- Hi, I'm Dr. Tracey Marks
and I make mental health education videos.
There's been recent studies showing that a ketogenic diet
improves psychotic symptoms in people with schizophrenia.
In a previous video that I did,
I talk about how the Mediterranean diet
is being shown to improve depression
and I have a link to that video in the corner
and in the description.
The ketogenic diet and Mediterranean diet
couldn't be more different,
but they are addressing different problems
which then leads to the question
what is it about schizophrenia
that makes this specific diet more helpful?
We don't have a clear understanding
of what causes schizophrenia.
The fact that this diet helps though and how it helps
gives us more information about what goes wrong
in the brain that causes schizophrenia.
I explain schizophrenia in this video
and you can watch it after this one.
I'll also have a link in the description.
First I'll explain what the ketogenic diet is
and then I'll explain how it was shown to help
the brains of people with schizophrenia.
The ketogenic diet is a high fat, low carbohydrate diet.
Normally your body uses carbohydrates to burn energy.
The carbohydrates are broken down
into the simple sugar glucose.
Your brain especially needs glucose
and that's why if your sugar levels drop for whatever reason
like you didn't eat for an entire day
and then you go on a run,
a sign of your glucose being low
is becoming lightheaded or losing consciousness.
When you restrict how much carbohydrates you eat,
your body will turn to fat as your fuel source
so your liver will take the fat and break it down
into fatty acids that are converted to ketone bodies.
These ketone bodies then become the fuel source
instead of glucose.
When you have elevated ketone bodies in your blood,
you're considered to be in a state of ketosis
so this is where the name ketogenic diet comes from.
Ketosis is not the same as ketoacidosis.
Ketoacidosis is a dangerous metabolic state
that we usually see in people with diabetes.
In this scenario you're producing ketone bodies
in an uncontrolled way.
What normally happens is when you produce ketones,
you simultaneously produce small amounts of insulin
that cause glucose to be produced
from other sources in your body.
We call this basal insulin secretion.
It works in the background to keep you
from completely depleting your glucose stores,
but in people with type 1 diabetes
and some people with type 2 diabetes who require insulin,
they lose the ability to produce that minimal
acceptable level of glucose in the body.
In that case once you trigger
the production of ketone bodies,
it's like an avalanche of ketones that overwhelm the body
and put the person in a state of metabolic acidosis
because ketones are acidic.
Ketosis from carbohydrate restriction
doesn't lead to ketoacidosis
in someone who has normal insulin production.
The ketogenic diet can help with blood sugar control
in people with diabetes,
but you have to be careful and should talk with your doctor
about whether or not it's a good idea for you to follow.
It may be that you do a modified form of it.
This diet is not new.
It's been studied in other conditions like seizure disorder,
Alzheimer's disease, Parkinson's disease and others.
It also's become a popular lifestyle diet
because of the fat-burning mechanism
causes a lot of weight loss.
Here's an example of what a day in the life
can look like eating a keto diet.
For breakfast you could have scrambled eggs
in a cream sauce with bacon.
Lunch could be a chicken breast with sliced avocado
and broccoli with butter.
And for dinner you could have salmon in a lemon cream sauce,
salad greens with high fat dressing.
Here's what we understand so far about what happens
in the brain of a person with schizophrenia.
We believe that it's related to three things,
abnormal energy metabolism of the neurons,
abnormal function of the mitochondria
and mitochondria is an organelle inside of your cell
that acts like a power station.
And the third contributor is oxidative stress.
Oxidative stress is damage to the cells
at the gene level from free radicals.
Lots of things that we do, eat and are exposed to
create excess free radicals that cause oxidative stress
and this is where consuming antioxidants are helpful.
Your brain relies heavily on glucose to function,
but with schizophrenia
the neurons don't process glucose properly.
Then you get abnormal communication between the neurons.
We call this impaired synaptic activity.
The synapse is a gap between the cells.
Think of the cells as an engine that's choking or sputtering
because it doesn't have enough fuel.
Because the ketogenic diet
provides another source of fuel for the brain,
it restores the metabolic activity of the cell
so that they function in the way that they're supposed to.
So in our analogy the engine stops choking
and runs smoothly.
The evidence that we have on the ketogenic diet
is several case studies.
We still don't have any randomized control studies
testing groups of people with schizophrenia with the diet
and see who does better.
Randomized control studies are the highest level
of evidence that we look for
to conclude that a finding is valid and reproducible.
So we're not there yet as far as seeing this
as a definite intervention for schizophrenia,
but we're getting there.
It's still a positive thing to see
because not only can the diet improve symptoms,
but it can also improve the weight gain
that comes with the medications
we prescribe to treat the symptoms.
So that's a twofold benefit.
It's not an easy diet to follow though
and it takes a lot of discipline,
but it's something to look into as a non-medication option
to benefit schizophrenia.
If you wanna know more about schizophrenia,
watch this video.
See you next time.