Keto to tackle depression?
Text: Lara UebelhartPeople who follow a ketogenic diet consume very few carbohydrates. This causes the body to rely more on fat and ketone bodies for energy. Researchers from Basel are investigating whether this could also benefit mental health.
Key takeaways
- The Keto-Mood study compares a ketogenic diet with a healthy control diet, with both groups receiving the same professional support.
- Ketones provide energy and act as signaling molecules, which may help explain potential effects on mental health.
- A ketogenic diet is not yet an established treatment for depression. Long-term evidence on its effectiveness and safety is still lacking.
For many people, a cold ice cream in summer or a nice piece of cake is one way to lift their spirits, at least momentarily. Sugar may not have the best reputation in terms of health, but it is widely associated with pleasure and well-being.
The extent to which diet affects the psyche has been the subject of research for many years. “Psychiatry still underestimates the impact of nutrition,” says Timur Liwinski, who believes there is still considerable potential in this area. “To this day, we see the psyche as something separate from the body. The potential has yet to be fully exploited, even though we already know how important diet is to health.” The same applies, he says, to the brain.
From epilepsy to depression: Research on the ketogenic diet
In both research and clinical practice, Liwinski has found several indications that a ketogenic diet may have a positive impact on mental health.
This idea is not new: The keto diet has been used to reduce seizures in patients with epilepsy since the 1920s. Now, Liwinski is investigating whether it can help to treat depression. “Depressive disorders have been rising sharply for years and represent a major public health problem.”
He says that although good treatment options already exist, they don’t work for everyone, and their effectiveness varies from one patient to another. The ketogenic diet could therefore complement existing treatments. “That’s the great thing about nutritional therapy, it doesn’t rule out other treatments but can be combined with them.”
A complex transition with careful preparation
Liwinski is working with a team drawn from the fields of psychology, dietetics and medicine to investigate whether a ketogenic diet could help people with depression, using a healthy control diet for comparison. A total of 86 people are taking part in the Keto-Mood study, around a quarter of whom have already completed the treatment. Over the first two weeks, the participants gradually adjust their eating habits before maintaining the new diet for eight weeks. They are closely monitored by professionals, particularly if they have preexisting conditions or are on medication.
Some people experience temporary issues when they first start a keto diet. Often referred to as “keto flu,” these can include sleep disturbances, muscle pain, weakness or nausea. To help participants avoid these and other side effects as far as possible, the researchers prepare them for the change in diet with both theoretical and practical support, including recipes and regular consultations.
Adapting to a low-carbohydrate diet
Among other factors, the body’s strong reaction is linked to the sudden drop in carbohydrate availability. “During this transition, most people switch their main energy source from carbohydrates to fat,” says Liwinski. People who drastically reduce their carbohydrate intake consume far less sugar and starch, which the body breaks down into glucose. Going without carbohydrates for two months is difficult even for people in good mental health, and Swiss food culture isn’t exactly conducive to a low-carbohydrate diet. Nevertheless, Liwinski is convinced that the treatment can be managed well with the right support.
So far, even severely ill patients have managed to make the transition, in some cases, with support from relatives. They are likely motivated by the severity of their suffering and the prospect of additional treatment options.
Ketones as energy sources and signaling molecules
The keto diet involves increasing the proportion of fat while sharply reducing the amount of carbohydrates. However, a potential effect on the psyche cannot be attributed to fat or reduced sugar intake alone. Liwinski explains: “When carbohydrates are in short supply, the liver produces what are known as ketones, or ketone bodies, from fat, and the body and brain can use these molecules as an alternative energy source.”
Under normal circumstances, the brain’s primary source of energy is glucose. In depression, there are indications of altered energy metabolism. “Ketones also act as signaling molecules in the body,” says Liwinski. This may help to explain observations from clinical practice, such as improvements in sleep, concentration and the ability to cope with stress.
Initial observations, but no definitive results yet
The keto diet also leads to changes in glucose and insulin metabolism, which could similarly have a positive impact on mood. Other key factors may include a more conscious approach to food, close monitoring by professionals and support from relatives. To better assess these effects, the study compares keto with a healthy control diet. “The two groups receive the same degree of support,” says Liwinski. An independent investigator evaluates the depressive symptoms without knowing which group each participant has been assigned to. According to the research team, improvements have so far been seen in both groups.
Liwinski, the project’s principal investigator, says: “In this comparison, we’ve seen clear advantages for the keto diet so far, but we’ll need to complete the study before drawing definitive conclusions.” This type of diet is therefore not yet an established treatment for depression. In particular, there is still a lack of long-term data on efficacy and safety. As with any therapy, whether the potential benefits outweigh the risks will need to be assessed case by case and with professional guidance. For now, it remains to be seen whether the keto diet can actually help people with depression.
Timur Liwinski is a psychiatrist at the University Psychiatric Clinics Basel (UPK) and conducts research at the University of Basel on topics including the influence of diet on mental health conditions.
More articles in this issue of UNI NOVA (November 2026).