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https://www.upr.org/npr-news/2024-0...l-illness-science-is-racing-to-understand-why
By Will Stone
Published January 27, 2024 at 5:02 AM MST
Tina Russell for NPR
Iain Campbell, a researcher in Scotland, has lived with Bipolar disorder for much of his life. After trying the ketogenic diet, he discovered life-changing improvements in his symptoms — and now wants to learn if it can do the same for others. He shared his recent findings at the Metabolic Health Summit in Clearwater, Fla., on Jan. 25, 2024.
Iain Campbell was gazing out the bus window on his way to work when he first sensed something radical was reshaping how he experienced the world.
The inkling emerged from an altogether ordinary observation: He felt peaceful, maybe even happy as he watched the trees along the road pass by.
"I hadn't experienced that in a really long time, probably since I was a kid," says Campbell, who lives in Edinburgh, Scotland.
"I didn't know what was going on at the time, but I thought this might be what it feels like to be normal."
Campbell had lived with bipolar disorder for much of his life. Mental illness runs in his family, and he'd lost loved ones to suicide. Over the years, he tried different treatments, but it had become "increasingly difficult to live with."
What had changed? A few weeks earlier, he'd started a new diet.
Campbell dealt with unwanted weight gain and metabolic troubles, a common side effect of psychiatric medications.
In an effort to lose weight, he drastically cut back on carbs and instead focused on protein and fat. It turns out he'd unknowingly entered ketosis: A metabolic state where the body switches from glucose as its primary energy source to ketones, which come from fat.
He started learning about the ketogenic diet, which is high fat and very low carb, on podcasts and YouTube videos. Soon, he was tracking his ketone levels, courtesy of an at-home blood test.
"I realized it was actually the ketone level that was making this shift in my symptoms in a way that nothing else ever had," he says. "It struck me as really significant, like life-changing."
How exactly was a diet performing this alchemy? Campbell decided to pursue a Ph.D. in mental health at the University of Edinburgh, hoping to do his own research and learn whether it could help others.
In online forums, people with bipolar disorder were sharing similar anecdotes — they were finding improvements in their mood, increased clarity and fewer episodes of depression.
But as Campbell searched for ways to launch a proper clinical trial to test the diet's effectiveness, he became discouraged.
"It was really like you were considered wacky," he says. "At one point, I thought nobody's going to pay for this research."
He put together a 45-minute video summing up the biological rationale for using the ketogenic diet in bipolar disorder and posted it on social media, not expecting much after that.
/ Katie Hayes Luke for NPR
/
Katie Hayes Luke for NPR
The ketogenic diet avoids most carbs and instead focuses on high-fat foods, proteins and vegetables.
But some doctors had already started researching it after seeing the potential in their practice, among them Chris Palmer, a psychiatrist at Harvard Medical School and McLean Hospital.
Palmer had his own revelation about the diet a few years earlier, which he detailed in a 2017 case report. Two patients with schizo-affective disorder had "truly dramatic, life-changing improvement in their psychotic symptoms," he says.
In early 2021, he started working with the eldest son of Jan and David Baszucki, a wealthy tech entrepreneur. Their son Matt had bipolar disorder and had been on many medications in recent years.
Jan Baszucki enlisted Palmer's help as her son gave the ketogenic diet a try.
"Within a couple of months, we saw a dramatic change," she says.
Inspired, she started contacting clinicians and researchers, looking to bring more visibility — and funding — to the treatment. Since rigorous data on the diet is still lacking, she wants to see researchers conduct large clinical trials to back up anecdotes like her son's recovery.
Soon a big-time philanthropist was in touch with Campbell, ready to pay for his bipolar study — and others.
Now, around a dozen clinical trials are in the works, testing the diet's effect on mental illness, most notably for bipolar disorder, schizophrenia and depression, but also for conditions like anorexia, alcoholism and PTSD.
"The research and the clinical interest is suddenly exploding," says Dr. Georgia Ede, a psychiatrist in Massachusetts, who began using the ketogenic diet in her own practice about a decade ago.
The classic ketogenic diet contains an eye-popping amount of fat, roughly 90% of calories coming from that alone. Other versions have come along that dial down the fat and allow more room for protein and slightly more carbohydrates.
/ Tina Russell for NPR
/
Tina Russell for NPR
Dr. Chris Palmer (left) signs a copy of his book, Brain Energy, for Addanilka Ramos during the Metabolic Health Summit in Clearwater, Fla. Palmer has been researching the keto diet for years.
Serious followers may buy a device to measure ketone levels in their blood, to track whether they've entered a range that means they're experiencing what's called nutritional ketosis.
The diet's entrance into the mainstream has fed plenty of debate about its merits, with some medical groups raising concerns. Yet, there's also growing attention — and clinical trials underway — on its potential, not only for obesity but a variety of other conditions.
"It's not a fad diet," says Dr. Shebani Sethi, who's leading researchinto the diet's potential for mental health at Stanford University. "It's a medical intervention."
The ketogenic diet was developed over a hundred years ago for pediatric epilepsy and has seen a resurgence in that field over the last three decades.
"It's a general standard of care for epilepsy," says Dr. Eric Kossoff, a pediatric neurologist at Johns Hopkins University.
This track recordin epilepsy, the thinking goes, paves the way for its adoption in psychiatry. There are links between the conditions. Medications developed for seizures are regularly prescribed for a range of psychiatric conditions such as bipolar disorder.
"We use them off label, even when we don't have studies to suggest or prove that they are helpful for people with mental illness," says Palmer. "So, in many ways, this is nothing new."
Patients say keto helps with their mental illness. Science is racing to understand why
By Will Stone
Published January 27, 2024 at 5:02 AM MST
Tina Russell for NPR
Iain Campbell, a researcher in Scotland, has lived with Bipolar disorder for much of his life. After trying the ketogenic diet, he discovered life-changing improvements in his symptoms — and now wants to learn if it can do the same for others. He shared his recent findings at the Metabolic Health Summit in Clearwater, Fla., on Jan. 25, 2024.
Iain Campbell was gazing out the bus window on his way to work when he first sensed something radical was reshaping how he experienced the world.
The inkling emerged from an altogether ordinary observation: He felt peaceful, maybe even happy as he watched the trees along the road pass by.
"I hadn't experienced that in a really long time, probably since I was a kid," says Campbell, who lives in Edinburgh, Scotland.
"I didn't know what was going on at the time, but I thought this might be what it feels like to be normal."
Campbell had lived with bipolar disorder for much of his life. Mental illness runs in his family, and he'd lost loved ones to suicide. Over the years, he tried different treatments, but it had become "increasingly difficult to live with."
What had changed? A few weeks earlier, he'd started a new diet.
Campbell dealt with unwanted weight gain and metabolic troubles, a common side effect of psychiatric medications.
In an effort to lose weight, he drastically cut back on carbs and instead focused on protein and fat. It turns out he'd unknowingly entered ketosis: A metabolic state where the body switches from glucose as its primary energy source to ketones, which come from fat.
He started learning about the ketogenic diet, which is high fat and very low carb, on podcasts and YouTube videos. Soon, he was tracking his ketone levels, courtesy of an at-home blood test.
"I realized it was actually the ketone level that was making this shift in my symptoms in a way that nothing else ever had," he says. "It struck me as really significant, like life-changing."
A career-launching moment
How exactly was a diet performing this alchemy? Campbell decided to pursue a Ph.D. in mental health at the University of Edinburgh, hoping to do his own research and learn whether it could help others.
In online forums, people with bipolar disorder were sharing similar anecdotes — they were finding improvements in their mood, increased clarity and fewer episodes of depression.
But as Campbell searched for ways to launch a proper clinical trial to test the diet's effectiveness, he became discouraged.
"It was really like you were considered wacky," he says. "At one point, I thought nobody's going to pay for this research."
He put together a 45-minute video summing up the biological rationale for using the ketogenic diet in bipolar disorder and posted it on social media, not expecting much after that.
/ Katie Hayes Luke for NPR
/
Katie Hayes Luke for NPR
The ketogenic diet avoids most carbs and instead focuses on high-fat foods, proteins and vegetables.
But some doctors had already started researching it after seeing the potential in their practice, among them Chris Palmer, a psychiatrist at Harvard Medical School and McLean Hospital.
Palmer had his own revelation about the diet a few years earlier, which he detailed in a 2017 case report. Two patients with schizo-affective disorder had "truly dramatic, life-changing improvement in their psychotic symptoms," he says.
In early 2021, he started working with the eldest son of Jan and David Baszucki, a wealthy tech entrepreneur. Their son Matt had bipolar disorder and had been on many medications in recent years.
Jan Baszucki enlisted Palmer's help as her son gave the ketogenic diet a try.
"Within a couple of months, we saw a dramatic change," she says.
Inspired, she started contacting clinicians and researchers, looking to bring more visibility — and funding — to the treatment. Since rigorous data on the diet is still lacking, she wants to see researchers conduct large clinical trials to back up anecdotes like her son's recovery.
Soon a big-time philanthropist was in touch with Campbell, ready to pay for his bipolar study — and others.
Now, around a dozen clinical trials are in the works, testing the diet's effect on mental illness, most notably for bipolar disorder, schizophrenia and depression, but also for conditions like anorexia, alcoholism and PTSD.
"The research and the clinical interest is suddenly exploding," says Dr. Georgia Ede, a psychiatrist in Massachusetts, who began using the ketogenic diet in her own practice about a decade ago.
From epilepsy care to the mainstream
The classic ketogenic diet contains an eye-popping amount of fat, roughly 90% of calories coming from that alone. Other versions have come along that dial down the fat and allow more room for protein and slightly more carbohydrates.
/ Tina Russell for NPR
/
Tina Russell for NPR
Dr. Chris Palmer (left) signs a copy of his book, Brain Energy, for Addanilka Ramos during the Metabolic Health Summit in Clearwater, Fla. Palmer has been researching the keto diet for years.
Serious followers may buy a device to measure ketone levels in their blood, to track whether they've entered a range that means they're experiencing what's called nutritional ketosis.
The diet's entrance into the mainstream has fed plenty of debate about its merits, with some medical groups raising concerns. Yet, there's also growing attention — and clinical trials underway — on its potential, not only for obesity but a variety of other conditions.
"It's not a fad diet," says Dr. Shebani Sethi, who's leading researchinto the diet's potential for mental health at Stanford University. "It's a medical intervention."
The ketogenic diet was developed over a hundred years ago for pediatric epilepsy and has seen a resurgence in that field over the last three decades.
"It's a general standard of care for epilepsy," says Dr. Eric Kossoff, a pediatric neurologist at Johns Hopkins University.
This track recordin epilepsy, the thinking goes, paves the way for its adoption in psychiatry. There are links between the conditions. Medications developed for seizures are regularly prescribed for a range of psychiatric conditions such as bipolar disorder.
"We use them off label, even when we don't have studies to suggest or prove that they are helpful for people with mental illness," says Palmer. "So, in many ways, this is nothing new."
