New article: Ketogenic diet put schizophrenia into remission in two patients

[birchswing]

Chronic Schizophrenia Put Into Remission Without Medication

New research suggests ketogenic diet may play a role in treating schizophrenia.

www.psychologytoday.com

One question I had was about this part:

"Interestingly, the effects of this diet on the brain have been studied for decades because neurologists have been trying to figure out how it works in epilepsy. This diet is known to produce ketones which are used as a fuel source in place of glucose. This may help to provide fuel to insulin resistant brain cells. "

The brain uses insulin to get glucose to cross the cell membrane like in the rest of the body? For some reason I imagined glucose just floating around in the brain being sucked up as needed, even though I knew the mechanism (crudely) by which insulin helps transport glucose in the rest of the body. I guess because I knew there's no blood in the brain I assumed it was a different mechanism.

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[tr]

Yes neurons express the insulin receptor

 

[whopper]

Fascinating.


Seriously.

 

[nitemagi]

Can't wait for this to be replicated. Original data -- ScienceDirect

 

[hamstergang]

I guess because I knew there's no blood in the brain

What?

 

[Wilf]

What?

 

[birchswing]

What?

Well I know there are obviously vessels and whatnot or people wouldn't have strokes, but I always thought the brain tissue itself was different than the rest of the body with the brain-blood barrier. Admittedly I know next to nothing about it except that some things can permeate across it and some can't. But I guess I meant in the sense that blood doesn't saturate the brain—blood is toxic to the brain from what I know. Which I believe is different from the rest of the body. I don't know. I could be wrong about all that.

 

[birchswing]

I'm glad I could be of some amusement.

Sometimes you learn something new by stating what you thought you knew as fact and learning it was not. I will have to do some research on the brain-blood barrier, the name of which suggested to me the actual brain tissue does not contain blood, especially given that people have brain damage when they bleed into the brain. I assumed somehow only the needed nutrients like glucose or gases like oxygen passed through but not the blood itself. I will need to look into this more to see what is actually true regarding that.

 

[hamstergang]

Well I know there are obviously vessels and whatnot or people wouldn't have strokes, but I always thought the brain tissue itself was different than the rest of the body with the brain-blood barrier. Admittedly I know next to nothing about it except that some things can permeate across it and some can't. But I guess I meant in the sense that blood doesn't saturate the brain—blood is toxic to the brain from what I know. Which I believe is different from the rest of the body. I don't know. I could be wrong about all that.

Ok, with that clarification I don't think you're likely picturing this all that incorrectly if at all. It was just a strange sounding sentence to me.

 

[birchswing]

Ok, with that clarification I don't think you're likely picturing this all that incorrectly if at all. It was just a strange sounding sentence to me.

My lay understanding is that insulin helps glucose (along with other nutrients) cross into cells in the non-brain part of the body. For some reason in the brain I just imagined the brain soaking in its CSF with glucose. I never considered that the insulin would also be crossing the BBB to help glucose uptake in the brain. That was the part of the article that intrigued me, where it said that brain cells can be insulin resistant. It seems like if that were true you would see more cognitive changes in pre-diabetics, type 2 diabetics, basically a huge portion of the population with metabolic syndrome. But yeah I knew blood gets the nutrients up to the brain and then they sort of crossover into that CSF bath. I just didn't anticipate that the transporter (insulin) also crossed over into that bath of nutrients. I found that interesting.

 

[birchswing]

Can't wait for this to be replicated. Original data -- ScienceDirect

It seems feasible to try on an outpatient basis as it requires nothing more than what you'd find in a grocery store (and maybe a multivitamin due to the extremeness of the diet?), except that I have read that a medical ketogenic diet emphasizes even higher fat intake versus the weight-loss type, so it might be hard to get strict adherence unless you really love fat. Not having schizophrenia symptoms sounds worth it to me. And neurologists have been trying it with young children for years for epilepsy—of course they have the involvement of the parents to help. But if you had a person with a good support system or in a residential setting it doesn't seem like it would be too difficult to give it a go.

 

[Shikima]

I'm wondering what role(s) the upregulation of mitochondria is doing to help this process? I'm also trying to find a correlate study where Keto helps to manage CHF.

 

[nighthawk2551]

The paper doesn't go into exactly which keto diet these patients went on. There are several variants out there now, and even some commercial diets that are advertised as keto but are really just "paleo" or low carb. The classic keto diet is pretty much disgusting and relies heavily on unsweetened cream, butter and oil. I honestly can't see many schizophrenic patients being able to manage this unless they are inpatient.

 

[birchswing]

The paper doesn't go into exactly which keto diet these patients went on. There are several variants out there now, and even some commercial diets that are advertised as keto but are really just "paleo" or low carb. The classic keto diet is pretty much disgusting and relies heavily on unsweetened cream, butter and oil. I honestly can't see many schizophrenic patients being able to manage this unless they are inpatient.

That does sound so awful, but I think that's the one epileptic children use isn't it?

Could you administer a fat-based diet parenterally? I'd rather get it through an IV and eat sugar-free jello to satiate my mouth. If the jello were made exclusively with gelatin and no starches, sucralose or something similar, and flavoring, it seems like it would be permissible.

 

[clausewitz2]

That does sound so awful, but I think that's the one epileptic children use isn't it?

Could you administer a fat-based diet parenterally? I'd rather get it through an IV and eat sugar-free jello to satiate my mouth. If the jello were made exclusively with gelatin and no starches, sucralose or something similar, and flavoring, it seems like it would be permissible.

It works for epileptic kids because someone else is choosing their food for them.

 

[Shikima]

Meat, cheese and green veggies for a good balanced dietary selection in doing Keto.

 

[Asklepian]

The paper doesn't go into exactly which keto diet these patients went on. There are several variants out there now, and even some commercial diets that are advertised as keto but are really just "paleo" or low carb. The classic keto diet is pretty much disgusting and relies heavily on unsweetened cream, butter and oil. I honestly can't see many schizophrenic patients being able to manage this unless they are inpatient.

The authors reference the ketogenic diet as used in epilepsy. Some information can be found at this link.
This diet requires medical monitoring by a physician and strict adherence to ratios as well as avoidance of products containing carbohydrates (even including skin-care products, etc.).

The "keto" diets used in the popular mainstream are not used in the same way medically.