This weight loss diet may help reduce depression in college students

By Stephen Beech

A trendy weight loss diet may also reduce depression symptoms in students, according to a new study.

Researchers found an association between at least 10 weeks of following the keto diet and a roughly 70% decrease in depression symptoms among college students.

The high-fat, very low-carb, moderate-protein ketogenic, or keto, diet is designed to shift the body into a metabolic state called ketosis, where it burns fat for energy instead of carbohydrates

Celebrities who follow the eating plan include Gwyneth Paltrow, Halle Berry and Kourtney Kardashian.

Beyond the reduction in self-reported and clinician-rated depression, researchers found the students’ global well-being increased nearly three-fold and their performance improved on several cognitive tasks.

All but one participant also lost weight.

The 16 students who completed the pilot trial were receiving medication, counselling, or both for major depressive disorder before beginning the keto diet.

Researchers say their findings, published in the journal Translational Psychiatry, suggest achieving nutritional ketosis through diet is a "feasible adjunctive therapy" for depression and pave the way for a larger trial.

The pilot study did not have a non-keto control group for comparison.

Previous research has suggested medications and counselling reduce depressive symptoms by about 50% in a similar time period.

Study lead author Professor Jeff Volek, of The Ohio State University in the US, said: “So many people are suffering right now, so it’s rewarding to potentially bring forward a solution.

“There is more science yet to do, but because there is evidence of a benefit, expanding accessibility to a well-formulated ketogenic diet as an augmentation to treatment for depression is something to think about.”

Prof Volek’s lab teamed with Ohio State mental health experts to design and complete the trial with young adults studying at the University.

Study co-author Dr. Ryan Patel, a psychiatrist in Ohio State’s Office of Student Life Counselling and Consultation Service, says around 40% of college students report depression symptoms, and about half of them are receiving treatment of some kind.

He said: “We have a treatment gap in that we have more students suffering from mental health concerns than can feasibly receive professional treatment.

“There is a need for finding ways of helping students on a large scale. And nutrition is one way we can do that.”

A total of 24 students were enrolled in the trial and 16 students – 10 women and six men with an average age of 24 – completed the entire study.

Participants received extensive education on the keto diet, consisting of fewer than 50 grams of carbs per day combined with higher fat and moderate protein intake.

The keto diet converts fat into ketones used by cells in the body and brain as an alternative to glucose, and is designed to put the body in a state of "nutritional ketosis" when it has greater access to ketones as both fuel and a signalling molecule.

Study first author Drew Decker, a graduate student in Prof Volek’s lab, said: “It was very important to make sure participants knew what they were getting themselves into.

“And a big part of increasing chances for adherence to the diet was talking to each individual about what they like and don’t like to eat so we could tailor some suggestions for how they could structure their diet.”

The team also provided 10 complete starter meals, offered consistent advice and snacks for the first half of the trial, and communicated throughout the study with participants through a private app.

The students were advised to eat when they were hungry and finish eating when they were full, and not to worry about calories.

At the outset and over the course of 10 to 12 weeks, the students reported depressive symptoms.

They also took a series of tests assessing episodic and working memory, processing speed, executive function, and attention and inhibitory control.

Co-author Professor Jennifer Cheavens oversaw clinical assessments of participants before and throughout the trial.

She said: “One of the things we really wanted to make sure of is that we were providing a treatment for people who met the diagnostic criteria for having major depressive disorder.

“Each participant had a 2.5-hour interview at the beginning, and then weekly assessments of their symptoms.”

The findings showed that self-reported depression scores decreased 35% by week two and reached 67% of improvement at week 10-12.

The range of symptom severity varied, but nobody’s symptoms worsened.

As a group, participants lost an average of 11lbs and their body fat decreased by 2.4% – with most exceeding the "clinically significant" drop of 5% weight loss.

Dr. Patel, who met with the participants throughout the trial, described the magnitude of the reduction in depressive symptoms linked to the keto diet as "notable".

He said: “The average effect size for medications and counselling after 12 weeks is about 50%, and we saw a substantially greater result.

“That is an impressive finding, that across the board, in this real-world setting, everybody got better, and across the board, our participants did not need more treatment or emergency intervention.”

Prof Volek said: “The idea is that the ketogenic diet is working through a variety of potentially different mechanisms – there’s a whole range of physiological metabolic adaptations to the diet that could overlap with some of the pathophysiology of depression."

He added: “This is one of the first really well-controlled studies and it has limitations, but the results encourage us to want to keep pursuing it.”