Föra veckan skrev jag om en uppmärksammad stor studie där man ser att sockerkonsumtion är kopplat till ökad risk för psykisk ohälsa https://4health.se/socker-okar-risken-for-psykisk-ohalsa
På samma tema har läkaren Georgia Ede skrivit en bra artikel om motsatsen – nämligen hur en ketogen kost hjälper mot psykisk ohälsa. En ketogen kost är ju en kost som innehåller tillräckligt lite blodsockerhöjande mat för att kroppen ska producera en betydande mängd av bränslet ketoner. Du kan lära dig mer om detta i avsnitt 12 av podcasten
Edes artikel är baserad på en ny vetenskaplig översiktsartikel där man sammanställer forskningen på området.
Många känner till att en ketogen kost framgångsrikt används istället för mediciner vid epilepsi. Georgia Ede skriver bl.a. om likheterna mellan epilepsi och bipolär sjukdom, och fördelarna med en ketogen kost i båda fall.
Hon skriver vidare
“They [ketogenic diets] have also shown promise in the management of other brain-based disorders such as Parkinson’s Disease, ALS, Traumatic Brain Injury, Multiple Sclerosis, and chronic headaches, as well as in metabolic disorders like obesity, cancer, and type 2 diabetes.”
Och på temat psykisk hälsa och hjärnan:
“On a fundamental level, we are not even sure whether it is the presence of ketones, the reduction in blood sugar, the reduction in insulin and other growth-promoting hormones, or the combination of all of these which are responsible for the brain-stabilizing effects of these diets. Theories abound, and include altered neurotransmitter levels, changes in electrolyte gradients (lower intracellular sodium and calcium), reduction in markers of inflammation, and improved mitochondrial function. The general consensus is that the brain functions more cleanly and efficiently when a significant portion of its energy comes from ketones, calming overactive and overly-reactive brain cells.”
Och så summerar hon de 17 studier som ingår i den vetenskapliga summeringen:
“Ketogenic Diets and Bipolar Disorder
2002: A one-month case study of a woman with unspecified, treatment-resistant bipolar disorder noted no improvement after two weeks on a ketogenic diet followed by two weeks of MCT oil supplementation. Urine testing found ketosis was never achieved.
2012: A case study of two women with bipolar II disorder who ate a ketogenic diet (one for two years, the other for three years) found that the diet was superior to the anticonvulsant/mood stabilizer lamotrigine (Lamictal) in management of symptoms. Ketosis was documented using urine test strips.
Ketogenic Diets and Schizophrenia
A 3-week mouse study showed that a ketogenic diet normalized pathological behaviors.
1965: A 2-week study of 10 women with treatment-refractory schizophrenia found a significant decrease in symptoms when a ketogenic diet was added to their ongoing standard treatments (medications + ECT). Ketone monitoring was not reported.
2009: A 12-month case study details the experience of a 70-year old overweight woman with chronic schizophrenia who was prescribed a diet limited to 20 grams of carbohydrate per day. She noted significant improvement in severe symptoms beginning only eight days after starting the diet, which consisted of “beef, poultry, ham, fish, green beans, tomatoes, diet drinks, and water.” [ Kraft and Westman 2009 Nutrition & Metabolism 6:10.] She reported complete resolution of auditory and visual hallucinations–with which she’d suffered since age seven. Ketone levels were not monitored.
Comment: This diet is best characterized as a low-carbohydrate, primarily whole foods diet. As protein wasn’t limited and fat intake wasn’t manipulated, this may or may not have been a truly ketogenic diet.
Ketogenic Diets and Anxiety
A rat study found that adding ketone supplements to a standard high-carbohydrate diet reduced anxious behavior.
Ketogenic Diets and Depression
A rat study found that a ketogenic diet reduced depressive behaviors.
A mouse study found that feeding pregnant animals a ketogenic diet reduced offspring susceptibility to depressed (and anxious) behaviors.
Ketogenic Diets and Autism Spectrum Disorder (ASD)
A 70-day mouse study found that a ketogenic diet improved behavior.
A 10-14 day rat study found that a ketogenic diet improved complex social behaviors and mitochondrial function.
A 3-4 week mouse study found that a ketogenic diet improved behaviors in ways that were different for males than females.
2003: A 6-month inpatient study evaluated the effects of a cyclical ketogenic diet (4 wks on, 2 wks off) on 30 children with ASD. Of the 18 children who completed the study, eight showed moderate improvement, and two showed “significant” improvement. Benefits appeared to persist even during the 2-week “diet-free” periods. Urine and blood ketone monitoring confirmed that all children were in ketosis.
Comment: blood ketone levels ranged from 1.8 to 2.2 mMol during ketogenic phases and from 0.8 to 1.5 mMol during “diet-free” periods, meaning that the children actually spent the entire 6-month study period in ketosis.
2013: A 14-month detailed case study of one child with ASD, epilepsy, and obesity who was placed on a ketogenic diet in combination with anti-epileptic medications, noted numerous improvements. “In addition to improvement in seizures, there was a 60-pound weight loss…as well as improved cognitive and language function, marked improvement in social skills, increased calmness, and complete resolution of stereotypies.” [Herbert and Buckley 2013 J Child Neurol 28(8)]. Ketosis was confirmed (presumably by urine testing).
Ketogenic Diets and ADHD (Attention Deficit Hyperactivity Disorder)
A 6-month study of dogs with ADHD and epilepsy found significant improvement in ADHD behaviors on a ketogenic diet.
Ketogenic Diets and Alzheimer’s disease
2009: A 90-day randomized, double-blind, placebo-controlled, parallel study of 152 people with mild to moderate Alzheimer’s Disease tested the effects of a daily MCT supplement (previously marketed under the name Axona) on cognitive test performance. People continued their usual diets and took either the MCT supplement or a safflower oil placebo. Regular medications were continued throughout the study. At 45 and 90 days, patients taking MCTs showed significant improvement on a cognitive test known as the ADAS-Cog scale, unless they carried a gene called ApoE4, which is associated with higher risk for Alzheimer’s disease. Cognitive benefits did not persist after MCTs were discontinued.
Not mentioned in the Bostock review are the following two studies:
1) A 6-week study of a simple low-carbohydrate diet (protein and fat unrestricted) in people with mild cognitive impairment (MCI, aka “pre-Alzheimer’s” disease) demonstrating improvement in verbal memory, with greater benefits seen in those who achieved higher ketone levels [Krikorian R et al 2012 Neurobiol Aging 33(2):425].
2) A 20-month case study of a man with Alzheimer’s Disease whose cognition and function significantly improved with the use of ketone supplements [Newport MT et al 2015 Alzheimer’s & Dementia 11] .”