Diet and its effects on the gut biome in the pathophysiology of mental disorders
nature.comI’m a neuroscientist and have struggled with my (mental) health for 30 years. With the pandemic I realized how much foods affect how I feel every day. Going more than 6 months without eating out I became attuned to the differences of meals I prep and what goes into them.
The best explanation I’ve heard is food is like explicit instructions for how our bodies and brains perform through our DNA. Gut health is the engine of the biological machine humming or sputtering accordingly. The research is out there on the differences between food types and impacts of processed foods. The Pollan mantra still still sticks with me: Eat (whole) foods. Not too much. Mostly plants. I’ve added: Sleep better. Move more. Stress less. (To eat well.)
Best thing I ever did for health was a 30 day elimination diet. I felt much better, and could easily tell which foods bothered me when I reintroduced them.
I would eat a roll and 20 minutes later I was feeling hot and flushed and irritated. Just like I had been for years. A slice of pizza is basically a day of feeling horrible.
Have you heard of the FODMAP diet? It can really help with IBS. You start by eliminating all foods with FODMAPS[1] for six weeks and then gradually reintroduce foods from each of the FODMAP categories. It’s recommended to have a dietician/nutritionist help with the temporary diet. It was pioneered by Monash University. [ https://www.monashfodmap.com ]
[1] the FODMAP acronym: Fermenatble Oligo-,Di-,Monosaccharides And Polyols
I've read about that, but it's really hard to find an example diet and it's not like most of those things appear on the nutrition labels.
Also they say not to avoid all of those long term, just temporarily.
The FODMAP diet help me understand that my condition was genetic.
Deets on the diet?
Was this a self-directed or clinician (nutritionist / MD / ...) programme?
I'm presuming this began with a minimum baseline to which you added foods over time?
I could be wrong, but I think OP meant, choose something to eliminate and do it for 30 days. Then choose to introduce it back in if you wish. This allows you to observe the effect it has on you.
I did this with added sugars. I could definitely feel the cravings to not only eat more as you added it back in but also the baseline cravings to just have some amount of sugar in your body. It is very eye opening.
You also become very aware of how much sugar is in everything.
An elimination diet is a protocol where you start with a baseline of "safest" foods and exclude everything for a while, and then.. in an orderly fashion, start to re-introduce foods while noting how you respond or change in light of those additions. It's a protocol, one you can get from a nutritionist or dietician or by searching online. And the food lists can be adapted to people with varying eating modalities.
NB: "Nutritionist" and "dietician" are similar terms which can have very different meanings in practice.
In the U.S., a dietician is a board-certified credential with specific training and licensing requirements.
Nutritionist is a far looser term, though there may be some registration required.
Elsewhere, the terms may be interchanged, or used interchangeably.
Be aware of which you're looking at.
https://www.healthline.com/nutrition/dietitian-vs-nutritioni...
To clarify, the thing one eliminates is typically a molecule or a food group--the most common are probably (in no order) added sugar, gluten, fried foods, processed foods, dairy, and red meat. One can eliminate any or all of those, typically for a month (gives your gut time to change), and then, if you want to, experiment with adding things back in.
A nice thing about the gut microbiome is that it's self-reinforcing, both psychologically and gustatorily--as in, once one's body realizes a food doesn't help, one tend to both think "why would I make myself feel like that?", and to find the experience of eating/drinking it less pleasurable, alien, or even disgusting.
plain chicken. broccoli and sweet potatoes. All plain. No spices, no oils. I wanted a baseline. Water or green tea only.
This was self directed. I was in horrific agony every moment of every day, stuck in bed 20 hours a day.
I slowly added things back in, most things caused issues. Eventually I realized I was just re-inventing the AIP diet.
Few months later I was out kayaking every weekend.
I'll add my anecdote. Nightshade vegetables, in particular the potato, wreak havoc on my body. Took me years to figure out. I didn't even know what a nightshade was. Every few months I'll start to question my sanity and I'm sure potatoes won't bother me. Without fail, every time, rashes, pain, insomnia, deep depressive thoughts, all within 8 hours of consuming potatoes. It's truly crazy. I still have a hard time believing it. Funny enough, I grew up in Idaho, can't eat potatoes. Sweet potatoes it is!
Sjogrens autoimmune support forums are full of anecdotes from people who discover that nightshades are problematic for them. They will often give a list of good / bad things that work for them.
I find it highly amusing that people who have never heard of AIP diet end up recreating it over and over again.
Thanks.
Rice is often mentioned as another low-inflammation / -irritation food. Though I've heard through a friend of someone with a rice allergy --- by an east-Asian, to boot!
I'd look at minimising complexity whilst achieving nutritional sufficiency (macros, vitamins, essential oils) and take it from there, I suppose.
> I was in horrific agony every moment of every day, stuck in bed 20 hours a day
Surely not as a result of the diet?
If something you're eating is making you sick, then not eating that thing will make a tremendous difference in your health and quality of life.
"If you haven't got your health, you haven't got anything."
-- Tyrone Rugen
That is indeed quite obvious, but parent comment was asking about a specific person's situation, not whether food is possible or making somebody sick generally or whether it's bad to be sick.
I'm not OP.
But I've found myself occasionally faced with food-related unpleasantness, and it's remarkably debilitating.
YMMV
It can even lead one to the Pits of Despair.
Milk addition and standard American crap diet.
Fixing diet, adding supplements (Vit E, D, K B12, magnesium) avoiding the sun were massive in getting body under control.
I'm doing something similar, but I'm using meal replacements. Huel is my choice, but there are a lot of others that seem just as good. I basically switched to Huel only for 2 weeks. Then started re-introducing other foods to see how I felt.
It became very obvious, very quickly that a few foods (mostly dairy) were causing me major issues.
Maybe he meant carnivore. U start only with meat, then add stuff back in slowly.
It's not just the food that determines how our body reacts; it's also the microbiome, which produces a wide array of compounds that can enter our bloodstream, and possibly cross the blood-brain barrier. The microbiome is an incredible collection of microbes that is necessary for our health, and yet mostly a mystery at this point. The foods we eat have a direct impact on which microbes thrive, or don't thrive, in our gut -- which is a siginificant part of how our diet affects our gut health.
Dr. Rhonda Patrick talks about diet resistant starch feeding the gut itself. Potato starch is a cheap and easy way to augment that need (YMMV).
You microbiome is more akin to a forest than a farm. You can't just plant potatoes (or whatever) and assume that it will get balanced. Sometimes things like this do help, but sometimes they don't. Fertilizer makes plants grow, but it can have unintended consequences. (For example, runoff leading to bacterial blooms in a watershed.) The gut is an ecology, hence the difficulty of determining one-size-fits all fixes to a complex ecosystem.
I'm well aware, thanks (YMMV was the disclaimer).
My suggestion was for a cheap and easy hack that is likely to benefit a majority of the population. Obviously the best way is to have a well-rounded diet and get all nutrition that way but we know that can be challenging for many.
Edit: in today's news feed: https://www.sciencealert.com/in-a-first-a-dietary-supplement...
I'm old enough to remember when this sort of thing was "woo-woo", so it's good to see it getting a grounding in solid scientific investigation. "Let your food be your medicine." and all that, eh?
Historically our microbiome and the external environment must have been in a kind of dialog: available food would be a pretty direct function of the local ecosystem, and our feces, which are something like 80% microorganisms, would of course be integrated back into the soil. (It's not really that surprising, from this POV, that our bellies would have brains.)
Hi neuroscientis, maybe you should look into the genetics of you own, and others, gut metabolism. I did and it change my life. (Disabled with Scizoaffective Bipolar Disorder and Ankylosing Spondylitis).
I found out I am a FUT2 non-secretor through 23andMe, unusual for a European Caucasian. So basically I cannot fight of gut microbes like you heart farmer folk.
Secretor Genotype (FUT2 gene) Is Strongly Associated with the Composition of Bifidobacteria in the Human Intestine
https://journals.plos.org/plosone/article?id=10.1371/journal...
Human genetic variation and the gut microbiome in disease https://www.nature.com/articles/nrg.2017.63
Since FUT2 releases fucose (Not fructose) I decided to see what foods contained fucose and try eating those. Turned out it is very high in seaweed and mushrooms, which is interesting because I have Sami heritage. Also the spuds that changes my gut microbiome were important as well, this meant reducing my short chain PUFAs as low as possible because of my FADS1 and FADS2 genetics.
Eating those regularly turned my IBD into IBNormal and it helped my brain and inflammation as well.
So "Eat (whole) foods. Not too much. Mostly plants" is quite wrong for me, genetically. In fact, when I was a (good) vegan and vegetarian my HDL was 30 with hyperlipidemia! Eating kind of keto with only seafood pushed my Hal up to 55.
As a neuroscientist you should know that Mood Disorders are highly polygenic so there is no same cause and therefore no same cure for anyone.
So can you please start looking into personalized medicine so people like me do not have to live in constant hell? Thanks.
> Since FUT2 releases fuctose (Not fructose)
Fuctose has no wikipedia page. Could you provide some sources?
> I found out I am a FUT2 non-secretor through 23andMe, unusual for a European Caucasian.
Wikipedia says:
> Approximately 20% of Caucasians are non-secretors due to the G428A (rs601338) and C571T (rs492602?) nonsense mutations in FUT2
20% doesn't seem extremely unusual.
Yes, I fixed the spell check from fructose to fuctose, but not all the way to fucose.
20%, uncommon, unusual, whatever. It is not rare but it is not usual.
Still 20% of the people might be eating a diet that is wrong for them. But I suppose you think this does not matter? I mean are you denying the science behind this? Are you denying it helped me?
Fuctose yourself! Kidding of course. I think there's a lot of mental health to gain by following a personalized diet taking into account your own body's "specifications" as it were.
I'm guessing current western high carb/low nutritional value diet is detrimental to mental health.
I was just interested and checking facts, not trying to be judgemental. Thanks for the correction.
As you can understand and see I am on a razors edge when it comes to talking about this stuff, and even more so with this in the medical field. It was really the "20% is not unusual" part that skewered me in the brain because before I posted this no one here probably heard of this gene and its strong effect on the microbiome and diet.
And now I just want to add, for your interest, that Mood Disorders are not fundamentally neurological, I am sorry to say, but in fact they are immune disorders which affect neurology. You would do the mentally ill a huge favor by sending your patients to rheumatology for care.
It has been 50 years since my mother was diagnose with Bipolar Disorder and here I am now, with the same issues, and they are pretty much prescribing the same meds and looking at it in the same way. So whenever I meet a neurologist I have to express my frustration because you need to think about mood disorders in a radically new way if something is to change and being nice did not change anything. And now, when I find things out that help me I get no help from my doctors, just a "glad that worked for you" and the cold shoulder when I ask for more testing.
> Mood Disorders are not fundamentally neurological, I am sorry to say, but in fact they are immune disorders which affect neurology
This is interesting to me, thank you. The gut-brain link is fascinating.
Have you read "The Body Keeps the Score"? There are some absolutely shocking stats in that book about the correlation between early childhood trauma and mood disorders. You may find the stuff about EMDR and reconnecting with the body interesting. That said, BPD is often an outlier; as in, it doesn't respond the same as most others.
... I'm not an expert. But, I think the author of that book would agree with you on the difficulty of presenting new information to doctors/neurologists/psychiatrists. It seems to require a lot of resilience.
Your are welcome.
Yes, I have read Mate's book. I assure you my fcked up childhood was one part of the problem but my genetic risk combined with a "farmer's diet" is a greater factor for me, even more so in relation to my cardiovascular and autoimmune health.
I do have a feeling that genetics is even more important than trauma and that the correlation between the two is found because of the genetics.
There are very many theories regarding what is and isn’t a contributing mechanism to mental health. Nutrition is one thing, when I ate less I lost weight and had less fatigue and depression. But that happened in concert with treatment aligned with the serotonin/norepinephrine signaling theory of depression, and it worked for me, as it has very many others in regular drug studies.
I don’t think it’s a good idea to dismiss medicine right away but it was an essential 15% to the 85% of my work putting in place methods and giving myself a chance to change.
> There are very many theories regarding what is and isn’t a contributing mechanism to mental health
That was pretty much the whole point of my comment. Why are there many theories? Because their are are many causes. Until we start looking at every one individually no one will get well.
And I am in no way dismissing medicine, I only want doctors to start practicing it again.
> But I suppose you think this does not matter
That's an ungenerous interpretation when otherwise the GP demonstrated curiosity about your provided information. It's easily read as "this may be important to more people than you implied".
The statement "20% doesn't seem extremely unusual" is a total write off of those 20% of people. You see, he is looking for a single case of disorder and there is not one. This is frustrating and ignores the huge genetic diversity in humanity.
As someone with Inuit heritage this is harmful to me. For 80% of people a vegetarian diet will be helpful. But for 20% it is probably not helpful. But all you will read in the news is how a vegetarian diet is the only diet to cure heart disease, etc...
Inulin is in every food now because it is "healthy". Do you know what inulin does to my gut? But this is one of those "healthy" foods.
I think it's a typo, it should be Fucose not Fuctose.
If you haven't yet it's a good idea to do a microbiome stool test kit to see if there is any overgrowth of bad bacteria or yeast in your GI tract, as well an Igg food sensitivity test/food panel for 200+ foods to see if there are any common foods you're regularly or irregularly eating that may be causing inflammation, irritating your GI tract.
Also important to note, many plants have toxins in them to prevent animals eating them, and that most research studies on red meat are greatly flawed.
1) IgG food tests are not scientifically validated.
2) GI irritation is separate from inflammation, and many common food stuffs that may be causing irritation generally decrease inflammation.
3) Those "plant toxins" are either deactivated by processing (cooking etc.) or are in such low quantities that there's no negative effect, and most of the time even a slightly positive one.
4) "Most research studies" on red meat are not flawed.
Edit: Formatting.
> many plants have toxins in them to prevent animals eating them
Almost all of the plants humans eat have been domesticated and bred to no longer produce these compounds in the parts that we eat. For other plant parts, such as fruit, being full of sugar and tasty is an adaptation because it helps with dispersing the plant's seeds. If this is something that interests you I recommend reading 'With Bitter Herbs they shall eat it: Chemical ecology and the origins of human diet and medicine.' by Timothy Johns. It was published 30 years ago and is essentially his PhD dissertation but quite readable and still one of the best resources on this subject.
Sugar and Candida was really eye opening - it’s the fungal overgrowth driving my addiction to sweet stuff.
> Igg food sensitivity test/food panel for 200+ foods
Last I looked into this, the science didn't really support this interpretation and in fact may have been directionally opposite.
Iirc in layman's terms, a "positive" result in that test didn't really mean "immune response" it just meant your body had the corresponding chemical to break down the food. What you had eaten in the past week could alter the results of the test and the results weren't predictive of foods that would cause digestive issues.
What test do you recommend and why?
Last time I googled these tests I got so many results it seems like a small bullshit industry.
Gut bacteria is obviously important but I'm not sure the results of these tests are useful.
https://www.nowleap.com/the-patented-mediator-release-test/
Importantly, should be ordered by a nutritionist and requires a blood draw. It’s got some challenges but overall helped me when paired with a restricted diet. Easy to relapse though, 2-3 months versus a lifetime of eating behaviors.
> and that most research studies on red meat are greatly flawed.
Care to elaborate on this? Preferably with sources.
You might be interested in this document from Credit Suisse: https://research-doc.credit-suisse.com/docView?language=ENG&...
There are more than 450 references to saturated fat in the document, but I found this phrase early on:
> Our view is that saturated fats intake is at worst neutral for CVD risks and the current 10% upper limit should be lifted.
Apologies if there was some other property of red meat that you had in mind, although I've been convinced from people commenting studies purportedly linking red meat and say, colon cancer, are just based on poor quality epidemiological data. And, while there was some sort of intuitive sense in which one could imagine the saturated fat eaten with meat/dairy products would mechanically clog arteries, I don't see anything like this with red meat. In fact, we are made of it, why would eating it have a deleterious effect? To the contrary, it seems that abstaining from meat often quite quickly causes iron deficiency/disregulation, B12 deficiency and so on.
I don’t have any sources for you, but a lot of people have been revisiting saturated fat and cholesterol, and it appears that they probably aren’t as bad for you as we once thought.
While moderate amounts of saturated fats are not bad, there is no doubt that it is recommended that in the eaten fat the most abundant fatty acid must be oleic acid (i.e. the fat must contain mostly MUFA, mono-unsaturated fatty acids).
The reason is simply that oleic acid is the most abundant fatty acid in human fat. When the ingested fat consists mostly of oleic acid, it can be used as such, while when the ingested fat contains either mostly saturated fats, like many animal fats or mostly poly-unsaturated fatty acids, e.g. linoleic acid, like most cheap vegetable oils, the ingested fatty acids must be converted by the liver into the fatty acids preferred inside the human body, so that is extra work for the liver and the liver becomes less efficient at old ages. If the liver does not succeed to convert all the ingested fatty acids that should have been converted, than the composition of the fat used for various purposes in the body may be suboptimal.
Examples of foods with optimal fatty acid composition are olive oil, high-oleic sunflower oil (not classic sunflower oil, which contains mostly linoleic acid), hazelnuts, almonds, pistachios, cashews, peanuts.
By this logic (which I agree with), land animal fats would best match (for beef fat: "oleic acid (36.21%), palmitic (25.67%) and stearic (20.97)").
Nuts & seeds are often high in omega-6 and are hard enough to digest that it's hard to have them as a staple. I say this as someone who was a big fan of nuts, especially almonds, but had to give them up as they triggered autoimmune symptoms. Macadamia nuts by be okay though, they are also the highest in MUFA and low in phytic acid (which causes digestive troubles and inhibits mineral absorption).
I do believe cooking food neutralizes most of those toxins.
Anyway, I do believe (citation needed) that food sensitivity is also correlated to gut biome, and that some sensitivities can be overcome with dietary and/or gut biome changes.
While the toxins that are proteins are usually inactivated by cooking, some of the other substances require additional steps, which were always used in traditional cooking, but not all modern cooks are aware of them.
For example, all the kinds of seeds, including all kinds of dry legumes and all kinds of nuts, require soaking in water for many hours and the water must be dumped and they must be washed before cooking, in order to remove as much of the phytic acid as possible.
The soaking in water is much more efficient if the water is acidulated, e.g. with lemon juice or with vinegar.
Another example is with the vegetables rich in oxalic acid, e.g. spinach, which must be boiled in several stages. After each stage, the boiling water must be dumped and replaced by fresh water, in order to remove as much of the oxalic acid as possible.
> For example, all the kinds of seeds, including all kinds of dry legumes and all kinds of nuts, require soaking in water for many hours and the water must be dumped and they must be washed before cooking, in order to remove as much of the phytic acid as possible.
Or you can just... not do any of that. Eat raw almonds and shit out phytic acid. What's the problem?
Did the food sensitivity test (MRT) and helped a bit but also learned how immune responses can become associated with foods we eat a lot. Overall gut health and inflammation is so obvious, the engine strains with bad fuel, but very difficult to live it when pasta and pizza and burgers are staples.
Why I think Pollan’s mantra is great, he’s not absolutist about any meat. Just mix and match, which we would in nature. It’s really hard to catch a consistent meat source.
Can you provide a little more insight/some links on the last paragraph?
IgG tests are junk and meaningless.
Uh, why exactly am I being downvoted for this? ^
IgG tests are objectively bad science, used to scam people into thinking they have allergies when they don’t. IgG will basically just give you a list of what foods you’ve eaten lately. They are completely and utterly useless.
IgE tests are what matter. I have dozens of food allergies and unfortunately have had to learn more about allergies and the immune system than I ever imagined. I know what I’m talking about here.
It's interesting that we've become so obsessed with the gut microbiome even though stool only captures a tiny fraction of the composition of the gut.
Similarly, the salivary oral microbiome has also been correlated with mental disorders, cognitive health, is modulated by diet, and plays a major role in systemic health. And saliva is objectively easier to collect. Instead of jumping straight into collecting poop, we should be collecting our spit instead!
https://www.nature.com/articles/s41398-022-01922-0 https://www.nature.com/articles/s41598-021-94498-6
I have a chicken and egg issue with microbiome stuff. Does your microbiome look different because you are suffering from an issue, or does your microbiome looking different cause the issue.
Kind of like when an auto-immune disorder is causing inflammation. You can treat the inflammation, but you aren't treating the real problem.
well, for the most part in healthcare we treat symptoms not causes.
cavities caused by acid producing bacteria? drill and fill
gum disease caused by oral dysbiosis? bone and gum grafts
diabetes from autoimmunity? insulin
high cholesterol from… anything? statins
A great reminder that you are the only one truly held responsible for "figuring out" your health.
Yes, I can assure you it is bidirectional, since my mental stress certainly affected my gut.
I can only add my anecdotal story here.
I recently had mouth surgery where they had to open up the lower part to access the jaw bones. From what I understand, they sterilize your mouth pretty well beforehand. I had to rinse my mouth out with a foul tasting mouthwash and woke up with strange tastes and dark products around my lips. Since then, I've felt like crap. At first I thought it was the surgery itself. Then a long effect of the anesthesia. Except that it did not go away.
Anyway, I recently read a lot about probiotics and decided to try L. reuteri orally.
The result is so instantaneous that I was scared it might be psychosomatic from a placebo. But if it is indeed a placebo, it is the strongest I have experienced, so I doubt it.
My mouth went from always dry and smelly to well hydrated in one day. After 5 days, my mood completely changed, including the quality of my sleep.
I don't know if I was depressed per se, I had not consulted anyone. However, I had a heavy weight on my shoulders that is now gone.
Since that experience, I have added L. reuteri pills made for gut health to my diet. I am now considering making my own probiotic yogurts and as a family we have started to experiment with fermented sauces and pickled vegetables.
There is something very important about probiotics that is almost overlooked. I think we should all pay much more attention to it.
How does this study relate to fairly recent topic of lack of evidence that low serotonine levels causes depression ? Should the diet metaanalysis be redone after that study ?
In the first table the "eating disorders" entry makes references to "Kleinman et al. 2015" and to "Morita et al. 2015". Neither can be found in the bibiography. I couldn't find a paper by some Kleinman on the topic between 2014 and 2016 (https://scholar.google.com/scholar?start=0&q=author:kleinman...). Morita wrote this (https://journals.plos.org/plosone/article?id=10.1371/journal...).
Neither the linked article nor Morita's mention Serguei Fetissov's pioneering work on the topic though, which is disappointing, given that he and his colleagues have long documented the link between E. Coli, the immune system and eating disorders.
The gist is that E. Coli produces a protein (CLBP) that mimics a feeding-related hormone (IIRC melanocortin). That protein ends up in the blood stream and can bind the corresponding receptors. It can also generate an immune response, and these antibodies are cross-reactive, causing autoimmunity and complicating the story.
Do you have any links to his work?
Plucking from Google scholar you can check
this https://www.pnas.org/doi/full/10.1073/pnas.222658699
and this https://onlinelibrary.wiley.com/doi/am-pdf/10.1002/eat.22531
among many others...
https://scholar.google.com/scholar?hl=en&as_sdt=7%2C39&q=ser...
A key point is that the same anomalies are seen in anorexia, binge eating and bulimia.
Anyone here drink kefir yogurt? I have kefir grains which I ferment in milk and get a weekly yield of yogurt that I drink out of a bowl after straining the yogurt. It’s packed with probiotics, and helps with my mood. It’s an all round useful elixir to make.
I add Kefir to a lot of dishes (both cooked and uncooked) that call for some dairy component. I actually prefer it to milk in things like pancakes, even though cooking it must kill some/many/all of the probiotics. I was making my own, but I was finding the process a bit more involved than I wanted to deal with, so I just recently started buying pre-made kefir.
I can't say that I've experienced a world-altering impact to my life (wow, no more acne and I've lost 22lbs!) but I do think I've been able to eat dairy products (cheese and yogurt) with far less upset stomach than before. Careful with introducing Kefir if you're looking to try it out - start small. I was adding a tablespoon to my dishes and it made me gassy as heck for the first couple of days.
if i drink a certain brand of kefir before bed i get space dreams 2 out of 3 times, in germany it's called müller milch kefir, good stuff xD
can't do it too often since I don't to well with the sugar content of dairy but it's fun!
Warped in a space battle once, barely missed some shooting turret and deep dove into a beforehand invisible sun wich was made of blue water filled cells, good thing, dreams don't have to make sense!
Thats pretty cool, I wonder what causes it? I wonder if you could do a double blind, have someone fill a cup of müller milch kefir, and another brand for a few nights (secretly your assistant has only used the off brand, do you still get space dreams?)
A few years ago I started making and eating a lot of fermented foods for purely gastronomic reasons, including kefir. I haven't really noticed any obvious changes.
I've been on antibiotics twice in this time and do feel like I get my appetite back more quickly after stopping them now. An antibiotic course used to mean weeks or months of poor appetite, nausea and indigestion now it's like 10 days. But that could be coincidence or something else entirely, who knows.
Do you have a link about this? I would love to experiment with it.
One time, someone told my girlfriend she should try Keto to help with her Epilepsy. Maybe they were on to something, I guess.
The Ketogenic diet is actually fully effective in many patients. Interestingly, its more commonly used as a "last resort" when patients don't respond to pharmaceutical interventions instead of a first line of treatment.
https://my.clevelandclinic.org/health/treatments/7156-ketoge...
That's terrible to hear that doctors would try pharmaceuticals before a relatively simple diet change.
I'm involved in many support forums.
A few patterns I've noticed.
The people who have been mostly managing their conditions via diet without understanding whats happening. Basically they eat healthy, and it mostly works.
People who love food / don't want to cook healthy and refuse to acknowledge the possibility that's causing problems.
People who say they eat healthy but really don't. (Salad once a week) Or a variation, people who ate a salad, didn't get better and claim diets don't work).
The ones who are at deaths door and are finally desperate enough to try anything.
Actually following a strict diet like KETO / AIP. Paying close attention to trigger foods, etc. These ones often can reduce or eliminate medication.
Learning to be honest with yourself about food is one of the major challenges. Giving up various food addictions can be brutal.
I agree that on the surface, it sounds dreadful. The problem is that many doctors have found through experience that patient compliance with a daily pill is much better than with dietary changes. If a doctor wants to actually help a patient, the treatment that a patient will actually do becomes the most effective by default.
Having said that, I do think that doctors need to be aware of and make sure the alternatives are discussed with the patient. The paternal MD attitude of just tell the patient what they think the patient needs to hear should not be tolerated. If I ever get that vibe from a doc I move on and find someone who will respect me as a patient.
I think that happens because that is what most patients want. They don't want to give up pizza and alcohol. Give me a magic pill instead so I can do what I want.
Keto is not a simple diet change. It is very difficult to stick to and comes with a lot of prohibitions. Adherence is low and side effects do happen.
Keto worked for me only when I cut out carbs completely, I eventually switched to zero carb because it's easier to maintain. As long as I allowed myself anything carb, I'd got on a binge-frenzy, even with dairy... willpower is a terrible thing.
~zero carb is much easier to maintain than keeping track to stay under 15 Grams
yes!
I suspect patients feel the same.
It's a last resort because adults can't reliably stick to the diet and doctors know it. People don't even stick to medication very well. It's really only prescribed in kids with severe forms of genetic epilepsy because it works well for those conditions, and their parents control what they eat. It's a lot easier to take a pill than to change your entire lifestyle.
Unfortunately, keto doesn't always control seizures either. Pills still work better than diet for some people.
Apparently it's helpful to more than epilepsy, from a study this month: https://www.psychologytoday.com/us/blog/diagnosis-diet/20220...
> Symptoms of depression and psychosis improved in all 28 patients who followed the diet for longer than two weeks, with improvements becoming noticeable within three weeks or less. 43% of patients achieved clinical remission, and 64% were discharged from the hospital on less psychiatric medication.
It's amazing that results were seen in just 3 weeks
Check out the LGIT (low glycemic index treatment), aka "the south beach diet". It's a more relaxed low-carb diet (80g/day), which has shown similar efficacy to keto for seizure control. It makes it much easier to feel somewhat normal at restaurants and the dinner table when out with people.
https://www.epilepsy.com/treatment/dietary-therapies/low-gly...
One interesting thing about these low-carb diet therapies is that they can result in long-term seizure control even after discontinuing the diet. They are worth trying imo. However, I'll personally attest to the fact that they are not a silver bullet.
Per this link.
https://charliefoundation.org/am-i-a-candidate/keto-for-epil...
"Ketogenic Therapies and brain surgery are the only known cures for Epilepsy. Half of the people with epilepsy who try the diet have a seizure reduction of at least 50%. Up to 25% become completely seizure free. In the sections below, we explain how Ketogenic Therapies compare to anti-epileptic medications, how keto’s mechanisms are thought to affect the body, and stories from a few of the thousands of families who have had amazing results by implementing keto for epilepsy."
I mean no harm no foul, I too have heard mostly anecdotal accounts of diet and various health conditions - migraines, allergies, ADHD, etc.
There's plenty of science out there but it's still early.
Role of diet and its effects on the gut microbiome in the pathophysiology of mental disorder
What’s the tl;dr? What does it say we should eat?
I only skimmed the article, but many sections, with the glaring exception being diet and epilepsy, mentioned a Mediterranean style diet, and looking closer at the studies cited it seems like the Mediterranean diet proposed by Low-Carb Satan Ancel Keys.
But I didn't read it too closely. One of my favourite YouTubers just released a video on the subject: https://youtu.be/FleMtTEEYlc
I like that guy too. One of the few nutrition youtubers I can find who seem open minded.
Andrew Wakefield's original disputed paper was about the brain-gut-microbiome axis.
Regardless of what you think of Wakefield, and the disservice he (and/or Brian Deer) did with respect to autism and vaccines, an even bigger tragedy to me is that nobody dared to investigate the BGM axis for decades now, for fear of association.
It's good to see it back on the list of acceptable research agendas. Perhaps finally the healing can begin.
tldr:
> to date there is insufficient evidence from mechanistic human studies to make conclusions about causality between a specific diet and microbially mediated brain function.
A line from the abstract is not a fair summary of this article
That's because there's not a straight line between correlation and causation. The controlled experiments haven't been done yet. But that's not all there is to science.