Can Nutrition Treat Mental Disorders?

In today's video, we're going to show you how what you eat can make a substantial impact on your health, not just your metabolic health, but also your mental health. Welcome back to Metabolic Mind, where we're working to revolutionize the treatment of mental illness by providing information and resources at the intersection of metabolic health and mental health. I'm Dr. Brett Scherr. Metabolic Mind is a non-profit started by Roblox founder, David Buzuki, and his wife, Jan, after their son, Matt, sent his psychiatric symptoms into remission with a metabolic intervention called nutritional ketosis. Our goal is to help families like theirs learn about this new approach to treating mental disorders and to offer a message of hope that freedom from the burden of mental illness is possible. Now to start today, I'm going to describe the dietary changes that experts agree pretty much apply to everyone and that is sure to improve your health. And then we'll go a little further, focusing specifically on therapeutic nutritional ketosis. After watching this video, you should better understand how therapeutic nutritional ketosis can improve psychiatric symptoms or symptoms of mental illness and why you may want to consider discussing it with your healthcare provider. But first, please remember, our channel is for informational purposes only. We're not providing individual or group medical or healthcare advice or establishing a provider-patient relationship. Many of the interventions we discuss can have dramatic or potentially dangerous effects if done without proper supervision. Consult your healthcare provider before changing your lifestyle or medications. Now in our previous videos, we described the correlation between insulin resistance or metabolic dysfunction and mental illness. We also explained how you can know if you have insulin resistance. And now we're going to go into more detail about how what you eat can directly impact your metabolic health and your mental health. Let's start with the easy part, the dietary advice that applies to pretty much everyone. Get off the standard American diet or standard Western diet, standard industrialized diet, whatever you want to call the diet that combines high-carb, high-fat, high-calories, highly-processed foods. And instead, focus on whole food sources and natural sources, pretty much avoiding anything that's refined or processed or anything that has added calories with little nutritional value. Those foods, the added calories, the nutritional value, ultra-processed foods, they're a recipe for insulin resistance, metabolic dysfunction, and this rollercoaster of rising and falling glucose and rising insulin levels. Now before you get upset with me, let me clarify what I mean when I say this was the easy advice. What I mean is that this advice is easy to give, as it's a rare thing that almost all nutrition experts agree on, but I know it's not always easy to implement. I mean, we live in a world that's full of tempting foods, which are exactly the ones we should be avoiding. If it was easy for everyone to follow this advice, we wouldn't have our obesity and diabetes and metabolic health crisis that we currently have, and we probably also wouldn't have as bad of a mental health crisis. Now we have to be honest, that the food environment we live in is against us. The advice to eat all things in moderation and simply reduce your calories are often destined to fail with the ubiquitous easy availability of cheap, tasty, and potentially addictive refined and processed products. It's no secret that almost any diet that focuses on whole food sources is going to be better for metabolic health and mental health than the standard industrialized diet. So many people can see benefits from a whole foods, vegan, vegetarian, Mediterranean, or even other diet, as long as it sort of fits with their overall health and their overall liking that they can maintain it long-term in a healthy way. But the question we have to ask is, is it enough to simply reduce refined and processed foods, or is there something potentially even more effective for metabolic and mental health? Well, at Metabolic Mind, we want to explore the concept that simply eating better, although helpful, may not be the most impactful approach. Instead, we hypothesize that therapeutic nutritional ketosis may be the most effective nutritional approach for mental health and treating symptoms of mental illness. But before we go any further, let's make sure we're on the same page and what we mean by therapeutic nutritional ketosis. This refers to any nutritional approach that reduces carbohydrate intake low enough so your body changes from using glucose for fuel to using fat for fuel. That can be the fat you store in your body or the fat you eat. And as a result, your body produces ketones, which the brain can specifically use for energy production. As you can see, this is more than just a diet. I mean, it's a powerful intervention that radically changes your body's metabolism and how it produces energy. That's why simply calling it a ketogenic diet kind of doesn't do it justice. It's not what is sometimes promoted as the fad weight loss diet, but rather it's a therapeutic medical intervention that's been around for over a century. So how can therapeutic nutritional ketosis benefit mental illness? Let's get into that. But first, please remember, therapeutic nutritional ketosis, or simply starting a ketogenic diet, is a powerful health and medical intervention that can change your body's metabolism and can dramatically alter brain function, medications levels, sleep patterns, energy levels, and other physiologic functions. If you have a psychiatric diagnosis or symptoms or take psychiatric medications, you should not start a ketogenic diet alone. Instead, you should only consider starting therapeutic ketogenic intervention with careful monitoring from your healthcare provider or an experienced clinician. We hope you'll learn from our information and take the information to your healthcare provider to discuss whether therapeutic ketosis is an appropriate, safe, and potentially effective intervention for you. Okay, now back to the question. So how can therapeutic nutritional ketosis benefit mental illness? Well, there are two main ways, probably more, but two main ways. And the first is a direct effect from ketones. Scientific studies have shown that with a diagnosis of serious mental illness, seizures, or even dementia, brain cells have trouble efficiently using glucose for fuel. Essentially, there's a disruption to the brain's energy production. Ketones supply a completely different fuel that doesn't depend on insulin or the cell's ability to metabolize glucose. This can result in more efficient energy production for the brain. Now, you might have heard that the brain can't run 100% on ketones, and that's true. Your brain will always require some glucose, which your body can produce by itself, even when you're not eating carbohydrates. The best scientific evidence suggests that ketones can supply up to 70% of total brain energy. That's a potential huge benefit compared to running 100% on glucose, which is what frequently happens in the setting of insulin resistance and metabolic dysfunction, especially on the standard industrialized diet. But it's not just a benefit from more efficient energy production. When the brain switches from glucose to ketones for the majority of its energy, there's evidence of decreased neuroinflammation, something else that's been implicated in the cause of mental illness. There's also a change in neurotransmitters with an increase in GABA and a decrease in glutamate, and that combination can reduce the hyperexcitability of the sick or diseased nerve cells. And furthermore, using ketones for fuel can improve the function of mitochondria, the energy-producing part of the cell. So here's Dr. Chris Palmer, who postulates that the mitochondria serve as a unifying root cause of energy dysfunction in mental illness. When you look at the neuroscience linking metabolic disorders or metabolic problems and mental disorders, especially serious ones like bipolar disorder, schizophrenia, and chronic depression, that research actually goes back a couple of centuries. So we have known since the 1800s that diabetes and serious mental disorders are strongly connected, and that families who have high rates of diabetes are more likely to have serious mental disorders, and vice versa. Families with serious mental disorders, people are more likely to develop diabetes. Beginning in the 1940s, researchers began to identify all sorts of metabolic abnormalities in the bodies of people with mental illness. So they would take samples of blood from their veins and noticed increased levels of lactate, which is a biomarker of metabolic stress. Usually we have increased lactate when we exercise. They were noticing these increased levels of lactate in people with schizophrenia and bipolar disorder even when they were relaxing. And that research continued to escalate. And then in the 1990s, we had neuroimaging studies and all sorts of lines of evidence that all converged on metabolism. Metabolism is extraordinarily complicated, though, and so is the brain. And so researchers have been puzzled and overwhelmed by this complexity. Only over the last 20 years have we begun to see an entirely new body of research that helps us understand this complexity, and that is a body of research focused on mitochondria. Most people know mitochondria as the powerhouse of the cell, but actually they do so much more than that. And when you do a deep dive of the science of mitochondria and all of the different roles they play in cells and the human body, you can actually connect the dots of all of the factors that we know play a role in mental illness. So mitochondria are involved not only in metabolic disorders like obesity, diabetes, and cardiovascular disease, but mitochondria are directly involved in the production and regulation of neurotransmitters like serotonin and dopamine, but also some important hormones like cortisol and estrogen and testosterone. But they play a role in gene expression and inflammation as well. And when we look at that, when we look at this big picture of metabolism and mitochondria, we can actually begin to understand how symptoms of mental illness emerge, but more importantly, how the causes lead to those symptoms, and then much more importantly, ways that we can intervene to stop these symptoms and put these disorders into remission and restore people's health and lives. But remember, I said therapeutic nutritional ketosis has two potential effects. So the benefits I listed so far are the direct ketone effects, right? The other potential benefits come from improving insulin resistance and metabolic dysfunction. Now, any diet that helps you reduce excess body fat, especially visceral fat, the fat around your belly and your inner organs, any diet that does that can likely improve insulin resistance. But a ketogenic diet is probably the most effective nutritional intervention given the combination of reduced body fat and decreased carbohydrates and decreased insulin levels. This is very important to remember as we've already mentioned, the association between insulin resistance and metabolic dysfunction and mental illness. And also the fact that psychiatric medications can induce insulin resistance. They can be very effective for treating certainly acute psychiatric symptoms, but over the long run, they can induce insulin resistance. Now, therapeutic nutritional ketosis could help future health risks from the medications by reducing the risk of insulin resistance. But remember, nutritional ketosis is a medical intervention that changes your metabolism. So in reality, therapeutic ketosis should be prescribed just like a medication with a discussion of the risks and benefits and clear instructions on how to do it. And it should be used in conjunction with other psychiatric medications. In fact, nutritional interventions like ketogenic diets are typically initiated while keeping medication regimens the same, at least for some time. And in some cases, as needed medications for sleep may be required during the initial transition into ketosis, which can occasionally cause insomnia. So at this point, we've talked about the potential benefits and the potential precautions. So you're probably wondering why we're so cautious about recommending starting a keto diet and only doing it under the guidance of your healthcare provider. I mean, it turns out there are some potentially significant side effects and precautions, and we're gonna cover those in much more detail in our next video. So please click on that video to further understand how to safely start a ketogenic diet. As always, if you found this helpful, please click the thumbs up and subscribe buttons and make sure to share this video with your family and your friends and your healthcare providers so you can help us spread our message to help as many people as possible. And also please leave a comment. We'd love to hear from you and interact with you and hear what you found most helpful. So thanks for listening. Please take care of yourself, take care of others, and we'll see you here next time at Metabolic Mind.