US experts have condemned Health Secretary Robert F Kennedy Jnr’s statement recently that the keto diet could cure schizophrenia – an unfounded claim they say vastly overstates preliminary research into whether the high-fat, low-carbohydrate diet might help patients with the disorder, reports The New York Times.
Kennedy made the remarks on his national tour to urge Americans to “eat real food”, a message he is delivering in conjunction with his recent overhaul of federal dietary guidelines, which now emphasise protein and fats, including steak, cheese, butter and whole milk, over carbohydrates.
“We now know that the things that you eat are driving mental illness in this country,” he said, adding that a doctor at Harvard had “cured schizophrenia using keto diets”.
He added that there were studies “right now that I saw two days ago where people lose their bipolar diagnosis by changing their diet”.
Kennedy was apparently referring to Dr Christopher Palmer, who in 2019 wrote about “two patients with longstanding schizophrenia who experienced complete remission of symptoms” with the keto diet. “Both patients were able to stop antipsychotic medications and have remained in remission for years now,” he had written.
More recently, Palmer and his colleagues described the diet as a “promising therapeutic approach for schizophrenia”. Palmer did not immediately reply to a request for comment.
The Health Secretary’s claims were amplified on social media by MAHA Action, an advocacy group that promotes his “Make America Healthy Again” agenda, but the post was taken down after The New York Times asked a spokesman for Kennedy to provide evidence to support his assertions. The spokesman did not respond to a request for comment.
Kennedy has a history of promoting ideas with little to no scientific evidence to back them up. He has rejected established evidence that HIV is the cause of Aids, pushed the idea that Covid-19 was “ethnically targeted” to spare Jews and Chinese people, and has repeatedly insisted that vaccines are a possible cause of autism, despite a lack of proof.
The popular ketogenic diet typically consists of at least 70% calories derived from fat, less than 10% from carbohydrates, and less than 20% from protein. It has been hailed as a way to lose weight, but it also poses risks to heart health.
Many people find it difficult to stick to a ketogenic diet for the long term, because it prohibits so many foods.
Some small short-term studies, including one at Stanford University, “offer very preliminary evidence” that the diet “might be helpful” in patients with schizophrenia, said Dr Paul Appelbaum, a Professor of Psychiatry at Columbia University and past President of the American Psychiatric Association.
“But it is simply misleading to suggest that we know that ketogenic diets can improve schizophrenia symptoms, much less that they can ‘cure’ the condition,” he said.
Appelbaum said most of the patients in those studies continued to require antipsychotic medication. He and another Columbia psychiatry Professor, Dr Mark Olfson, both said that while the early research was promising, more thorough long-term studies were needed.
“There is currently no credible evidence that ketogenic diets cure schizophrenia,” Olfson said. Most of the studies that tested the ketogenic diet as a treatment for mental health disorders, including the Stanford study, did not include a control group that followed a regular diet.
Some small studies have also suggested that a ketogenic diet might help reduce symptoms of depression.
In a clinical trial published in JAMA Psychiatry recently, researchers reported that a group of participants following a ketogenic diet and another group following a control diet that emphasised fruits and vegetables both had significant improvements in their symptoms.
The benefits were slightly greater in the ketogenic diet group, but the authors called the clinical relevance of that small difference “uncertain”.
Antipsychotic medications, currently the first-line treatment for psychotic disorders, generally work by blocking dopamine receptors and can reduce symptoms like hallucinations and paranoia to a manageable level for many patients.
But they also have serious flaws. Weight gain, a common side effect, contributes to a high rate of cardiac disease and early death among people with schizophrenia. And many patients stop taking the medications, complaining that they leave them sluggish and unmotivated.
See more from MedicalBrief archives:
Dementia risk upped by 2.5 times with schizophrenia – UK meta-analysis
A ‘myopic focus on weight’ drives the popularity of keto diet
Long-term medication for schizophrenia is safe
Food preservative enhances schizophrenia treatment
Keto vs Mediterranean diet and diabetes – Stanford randomised trial