Ketogenic Diet Intervention on Metabolic and Psychiatric Health in Bipolar and Schizophrenia: A Pilot Trial

The ketogenic diet (KD, also known as metabolic therapy) has been successful in the treatment of obesity, type 2 diabetes, and epilepsy. More recently, this treatment has shown promise in the treatment of psychiatric illness. We conducted a 4–month pilot study to investigate the effects of a KD on individuals with schizophrenia or bipolar disorder with existing metabolic abnormalities. Twenty–three participants were enrolled in a single–arm trial. Results showcased improvements in metabolic health, with no participants meeting metabolic syndrome criteria by study conclusion. Adherent individuals experienced significant reduction in weight (12%), BMI (12%), waist circumference (13%), and visceral adipose tissue (36%). Observed biomarker enhancements in this population include a 27% decrease in HOMA–IR, and a 25% drop in triglyceride levels. In psychiatric measurements, participants with schizophrenia showed a 32% reduction in Brief Psychiatric Rating Scale scores. Overall Clinical Global Impression (CGI) severity improved by an average of 31%, and the proportion of participants that started with elevated symptomatology improved at least 1–point on CGI (79%). Psychiatric outcomes across the cohort encompassed increased life satisfaction (17%) and enhanced sleep quality (19%). This pilot trial underscores the potential advantages of adjunctive ketogenic dietary treatment in individuals grappling with serious mental illness.