Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Lemnos, Greece.
Department of Nutritional Sciences and Dietetics, Faculty of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece.
Nutrients. 2024 May 21;16(11):1546. doi: 10.3390/nu16111546.
The ketogenic diet (KD) has been highly developed in the past for the treatment of epileptic pathological states in children and adults. Recently, the current re-emergence in its popularity mainly focuses on the therapy of cardiometabolic diseases. The KD can also have anti-inflammatory and neuroprotective activities which may be applied to the prevention and/or co-treatment of a diverse range of psychiatric disorders.
This is a comprehensive literature review that intends to critically collect and scrutinize the pre-existing research basis and clinical data of the potential advantageous impacts of a KD on stress, anxiety, depression, schizophrenia and bipolar disorder.
This literature review was performed to thoroughly represent the existing research in this topic, as well as to find gaps in the international scientific community. In this aspect, we carefully investigated the ultimate scientific web databases, e.g., PubMed, Scopus, and Web of Science, to derive the currently available animal and clinical human surveys by using efficient and representative keywords.
Just in recent years, an increasing amount of animal and clinical human surveys have focused on investigating the possible impacts of the KD in the prevention and co-treatment of depression, anxiety, stress, schizophrenia, and bipolar disorder. Pre-existing basic research with animal studies has consistently demonstrated promising results of the KD, showing a propensity to ameliorate symptoms of depression, anxiety, stress, schizophrenia, and bipolar disorder. However, the translation of these findings to clinical settings presents a more complex issue. The majority of the currently available clinical surveys seem to be moderate, usually not controlled, and have mainly assessed the short-term effects of a KD. In addition, some clinical surveys appear to be characterized by enormous dropout rates and significant absence of compliance measurement, as well as an elevated amount of heterogeneity in their methodological design.
Although the currently available evidence seems promising, it is highly recommended to accomplish larger, long-term, randomized, double-blind, controlled clinical trials with a prospective design, in order to derive conclusive results as to whether KD could act as a potential preventative factor or even a co-treatment agent against stress, anxiety, depression, schizophrenia, and bipolar disorder. Basic research with animal studies is also recommended to examine the molecular mechanisms of KD against the above psychiatric diseases.
生酮饮食（KD）在过去曾被高度开发，用于治疗儿童和成人的癫痫病理状态。最近，它的重新流行主要集中在治疗代谢性心血管疾病上。KD 还具有抗炎和神经保护作用，可应用于预防和/或治疗各种精神疾病。
这是一篇全面的文献综述，旨在批判性地收集和审查 KD 对压力、焦虑、抑郁、精神分裂症和双相情感障碍的潜在有利影响的现有研究基础和临床数据。
进行这项文献综述是为了全面展示该主题的现有研究，并发现国际科学界的空白。在这方面，我们仔细调查了最终的科学网络数据库，如 PubMed、Scopus 和 Web of Science，使用有效的代表关键词来检索目前可用的动物和临床人类调查。
就在近几年，越来越多的动物和临床人类调查集中在研究 KD 在预防和辅助治疗抑郁、焦虑、压力、精神分裂症和双相情感障碍方面的可能影响。现有的基础动物研究表明 KD 有改善抑郁、焦虑、压力、精神分裂症和双相情感障碍症状的趋势。然而，将这些发现转化为临床环境是一个更为复杂的问题。目前可用的大多数临床调查都是中等规模的，通常不受控制，主要评估 KD 的短期效果。此外，一些临床调查似乎具有很高的辍学率和缺乏对依从性的测量，以及其方法设计的很大异质性。
尽管目前的证据似乎很有希望，但强烈建议进行更大规模、长期、随机、双盲、对照的临床试验，并采用前瞻性设计，以得出 KD 是否可以作为预防因素，甚至是治疗压力、焦虑、抑郁、精神分裂症和双相情感障碍的辅助治疗因素的结论。还建议进行动物研究的基础研究，以研究 KD 对上述精神疾病的分子机制。
