applications.
The ketogenic diet was used very effectively to treat epilepsy in the 1920’s, until anti-convulsant drugs were introduced in the 1940’s, when it fell out of favor. It’s easier to take pills than to follow a restrictive diet, and the pharmaceutical industry’s lobby is very influential. Pharmaceuticals, as opposed to dietary changes, remain the standard of care today in conventional medicine, not only for epilepsy, but for so many medical and psychiatric conditions that could be ameliorated and even cured with appropriate dietary intervention. This is the case despite the many common adverse frightening side effects associated with use of medications, and not to mention the expense of the drugs.
Many people report that a ketogenic diet increases mental clarity and vitality, and effectively reduces chronic depression and anxiety. People generally report significant weight loss when following a high fat diet. In the past, I have hesitated to recommend a ketogenic diet to my patients, because it can be quite difficult for the average person to implement. The transition from burning glucose for fuel to burning ketones can be physically and psychologically demanding. Not only can it be hard to refrain from eating beloved and habitual foods, but it is also a challenge to figure out how to palatably get most of your calories from fat.
A much needed resource has just appeared on the scene, which makes the Ketogenic Diet much more accessible, Leanne Vogel’s beautiful new book, “The Keto Diet”. Leanne seems to have thought of everything. She has many helpful remedies for trouble shooting common dilemmas and symptoms, and action plans which address all manner of contingencies. Her clear recommendations are customizable according to an individual’s metabolic needs, which she recognizes may change over time, and for which she offers accommodations and solutions.
Like so many women living under the patriarchy, Leanne has personal experience with disordered eating and preoccupation with body image, and the approach she advocates is born out of her own process. The voice that shines through the pages is very authentic, intimate and funny. Last October I had a conversation with her about an integrative approach to cultivating holistic health when I appeared as a guest on her podcast, Healthful Pursuits, and was moved by her refreshing genuineness and capacity to connect.
The Keto Diet also contains many yummy and practical recipes. In contrast to many other low carb cookbooks, Leanne’s is dairy free and based on nutrient dense whole foods. One recipe that I found particularly useful is her tasty Keto Lemonade. (p. 422) As I mentioned above, the process of becoming fat adapted, switching the metabolism from burning glucose for fuel to burning ketones, can be quite difficult for some people. A most uncomfortable systemic illness can occur in some people called the “Keto Flu”. Some of the symptoms can include brain fog, headaches, dizziness, irritability, insomnia, nausea, palpitations, carb cravings and hypoglycemia, heart palpitations, diarrhea, muscle cramps, fatigue and weakness. It does not happen to everyone, is transient and can be managed by taking the following measures.
Leanne recommends drinking more water, increasing your intake of electrolytes, eating more fat, engaging in movement, increasing supplementation with magnesium and potassium, and increasing digestive power with digestive enzymes, probiotics and fermented foods. She recommends preparing Keto Lemonade, which is full of electrolytes, and sipping it throughout the day during the transition to fat adaptation.
KETO LEMONADE
4 cups of water
1/3 cup of fresh lemon juice
1-4 tablespoons aloe vera juice
1/4 teaspoon finely ground Himalyan salt
4-6 drops stevia (optional)
1 cup ice cubes for serving
Fresh mint and thinly sliced lemon for garnish (optional)
Combine all ingredients together and shake.
Leanne makes many engaging instructional videos. Here is one where she describes what to expect when you start eating a high fat diet.
I haven’t read anything about the Keto diet and how the higher fat contributes to or diminishes the triglyceride count and the HDL or LDL levels. I had gallstones and a gallbladder removal @ age 16. I’m now 73 and avoid fats like the plaque. Someone with credentials in Gastroenterology please respond. Thank you.
Thank you so much for this post! I am 56, almost in menopause. In the past, I have tried the “Fat Fast” for up to 5 days and felt wonderful – anxiety-free, clear-headed. As you suggested in an earlier post, the Fat Fast acts almost like a re-set and gets the body back into a state of ketosis – at least, that was the effect for me. Last fall, I also incorporated daily fasting (20 to 22 hours, then a high fat dinner) and was able to loose 10 pounds in about two months fairly easily.
The winter was a very, very emotionally stressful time, including dealing with some events and people from my past that triggered PTSD (very old grief and emotional trauma from childhood and my late ’20x) and my ketogenic diet went “out the window” at the same time. I am fortunate to have found a wonderful psychotherapist and am working those things through. At the same time, I have noticed that diet has a huge effect on my state of mind; even eating roasted root vegetables causes my mood to slip quickly (too many carbs, in my opinion.) And certainly, the slightest sugar splurge will put me in a state of uncontrollable crying (yesterday, for example, I attended a wedding and had a piece of cake; 30 minutes later I had to leave the party, sobbing.) Even a glass of wine is too much in terms of the carbs from alcohol. Today, I’ve been eating avocado, hemp seed and a home-made “bread” made entirely of ground pecans and egg yolks (very high in fat) and a small amount of salmon, and now in the middle of the afternoon I feel very good, very balanced, and clear headed.
It is so good to discover your support for this way of eating. I realize that I need to stick with this approach to get well and be well, as well as control weight.
Thank you for this thoughtful comment. Many people find that too many carbs really depress the mood. Its unfortunately so easy to slip back into d habits. And paradoxically what feels like it would be comforting, ends up making you feel so much worse. It’s so great that you have discovered what you need to do for yourself to feel good.
Dear Dr. Tsafrir,
Thank you for the informative article, I am 43yrs old and have struggled like crazy these last 6/7yrs to lose weight. It seems that all I’m doing is gaining more and more weight. My husband and I tried a high fat low carb lifestyle change and he lost fenominal weight… i hardly lost anything!
It made me feel very discouraged, to say the least.
Could I be having trouble with pre-menopause? How can I test for that?
And do you think a ketogenic diet will work for me?
Many thanks,
Marion
Well, it would be right in terms of your age that you would are in perimenopause. It can be more difficult to lose weight as we age. I think that the Ketogenic diet would be worth a try. But make sure you figure out which of the 5 versions of the dietary plans Leann Vogel recommends is the right one for you. It really can make a difference. Some people can only tolerate a ketogenic-light version and must eat more carbs at night in order to sleep and to feel well. I for instance, because of my auto-immune type of issues, stopped sleeping and felt quite ill after just a few days on the diet, despite paying attention to my salt intake and electrolyte status. Eating more carbs solved the problem quickly and I feel great. I am keeping my carbs below 50 grams a day, but much lower does not agree with me. You need to figure out what is the right path for you and to have patience. Maybe consult with a professional if you feel confused trying to figure it out on your own.
I would read the Medical Medium’s new book about the thyroid. Very informative.
Frances Casale
This was such a helpful post, big thanks! I didn’t know about Leanne’s work, and I love her approach and candid information about her own experiences. There are many really helpful suggestions in her approach that make so much sense to me (that I didn’t know about before) and help already. I bought the book and look forward to being in touch with her through her posts, and it is inspiring to know you support her work too. Thanks!
So happy that you have found it helpful. I am feeling better myself eating a ketogenic diet. Keep me posted on what you notice in terms of your health.
Thanks, Judy, it’s good to know you’re trying it too. I’ll keep you posted and would love to hear updates if you post them.
You are welcome. Will do.
Thank you
from patricia in maine…………
I’m a retired special educator and holistic body therapist who was trained to apply the concept that an overly acidic body is a body in chronic pain. To understand this point, consider the following: a completely acidic body is a dead body in decay.
The sad irony is I’ve been living with chronic pain for years. This resulted from the overuse of radioactive contrast dyes in emergency surgery over three years ago. (These wipe out our good intestinal flora), another route to chronic pain.
Back to my main point. A year ago I cut way back on carbs to reduce inflammation, mainly in a ploy to ward off dementias and cancers. What resulted quickly was a massive reduction in chronic pain. It, therefore, seems obvious to me there’s a connection between carbs and pain syndromes, at least in me…………
It’s fascinating. Thanks for sharing. There are so many people suffering from chronic pain. It’s useful to know that a. Eye low carb diet might help. A much better option than pain medication.
Three resources from one of my favorite NDs in CO, Bruce Fife, who is very pro keto: The Coconut Ketogenic Diet: Supercharge Your Metabolism, Revitalize Thyroid Function and Lose Excess Weight
May 1, 2014
Dr. Fife’s Keto Cookery: Nutritious and Delicious Ketogenic Recipes for Healthy LivingMay 5, 2016
by Bruce Fife
Sign up form for his newsletter: http://thinkinginbinary.net/crc/hwnl_sign-up-form.htm
Thanks for taking the time to share these resources. I am familiar with his work and an admirer. I am planning to sign up for his newsletter. Thanks again.