Here is what a new clinical trial found
Curator’s Note: A new clinical trial investigated the effects of a ketogenic diet on metabolic health and psychiatric symptoms in adults with psychiatric disorders. Fifty-eight participants were divided into two groups: a ketogenic diet group and a conventional diet group. Results showed that those on the ketogenic diet achieved significant metabolic improvements and demonstrated enhanced cognitive performance, alongside reductions in psychiatric symptoms. Notably, improvements in depressive symptoms correlated with higher blood ketone levels, suggesting mechanisms beyond weight loss alone could influence mental health. The study’s findings encourage further research into the relationship between metabolism and mental illness, highlighting the interconnectedness of bodily systems. This is a summary of an essay written by Dr Mehmet Yildiz on Medium.com.
Summary of My Essay “A New Landmark Clinical Trial on Keto for Psychosis Gives New Hope for Metabolic Psychiatry“
The researchers asked whether a ketogenic dietary intervention could improve metabolic health while simultaneously influencing psychiatric symptoms and cognitive performance. To answer this question, they conducted the first randomized controlled clinical trial of its kind.
58 adults receiving outpatient psychiatric care were randomly assigned either to follow a ketogenic diet or to continue their usual diet for one month while remaining on their prescribed psychiatric treatment.
Partway through the study, participants from both groups were offered the opportunity to continue the ketogenic intervention, with twenty-five ultimately completing approximately four months of nutritional ketosis.
Throughout the trial, the investigators monitored blood ketone concentrations to confirm nutritional ketosis while assessing metabolic health, psychiatric symptoms, and cognitive performance using validated clinical measures.
I particularly appreciated this multidimensional design because it reflects an important principle of systems biology. Human physiology rarely changes one system in isolation. Metabolism, inflammation, hormonal regulation, cognition, and emotional health continuously influence one another. Measuring these interconnected domains simultaneously provides a much richer understanding than focusing on a single outcome.
The results were encouraging. Participants assigned to the ketogenic intervention successfully achieved nutritional ketosis and showed significant improvements in body weight, hemoglobin A1c, and insulin resistance compared with those who continued their usual diet.
These metabolic improvements alone are clinically meaningful because people living with schizophrenia-spectrum disorders and bipolar I disorder experience disproportionately high rates of cardiometabolic disease, which substantially contributes to reduced healthspan and life expectancy.
Even more intriguing were the neurological findings. Participants who continued the ketogenic intervention for approximately four months demonstrated improvements in cognitive performance together with reductions in positive symptoms, negative symptoms, and depressive symptoms.
A noteworthy observation was that improvements in depressive symptoms correlated with higher blood ketone concentrations rather than with weight loss itself. Although correlation does not establish causation, this finding suggests that the biological effects of nutritional ketosis may extend beyond changes in body composition.
Like all pioneering clinical studies, this trial has important limitations. Nevertheless, the consistency of the metabolic, cognitive, and psychiatric findings provides a compelling rationale for larger randomized controlled trials. More importantly, it offers encouraging clinical evidence supporting further investigation into the role of metabolism in serious mental illness.
Among all the reported findings, one observation immediately captured my attention. Improvements in depressive symptoms correlated with circulating blood ketone concentrations rather than with weight loss itself.
This distinction is scientifically important because it shifts the focus from changes in body composition to changes in brain metabolism. Had symptom improvement simply mirrored weight reduction, similar outcomes might reasonably be expected from many successful dietary interventions. Instead, the investigators found that participants with higher ketone levels tended to experience greater improvement in depressive symptoms regardless of the amount of weight they lost.
Although this correlation does not establish causation, it raises an intriguing biological hypothesis: nutritional ketosis may influence brain function through mechanisms extending beyond weight loss alone. This possibility aligns with the growing understanding that ketone bodies, particularly beta-hydroxybutyrate, function not only as efficient alternative energy substrates but also as signaling molecules that influence mitochondrial function, oxidative stress, inflammation, and neuroplasticity.
Readers familiar with my book Ketosis + BDNF: The Healing Molecules That Saved My Life will recognize another important biological connection: BDNF.
We know that BDNF is one of the brain’s master regulators of learning, memory, adaptation, and neuronal survival. Rather than acting as a neurotransmitter, it functions more like a growth-support molecule that helps maintain healthy neural connections throughout life.
Experimental evidence suggests that exercise, intermittent fasting, restorative sleep, intellectual engagement, and nutritional ketosis may all influence biological pathways associated with BDNF.
This convergence fascinates me because these different lifestyle practices share a common biological theme. They challenge the body just enough to stimulate adaptation rather than injury. The brain appears remarkably responsive to these carefully regulated metabolic signals.
Whether future psychiatric research confirms a direct relationship between ketosis, BDNF, and clinical improvement remains uncertain. Nevertheless, the hypothesis deserves careful exploration because it integrates multiple fields of neuroscience that have traditionally evolved independently.
From the perspective of my Neuro-Mitochondrial Intelligence™ framework, these findings become especially interesting because they highlight the intimate relationship between cellular energy production and neural function.
Every neuron continuously performs extraordinary biological work. It maintains electrical gradients across its membrane, synthesizes neurotransmitters, transports proteins along delicate axons, regulates calcium signaling, repairs damaged cellular components, and communicates with thousands of neighboring neurons.
These processes consume enormous amounts of ATP every second. Mitochondria serve as the primary generators of this energy. When mitochondrial networks function efficiently, neurons possess greater energetic capacity to maintain stable communication, adapt to changing demands, and support complex cognitive processes. When mitochondrial function becomes impaired, the same neurons must operate under energetic constraints that may influence signaling efficiency, resilience, and adaptability.
This does not imply that mitochondrial dysfunction alone causes psychiatric disorders. Such conditions arise through extraordinarily complex interactions among genetics, neurodevelopment, environment, trauma, immune regulation, hormones, neurotransmitters, social experiences, and many other factors.
However, energy remains fundamental to every one of these biological processes. Healthy neural networks require healthy energy networks. Viewed from this perspective, nutritional ketosis may be one approach to improving the energetic environment in which neural communication occurs.
From a personal angle, in addition to nutritional ketosis, I also practice daily intermittent fasting and periodic fasting lasting up to 10 days for 4 times annually to remain in ketosis for metabolic, neurological, cognitive, and mental health benefits.
You can read the full story on Medium.com:
A New Landmark Clinical Trial on Keto for Psychosis Gives New Hope for Metabolic Psychiatry: My Reflections on the First Randomized Controlled Trial Published in June 2026, Showing That Nutritional Ketosis Improved Metabolic Health, Cognitive Performance, and Psychiatric Symptoms in People Living With Psychosis
Cited Reference: Metabolic Improvements with a Ketogenic Diet Correlate with Symptom Improvement in Psychosis: A Randomized Controlled Trial. Schizophrenia Bulletin, Volume 52, Issue 4, July 2026, sbag082, https://doi.org/10.1093/schbul/sbag082 Published: 08 July 2026. The paper was authored by Samantha V Abram , Juliette M Kyner , An Vu , Zanib Naeem , Shebani Sethi , Michael S Jacob , Susanna L Fryer , Daniel H Mathalon , and Judith M Ford.
I reviewed several clinical trials over the years and compiled them into a list, which you can easily find.
List: Clinical Trials I Reviewed | Curated by Dr Mehmet Yildiz | Medium
Clinical Trials I Reviewed · 13 stories on Mediummedium.com
Related to this story, I wrote many stories about nutrition, brain health, fasting, ketosis, fat loss, and lean muscle building. You can find them via these lists:
Thank you for reading my perspectives. I wish you a healthy and happy life.
[End of the Chapter]
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