Skip to main content

Ketogenic Diet: Indications in Psychiatry and Neurology by Marvin Singh, MD

Diet is often used as a term to convey what we are consuming. On the contrary it is actually a lifestyle which is adaptable, adjustable and personalize aiming for foods that make the microbiomes stronger which means avoiding processed foods and obtaining more fresh and organic food even the type of water we are taking in.

Ketogenic diet is a type of diet that serves a specific purpose. Keeping in mind that it should be considered as a therapeutic diet which has been around for more than 100 years. This diet shifts your metabolism to glycolytic energy production to fatty-acid beta-oxidation and ketone body production.

Keto friendly food includes low carb vegetables and fruits that have low sugar. Doing dirty keto often includes highly processed foods which is considered junk food and impacts the gut microbiome negatively.


We only use the word diet because that’s what we humans like to use as a term to convey what you’re eating, what it really is, is a lifestyle. So, we want to make sure that in the long run diet is adaptable, adjustable, and personalized. We want to aim for a variety of foods because it’s the variety that actually makes the microbiome stronger. We want fresh food that’s organic and not genetically modified, preferably avoiding the processed foods, fast foods, junk foods, even looking at the kind of water that you’re drinking. Filtered water actually is an important component of nutrition and we want to have plenty colorful vegetables and fruits. Don’t forget that just because you’re thinking and talking about the ketogenic diet. That doesn’t mean that vegetables and fruits are out of the equation they are still a very important part of the equation.

How does the ketogenic diet fit in all this? We want everybody to keep in mind that the ketogenic diet should be considered a therapeutic diet, a type of diet that serves a specific purpose. The ketogenic diet is not a new thing, it’s become more sensationalized lately, but it’s been around for almost 100 years now. In 1921 Russell Wilder used it to treat epilepsy. Ketogenic diet is where you’re shifting your metabolism from a glycolytic energy production to fatty acid beta oxidation and ketone body production.

The main cycle that we talk about is all about energy production. We’re eating different kinds of foods and the purpose is to create energies to create fuel. Glycolysis will convert sugar to pyruvate and ATP. These are kind of main ingredients in order to enter the Krebs cycle where you get fatty acids, and the Acetyl-CoA converts crosses into the blood brain barrier and goes into the mitochondria and directly goes into Krebs cycle so there’s a lot less steps involved.

The ketogenic diet does change the microbiome. Plenty of research shows how the microbiome is altered in the setting of a high fat diet. When you’re thinking about the microbiome, and you’re thinking about how things affect the microbiome, even when you’re thinking about genes and how things affect your epigenetic expression of your genes, the theme is that the ketogenic diet does impact the microbiome and that certain shifts can occur in a variety of different conditions when the ketogenic diet is present and that these can be therapeutic in those particular people.

Remember again, the ketogenic diet is a therapeutic diet. We don’t really know if the ketogenic diet is good for 80 years. There are people that say they’ve been on a ketogenic diet for many years and they’re doing well, and that may be good for them, but that doesn’t mean that as good for you, it’s effects may be modulated by changes in the microbiome. There is certainly evidence in psychiatric and neurologic conditions. We definitely need more studies, particularly with humans as opposed to animals and we need better safety and efficacy, long term use, as mentioned, as well, it may not be for everyone. But it may also have a role as well. Just watch out for some of the withdrawal symptoms, the keto flu symptoms, and know that there are things that we can do to try to manage that accordingly.