It is important to understand that the statement that carbohydrates are “nonessential” is not only factually inaccurate, it results in adopting a low-carbohydrate diet or ketogenic diet that increases your risk for a wide variety of chronic health conditions that may ultimately shorten lifespan, decrease your quality of life, and accelerate your risk for chronic disease.
Although the exact role of the keto diet in mental and brain disorders is unclear, there has been proof of its efficacy in patients with schizophrenia. And, to boot, it works to reverse many conditions that develop as a side effect of conventional medications for brain disorders, like weight gain, type 2 diabetes and cardiovascular risks. More research is needed to understand the role of the ketogenic diet in treating or improving schizophrenia, as the current available studies are either animal studies or case studies, but the benefits of a low carbohydrate, high-fat diet in neurology is promising.
The primary outcome was the change from baseline to week 16 in hemoglobin A1c. Changes in all variables were analyzed by the paired t-test or Wilcoxon signed-ranks test, as appropriate. Linear regression analysis was used to examine predictors of change in hemoglobin A1c. A p value of 0.05 or less was considered statistically significant. Statistical analysis was performed using SAS version 8.02 (SAS Institute, Cary, NC).

Those with mental health conditions have higher rates of physical illness and premature mortality, with life spans shortened by 13 to 30 years. People with mental health conditions also have higher rates and worse outcomes for chronic conditions such as diabetes, cardiovascular disease, and cancer. Years lived with disability for mental and substance use disorders increased 45% from 1990 to 2013 worldwide – during the same time that the incidence of obesity and the diabetes exploded.
I told the nurse that I would not take the medications, and I would manage it with diet. She looked at me skeptically, and said “I would not recommend that.”. They had me scheduled for a follow up in a month and a half, so I told her that I would do my own thing for that time, and if my numbers did not improve, we could discuss the medication further.
We do recommend everyone eat something every 4-5 hours to maintain a healthy metabolism. If your meals are more than 4-5 hours apart, a snack consisting of a protein and a carbohydrate is a great choice. The protein will help fill you up quicker and keep you feeling satisfied between meals. The protein also has a slower effect on your blood glucose than most carbohydrates, so when paired with carbohydrates, your blood sugar will not spike nearly as high. We recommend eating a protein with every meal and snack.
We have solid evidence showing that a ketogenic diet reduces seizures in children, sometimes as effectively as medication. Because of these neuroprotective effects, questions have been raised about the possible benefits for other brain disorders such as Parkinson’s, Alzheimer’s, multiple sclerosis, sleep disorders, autism, and even brain cancer. However, there are no human studies to support recommending ketosis to treat these conditions.
The end result of the “ketone diet” is staying fueled off of circulating high ketones (which are also sometimes called ketone bodies) — which is what’s responsible for altering your metabolism in a way that some people like to say turns you into a “fat-burning machine.” Both in terms of how it feels physically and mentally, along with the impact it has on the body, being in ketosis is very different than a “glycolytic state,” where blood glucose (sugar) serves as the body’s energy source.

 Ketones are a cellular “superfuel” and one in particular – beta-hydroxybutyrate (BHB) – drives powerful, beneficial processes. Beta-hydroxybutyrate is important for the regulation of important genes, inflammation regulation, immune system activity, and even antioxidant function. This important ketone is one of the fundamental reasons the keto diet is so beneficial.
“Studies have shown that the ability to stick to a diet is more important for long-term success than the type of diet that’s followed,” says Yawitz. “Keto is incredibly restrictive and is particularly tough for those who have frequent social engagements or are prone to carb cravings.” The Mediterranean diet allows you to eat carbs, like as many fruits and veggies as you want, along with whole grains. Not to mention, the Mediterranean diet has been linked to a number of other health benefits, including a lower risk of Alzheimer’s and Parkinson’s disease, certain types of cancer, and heart disease, according to the Mayo Clinic.
Losing heart muscle may not be the only heart-associated risk with the keto diet, Derocha says. “If you have high blood pressure and are taking medication, the prescription mixed with the diet may cause abnormally low blood pressure test results,” Derocha says. Before you start the keto diet, she suggests you talk with your doctor to avoid low blood pressure, which can be dangerous, even deadly.
“Certainly, the quality of fat counts,” says Yawitz. “There’s a big difference nutritionally between bacon and almonds. As much as possible, people set on the keto diet should emphasize plant-based, unsaturated fats like nuts, seeds, olive oil, and avocado, which have even been shown to protect the heart.” If you have high cholesterol or other risk factors for heart disease, you should speak with your doctor before beginning the keto diet. This is because the diet may — but doesn't have to — include large amounts of saturated fat. Some studies have shown increases in cholesterol and triglycerides in people following the diet, while other research reveals that the keto diet may actually decrease heart disease risk as well as saturated fat intake.
If you’re science oriented, you can also try his 2008 book “Good Calories, Bad Calories”. For a more journalistic view on the events that led to fat phobia starting in the 1950’s (as well as the joke that is the Mediterranean Diet), there is also Nina Teicholz’s 2014 book “The Big Fat Surprise.” Be sure to check out youtube for some of these folks’ lectures and discussions. They are not advocating whacky stuff.
If you experience symptoms like fatigue, intense hunger and cravings, light-headedness, or heart palpitations, this may be a sign your blood sugar has dropped too low. Use a blood glucose monitor to track your body’s response to the diet change and make sure your body is adapting properly. If necessary consult your physician for necessary medication changes.

Thanks for this inputs. 20 years ago I gain 17 pounds a year for 5 years. I was healthy but my dr told me start diet, any diet just come back in a month I want to see you start loosing… I started Atkins and lost 7 pound in a month. She was checking my progress every six months and checking my condition. I lost 64 pounds in 3 years. Now I started eating out of control. I am eating healthy but too much… I gain 40 pound back after 20 years. Now I will start again my Atkins to take off 30 pounds…


I’ve been type 2 for about 15 years was pretty stable with diet and Metformin for 10 years. But eventually started trying more aggressive treatment like Victoza and without fail in 4 years I was on slow acting insulin. I lost weight lowered carb intake to 40mg or less in the morning my breakfast has been no carbs. People need to realize every diabetic is different you must manage it how it keeps you with good A1C levels. I myself got off insulin for a year and half but my fasting levels slowly increased again. Reversing diabetes is not possible. Reducing the effects is possible and more likely the better you monitor yourself and do what you need to do. Depending on medications or diets or counting carbs will all help but not cure the diabetes. These all are things that reduce its ability to affect your health negatively.
The keto diet dates back to the 1920s, explains Michelle Hyman, MS, RD, CDN a registered dietitian at Simple Solutions Weight Loss. "The original keto diet was designed for patients with forms of epilepsy that were resistant to standard treatments. The macronutrient breakdown was designed to mimic the fasting state — which seemed to help with relieving seizures — yet provide energy and nutritions to function," Hyman says.
Two, exercise, perhaps our most reliable and potent booster of mitochondrial biogenesis in the brain, is downright nootropic. Exercise increases blood flow to the brain, which provides more oxygen and energy but also reduces free radical damage and enhances memory. It stimulates the creation of new neurons and the production of brain-derived neurotrophic factor (BDNF), a chemical that is instrumental in neuron preservation and formation. Exercise also promotes gene expression that supports plasticity, the brain’s crucial power to alter neural pathways.
But when you consume a high-carbohydrate diet, your brain often can't convert enough glutamate into GABA because it's using glutamate as an energy source. This imbalance can lead to neurotoxicity, and this impaired functioning could potentially lead to brain fog. For reasons not completely understood, ketosis seems to favor an increased production of GABA, which can lead to reductions in neurotoxicity and, therefore, brain fog.
In 2009, Drs. Eric Westman and Bryan Kraft published a case study and a review of the literature for a 70-year-old woman with life-long schizophrenia. Diagnosed at age 17, she had experienced daily visual and auditory hallucinations (skeletons that urged her to hurt herself) since the age of 7. She also had obesity, sleep apnea, hypertension, and gastro-esophageal reflux disease (GERD) among a number of other health issues. After only 8 days on the ketogenic diet, the voices and hallucinations stopped. At the time of publication she had continued the ketogenic diet for more than a year, with no return of hallucinations, and had lost more than 10 kilograms (22 lbs).
In January 2017, at 63 years of age, I was diagnosed with type 2 diabetes. I had probably been living with it unknowingly for years. In 2009 my doctor recommended the South Beach diet because I was showing blood-sugar levels that were considered pre-diabetic. I stayed on it for a while but then, as with all other diets I’ve tried in my life, I failed and put all the weight back on, plus some. When I was officially diagnosed last year with type 2 diabetes I was a whopping 284 pounds (129 kg). I was always fatigued, could barely walk a block without getting tired and my health was failing.
When you eat foods high in carbohydrates and fat, your body naturally produces glucose. Carbohydrates are the easiest thing for the body to process, and therefore it will use them first – resulting in the excess fats to be stored immediately. In turn, this causes weight gain and health problems that are associated with high fat, high carbohydrate diets (NOT keto).

A growing body of research is finding that behind many psychiatric and neurological issues — such as bipolar disorder, epilepsy, migraine — are malfunctions in the work of sodium, potassium and calcium ion channels in brain neurons, which pass the electric charge between nerve cells. As noted above, two thirds of the brain’s energy is used to help nerve cells “fire,” or send signals between cells. Another nerve cell signaling chemical (neurotransmitter), called GABA (Gamma-aminobutyric acid) has also been found to be disordered in bipolar, epilepsy and schizophrenia. A 2017 genetic study also found common genetic and biochemical pathways between bipolar disorder and epilepsy that create “excessive circuit sensitivity” in the neurons of both conditions.
A ketogenic diet elevates the levels of ketone bodies in the system—these are the byproducts of the body breaking down fat for energy when carbohydrates are in short supply, a process called ketosis. The average American gets most of their energy from glucose, which comes from carbs and sugars. When you’re in ketosis, though, your body goes into hyper fat-burning mode, also using up stored body fat, which is why it’s effective as a weight-loss strategy.  

Thank you for your wonderful comments Marcia. To share more about me personally with you all…I am not a completely non-diabetic Certified Diabetes Educator. I found out I had Prediabetes 15 years ago when I became a Diabetes Educator. I tested my own A1c and found it was 5.8%. The incredible news? There have been years when my A1c dropped to a normal level of 5.4%…out of the prediabetes range. My last A1c in May was 5.8%, so I still have Prediabetes 15 years later, but not diabetes, and without any medication, just the sensible diet I’ve discussed and exercise, so I really am living with this. I feel it everyday, I wonder what my A1c is going to be just like you every 6 months when I go to have it drawn.


I had 3 medical stents inserted for clogged arteries 11 years ago and I currently take a statin to keep my cholesterol at a healthy level and I also take a low dose diuretic to help keep my blood pressure at a good level. I am very much interested in the Keto Diet but I have some fears that eating foods which are high in saturated fats such as animal fats, butter, heavy cream and cheeses which I believe raise triglyceride levels which I have heard are a major contributor to blockages in the arteries. I would like to see more input from those who share a similar health history as mine and are on a Keto Diet. I was wondering if I can be on a Keto Diet and limit my fats to Olive Oil, Avocados, and the oils we get from fish such as Salmon, Sardines etc. or is it just a myth about saturated fats from butted, cheese and animal fats being bad for you?
The study concludes, “The ketogenic diet appears to improve glycemic control. Therefore, diabetic patients on a ketogenic diet should be under strict medical supervision because the LCKD can significantly lower blood glucose levels.” Previous research has also shown that for patients with type 2 diabetes, long-term administration of the keto diet lowered body weight, improved blood sugar levels and can result in a smaller needed dose of antidiabetic medication.

It’s a fairly common scene for new keto dieters. Aubrey Marcus recently referenced a highly-disturbing stat that 25% of physicians still equate consuming dietary cholesterol with increased blood cholesterol, an association that has been unequivocally refuted by recent science. But before you accept AHA-sanctioned diet advice, determine if there’s actually a problem.


Great article! Sustainability is key and Keto diet is extremely restrictive compared to others. Many of the comments I see don’t understand the importance of many years of research before stating something has a “significant difference” than the recommendations that are already in place. Also, understanding the pro/carb/fat balance in each meal instead of focusing on just carbohydrates. We have practiced the same modified Mediterranean diet at my practice where someone can enjoy life, eat complex carbohydrates and years later they are still successful and hundreds of pounds have been lost for good 🙂 Thank you for the reminder (and the comparison of Adkins supported research).
The New York Times pieces also points out that studies are disproving this concern and making a case for both children and adults with type 1 diabetes to consider a ketogenic diet. Specifically, a 2018 study published in the journal, Pediatrics, which took a look at glycemic control among children and adults with type 1 diabetes who followed a very low-carbohydrate, high-protein diet. The researchers found that both the adults and children who consumed this diet along with smaller doses of insulin than typically required exhibited “exceptional” blood sugar control without high rates of complications. In addition, the study data did not show an adverse effect of a very low-carbohydrate diet on children’s growth, although more research may still be a good idea, according to researchers.
With fats being my main source of calories, my body and energy levels have never been better. When I educated myself on it and understood the science behind it, it was clear to see why my joints started feeling better, and ailments started to go away. I now have more “oil” lubricating my cells so they’re more receptive/flexible/malleable to the nutrients in my foods. People can loose weight very fast, but honestly the first 10lbs or so is a lot of water weight so that’s really nothing to write home about.
The ketogenic diet may seem like the Jekyll to the Hyde-like low-fat craze of the 1990s. The bulk of current research finds that the middle ground between the two extremes is more beneficial for overall health. Make it easy for yourself: Eat at least two servings a week of fatty fish (salmon, sardines, mackerel) and cook with a variety of quality fats (olive oil, canola oil, avocado oil) throughout the week.
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
Increases in cholesterol levels need discussion too. We do see temporary increases in cholesterol levels often as individuals transition onto a ketogenic diet. However, when you examine lipid particle size (a more important way to look at the cardiovascular risks), the risk pattern doesn’t seem to increase with a ketogenic diet. Harvard Health has written about lipid particle size here before: http://www.health.harvard.edu/womens-health/should-you-seek-advanced-cholesterol-testing-
The research on how diet affects PCOS is minimal, but there is one compelling study on the ketogenic diet and women with PCOS. In this study, five overweight women ate a ketogenic diet (20 grams of carbohydrates or less per day) for 24 weeks. The results were astounding — average weight loss was 12%, free testosterone decreased by 22%, and fasting insulin levels dropped by 54%. What’s even more impressive is that two of the women became pregnant despite previous infertility problems.
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