Ketogenic Diet May Help Lower Stress and Boost Mental Health, Researchers Say

A recent study indicates that following a ketogenic diet could enhance mood and mental well-being in the general population. Natalia Mishna/Stocks


The ketogenic diet, recognized for its potential benefits to physical and mental health, is now being linked to improved mood and emotional well-being among the general population. Experts advise that newcomers to the keto diet should start under the guidance of a nutrition professional, such as a dietitian. While other diets like the Mediterranean or DASH diets have more substantial evidence supporting their mental health benefits, the ketogenic diet, characterized by high fat, low carbohydrate, and moderate protein intake, is gaining attention for its potential psychological advantages.


A pilot study from Stanford Medicine reported improvements in symptoms for patients with severe mental illness after following a ketogenic regimen for four months in conjunction with standard treatment. Building on these findings, new research delves into the potential mental health benefits of the ketogenic diet for the general public.


A recent study investigated the impact of the ketogenic diet on various aspects of mental health in a global population. The findings, published in the journal Nutrition, suggest that adherence to a ketogenic diet may be associated with better mental and emotional health, with benefits increasing over time.


How Does the Keto Diet Affect Mental Health?


Researchers at Northumbria University in Newcastle-upon-Tyne, England, explored how the ketogenic diet influences mental health, focusing on aspects such as:


- Mood (calmness, contentedness, alertness)

- Cognitive and emotional stress

- Symptoms of depression and anxiety

- Feelings of loneliness


The study compared self-reported mental health outcomes of individuals on a ketogenic diet to those on other diets using data from two online surveys. Participants were recruited via social media for two cohorts:


- 2021 cohort: 147 participants

- 2022 cohort: 276 participants


All participants were 18 or older and free from clinically diagnosed mood, anxiety, neurodevelopmental, and neurodegenerative disorders. The first cohort completed surveys including Bond-Ladder visual analog mood scales and the Perceived Stress Scale, while the second cohort completed the Depression Anxiety Stress Scale and the revised UCLA Loneliness Scale.


Participants provided demographic, socioeconomic, and health-related information, and dietary habits were collected using a one-week, 45-item food frequency questionnaire. Foods were categorized based on compatibility with the ketogenic diet:


- Ketogenic-friendly: meats, poultry, fish and seafood, certain dairy products, eggs, tofu, tempeh, nuts, most vegetables, tea, and coffee.

- Ketogenic-acceptable: fruit (fresh or frozen), most fruit juice, squash, low-calorie or diet beverages, certain meat substitutes, cottage cheese, and dairy or non-dairy spreads.

- Not ketogenic-friendly: fruits canned in syrup or dried, grains, potatoes, beans and pulses, sugary snacks and drinks, chips and savory snacks, low-fat and flavored yogurts, and breaded or battered meats, poultry, and fish.


Participants were asked if they were following a ketogenic diet, their main reasons for doing so, if they measured their ketone levels, and their most recent ketone reading. Only those adhering to the ketogenic diet for at least one week were considered ketogenic diet followers in the final analysis. Those not following the ketogenic diet were grouped under "other diets."


Keto Diet Reduced Stress, Anxiety, and Depression


Survey results identified 220 participants following a ketogenic diet across the two cohorts. Their primary motivations for adopting the diet were overall health and weight loss. Notably, over 70% of participants did not monitor their ketone levels, leaving their ketosis status largely unconfirmed.


In the first cohort, the average body mass index (BMI) was classified as overweight among both ketogenic diet followers and those following other diets. However, ketogenic diet followers had a significantly higher BMI than those on other diets, were older, and were more likely to have high blood pressure.


The second cohort showed similar age patterns but no significant difference in blood pressure or BMI between diet groups. Both cohorts reported better psychological well-being among ketogenic diet followers, including:


- Superior mood states (calmness, contentedness, alertness)

- Reduced anxiety and depression

- Fewer feelings of stress and loneliness


However, reported loneliness was not statistically significant after adjusting for group disparities. These psychological benefits appeared regardless of ketone levels, suggesting that sustained dietary habits might contribute to mental well-being regardless of metabolic changes.


Participants followed the ketogenic diet for an average of 24 months in the first cohort and 44 months in the second. The study authors noted that, unlike previous research, longer adherence to the ketogenic diet correlated with better mood.


How Does the Keto Diet Support Mood and Well-Being?


Medical News Today spoke with Jasmine Sawhne, MD, a board-certified psychiatrist not involved in the study, who explained how a ketogenic diet might improve psychological well-being. She noted that the diet could increase gamma-aminobutyric acid (GABA) levels, promoting calmness and relaxation similar to the effects of benzodiazepines, which are used to treat conditions like anxiety.


The ketogenic diet may also influence neurotransmitters like dopamine and serotonin, which regulate mood, and the gut microbiome, which affects behavior and stress response, Sawhne explained. However, she emphasized the need for future studies to include biological markers to complement self-reported data, especially regarding neurotransmitter levels, stress hormones like cortisol, and gut microbiome composition.


Kiran Campbell, a registered dietitian nutritionist with a background in psychology, who was also not involved in the study, agreed that further research is needed into the long-term mental health effects of a ketogenic diet. She pointed out that "some studies show no long-term benefits on mood or cognition," contrasting with the current study's findings of increased benefits over time. Additionally, research on cortisol levels during a ketogenic diet remains inconclusive.


Dietary Approaches to Improving Mental Health


Before attempting the ketogenic diet, Sawhney underlined the importance of consulting healthcare providers, "especially for those with complex health conditions or considering major dietary changes." 


"While this diet does show evidence of benefits for mental health, we are not yet at a point to safely recommend a ketogenic diet for mood disorders or to improve mental health in the general population," said Campbell. Instead, a balanced, whole-food, plant-forward diet is recommended. Both Sawhne and Campbell suggest Mediterranean or DASH diets, which have more documented mental health benefits and fewer associated risks. For individuals with mental health conditions, "[these diets] may be recommended in conjunction with traditional psychiatric treatments," said Sawhne. Limiting certain ultra-processed foods and consuming healthy carbohydrates and omega-3 fatty acids can further benefit mood and support mental health, Campbell concluded.