A new study published in the journal Nutrition, Researchers at Northumbria University in the United Kingdom investigated the relationship between adherence to the ketogenic diet and various aspects of mental health, such as calmness, contentment, alertness, and emotional well-being, in the general healthy population.
Research: The ketogenic diet has a positive relationship with mental and emotional health in the general population. Image Credit: Chinnapong
Background
The ketogenic diet, high in fat and low in carbohydrates, provides alternative energy substrates for the body and brain by shifting metabolism from glycolysis to fatty acid oxidation. Historically used to treat epilepsy and investigated in neurodegenerative and neurodevelopmental conditions, the effects of this drug on the general population have been less studied. More research is needed to clearly understand the long-term psychological effects of the ketogenic diet on different populations and conditions.
About the study
This study involved two groups, each recruited through opportunity sampling on social media platforms, adhering to ethical standards set by Northumbria University and the Declaration of Helsinki. All participants gave informed consent before data collection began.
In Group 1, individuals were recruited between February and October 2021. Participants in this group completed two assessment instruments online: the Perceived Stress Scale (PSS-10) and the Bond-Lader visual analogue scales (BL-VAS). The PSS-10 assessed overall perceptions of stress, with scores from 0 to 40 reflecting varying levels of stress. The BL-VAS measured mood through 16 opposing mood pairs, providing scores for alertness, contentment, and calmness using a sliding scale from 0 to 100.
Group 2 met from January to July 2022 and used different tools for psychological assessment: the Depression Anxiety Stress Scale (DASS-21) and the 3-item loneliness scale. The DASS-21 includes three subscales for depression, anxiety, and stress, each scored on a severity scale from 0 to 3. The loneliness scale, scored from 1 to 3, helped determine levels of loneliness among participants.
Both groups used an online platform to share the same demographic, socioeconomic, and dietary data collection methods. Participants reported on a number of variables, including eating habits assessed via a short-form food frequency questionnaire. This enabled comparison of dietary patterns between ketogenic diets and other diets and took into account the frequency of consumption of ketogenic-friendly and non-ketogenic food items. Data were analyzed for a variety of psychological and nutritional measures, examining differences and correlations within and between groups.
Study results
In the study, group 1 initially recruited 361 participants, but were excluded for various reasons, including lack of consent and missing data entries, resulting in 260 participants completing the PSS-10. Further reductions occurred during the transition between survey platforms, leaving 147 participants who completed the BL-VAS. This group examined perceived stress and mood changes between those on the ketogenic diet and those on other diets.
Cohort 2 started with 399 participants and was reduced to 276 after similar exclusions. This group used the DASS-21 and the 3-item loneliness scale to assess psychological well-being.
In terms of demographic and socioeconomic factors, Group 1 showed significant age and Body Mass Index (BMI) differences between the ketogenic and other diet groups. Ketogenic participants were generally older and had higher BMIs. Notable findings included higher incidences of high blood pressure among ketogenic diet participants. Dietary patterns revealed that ketogenic dieters consumed “ketogenic-friendly” foods more frequently and “non-ketogenic” foods less frequently than their counterparts.
Group 2 showed similar age and health differences; Ketogenic participants were again older, but there was no significant difference in BMI between groups. Health ratings and dietary habits followed similar patterns as in Group 1; Ketogenic participants reported better subjective health and reported stricter adherence to ketogenic food guidelines.
Psychologically, Cohort 1 findings showed that participants on the ketogenic diet reported better mood and lower stress levels than those not on the diet, with significant differences in alertness, contentment, and calmness. These differences persisted even when adjusting for demographic and health-related covariates.
Group 2 also found that participants on the ketogenic diet reported lower levels of depression, anxiety, stress, and loneliness. However, when adjusting for covariates, improvements in loneliness were not statistically significant.
Additionally, duration of adherence to the ketogenic diet was positively correlated with psychological benefits in both groups. However, the actual level of ketosis measured was not significantly associated with psychological outcomes; This suggested that duration of dietary consistency may be more influential than current metabolic state.
Results
To summarize, the study hypothesized that a ketogenic diet would improve psychological well-being, and this was supported by the findings. Participants on the diet reported significantly better calmness, contentment, alertness, and reduced stress, depression, and anxiety. Although improvements in loneliness were nonsignificant after adjusting for demographics, length of the diet was associated with increased benefits. Additionally, the study suggests that a ketogenic diet may improve mental health through mechanisms similar to anxiety medications.