BALTIMORE -- Studies have shown that converting the body’s metabolism from burning sugars and starches to proteins and fats can relieve certain neurological and mental illnesses that have not responded well to standard therapies, but most doctors have limited experience with using diets for therapy or partnering with nutritionists.

Researchers from the University of Maryland School of Medicine found that training doctors to use the ketogenic diet personally better prepared them to add it to their treatment options for patients with difficult-to-treat illnesses.

“We launched this study because the science around ketogenic metabolic therapy in mental health is advancing rapidly, and we wanted health care professionals to be prepared to add it to their treatment options,” lead investigator Dr. Deanna Kelly said in a statement. “Clinicians considering this approach with their patients should understand both the potential benefits and the practical challenges as new data continues to emerge.”

The ketogenic diet changes the body’s metabolism to get about 75% of calories from dietary fats and 20% from protein, with less than 10% of calories coming from carbohydrates. Commonly known as keto, the diet is already the standard of care for children with epilepsy who have not responded to seizure medications, according to the Epilepsy Foundation. Studies have shown promise in treating psychiatric conditions such as schizophrenia, bipolar disorder and depression in patients who are not getting relief from standard treatments for those illnesses.

The UMD study enrolled 40 healthcare professionals from across the country, including multiple disciplines. Participants took a four-hour course on ketogenic metabolic therapy, different approaches to keto, nutrition, monitoring and potential adverse effects. Afterward, they were offered guidance from dietitians and nutrition specialists for an optional four-week “lived-experience” phase of the training; 25 participants took the keto plunge.

Those who did reported increased confidence in explaining benefits and risks of the therapy to patients with difficult-to-treat mental health disorders. Firsthand experience in the potential challenges that come with starting and sticking to the diet contributed to greater confidence in working with nutritionists to engage patients in shared decision-making about the therapy.

Starting the ketogenic diet may have side effects including sluggishness for the first few days, according to Epilepsy.com. Long-term effects can include kidney stones, high cholesterol, constipation, slowed growth and an increased risk of bone fractures. Patients might also need vitamin supplementation, and some anti-seizure medicines increase the risks of kidney stones.

The research team published their findings in the September issue of Frontiers in Psychiatry.

They are preparing to publish a related paper discussing changes in the physicians’ health, mental well-being, nutrition and metabolic measures during the four-week ketogenic diet phase.

Kelly said the benefits of ketogenic diet therapy might be greater for those with certain illnesses.

“Many people living with schizophrenia struggle also with weight gain, insulin resistance, and other metabolic problems that may be worsened by antipsychotic medications and contribute to cardiovascular risk,” Kelly said in a statement. “An approach that could improve metabolic health while also helping psychiatric symptoms would represent a very meaningful advance for patients and families.”

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