In a recent address at The Heritage Foundation, Health and Human Services Secretary Robert F. Kennedy Jr. made headlines by asserting that a Harvard psychiatrist had “cured schizophrenia using keto diets.” This statement has drawn significant scrutiny from the medical community, which emphasises that while a ketogenic diet may show potential benefits for mental health, there is no evidence to support claims of a cure for schizophrenia.
Clarifying Claims About the Ketogenic Diet
Kennedy Jr.’s remarks appear to reference the work of Dr. Christopher Palmer, a Harvard psychiatrist known for his research in this area. However, Dr. Palmer has explicitly stated, “I have never once used the word ‘cure’ in my work. I have never claimed to have cured any mental illness, including schizophrenia.” While he acknowledges that the ketogenic diet can be a powerful approach to managing symptoms, he cautions against interpreting this as a definitive treatment or cure.
The ketogenic diet, typically characterised by a high fat intake and low carbohydrates, significantly differs from the more restrictive “carnivore diet” that Kennedy Jr. advocates. This discrepancy raises questions about the accuracy of his claims and the overall understanding of dietary interventions in mental health.
Research Insights on Keto and Mental Health
The potential of the ketogenic diet in relation to schizophrenia stems from two case studies published by Dr. Palmer in 2019. These reports involved two women, aged 39 and 82, both diagnosed with long-term schizophrenia. While initially following a ketogenic diet for other health concerns, they reported improvements in their psychiatric symptoms, leading to the eventual cessation of their antipsychotic medications.
However, Dr. Palmer cautions that these findings should not be overstated. He noted, “Yes, it’s only two… case reports don’t prove anything. They’re not controlled. They come with tremendous amounts of bias.” Despite this, the rarity of symptom remission in schizophrenia makes these reports noteworthy, albeit preliminary.
An important takeaway from Dr. Palmer’s work is the critical need for medical supervision when considering any changes to psychiatric medication. He recounted a troubling incident where one patient, after discontinuing her medication abruptly, faced severe psychosis and required hospitalization.
The Broader Context of the Ketogenic Diet
Historically, the ketogenic diet has been used for over a century, primarily to manage epilepsy in children. Its resurgence in recent decades has piqued the interest of researchers exploring its applications in various psychiatric conditions. Currently, around 20 controlled trials are underway to investigate the diet’s effectiveness in treating disorders such as schizophrenia and bipolar disorder.
Dr. Deanna Kelly from the University of Maryland School of Medicine highlighted that the diet may alter mitochondrial function, which plays a crucial role in many psychiatric disorders. The objective of a ketogenic diet is to induce a state of ketosis, wherein the body shifts from burning glucose to fat for energy.
Additionally, ongoing research at the University of Edinburgh is utilising brain imaging techniques to further understand the diet’s impact on brain chemistry. Dr. Daniel Smith has initiated a feasibility trial examining the ketogenic diet’s effects on patients with bipolar disorder, linking changes in brain glutamate levels to symptomatic improvements.
The Practicality and Challenges of the Ketogenic Diet
Despite the emerging interest in the ketogenic diet, its long-term viability as a treatment option remains uncertain. Clinical trials often last only weeks or months, raising questions about whether patients can maintain such a restrictive diet over time. The significant alterations in diet, which exclude staples like rice and bread, coupled with the necessity to consume high-fat foods, may prove challenging for many.
Sydney Murray, a postdoctoral researcher in Kelly’s lab, noted that individual responses to the diet can vary, suggesting that some might be able to adapt to a more flexible approach. However, the practicality of adhering to a stringent ketogenic regimen raises concerns about accessibility and cost, making it a less feasible option for some patients.
Why it Matters
The discussion surrounding the ketogenic diet’s role in mental health treatment is more than a matter of dietary preferences; it reflects broader societal attitudes towards mental illness and the importance of scientific integrity in public discourse. As health officials and researchers navigate the complexities of psychiatric treatment, it is crucial that claims are grounded in evidence to foster progress and understanding in the field. Misinterpretations can lead to misinformation, ultimately hindering the development of effective treatments for those suffering from debilitating mental health disorders.
