Department of Physiology, Anatomy and Genetics, Oxford University, Oxford, UK.
Metabolic Psychiatry Clinic, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California.
Curr Opin Endocrinol Diabetes Obes. 2020 Oct;27(5):269-274. doi: 10.1097/MED.0000000000000564.
Ketogenic diets, which have been used to treat drug-refractory paediatric epilepsy for over 100 years, are becoming increasingly popular for the treatment of other neurological conditions, including mental illnesses. We aim to explain how ketogenic diets can improve mental illness biopathology and review the recent clinical literature.
Psychiatric conditions, such as schizophrenia, depression, bipolar disorder and binge eating disorder, are neurometabolic diseases that share several common mechanistic biopathologies. These include glucose hypometabolism, neurotransmitter imbalances, oxidative stress and inflammation. There is strong evidence that ketogenic diets can address these four fundamental diseases, and now complementary clinical evidence that ketogenic diets can improve the patients' symptoms.
It is important that researchers and clinicians are made aware of the trajectory of the evidence for the implementation of ketogenic diets in mental illnesses, as such a metabolic intervention provides not only a novel form of symptomatic treatment, but one that may be able to directly address the underlying disease mechanisms and, in so doing, also treat burdensome comorbidities (see Video, Supplementary Digital Content 1, http://links.lww.com/COE/A16, which summarizes the contents of this review).
生酮饮食治疗药物难治性儿童癫痫已有 100 多年的历史，目前其在治疗其他神经系统疾病（包括精神疾病）方面的应用越来越广泛。本文旨在解释生酮饮食如何改善精神疾病的病理生理学，并对近期的临床文献进行综述。
精神疾病，如精神分裂症、抑郁症、双相情感障碍和暴食障碍，是具有共同的神经代谢性疾病的几种常见机制病理生理学的神经代谢性疾病。这些包括葡萄糖代谢不足、神经递质失衡、氧化应激和炎症。有强有力的证据表明生酮饮食可以解决这四种基本疾病，现在还有补充的临床证据表明生酮饮食可以改善患者的症状。
研究人员和临床医生需要了解生酮饮食在精神疾病中的应用证据的发展轨迹，因为这种代谢干预不仅提供了一种新的症状治疗形式，而且可能能够直接针对潜在的疾病机制，从而治疗负担沉重的共病（请观看视频，补充数字内容 1，http://links.lww.com/COE/A16，其中总结了本综述的内容）。
