• Contents
  • Key Takeaways
  • Protocols
  • Source
  • Full Notes
  • Support the Podcast
Mental Health
5 Min Read
Last Updated: 12.06.23

Dr. Chris Palmer: Diet & Nutrition for Mental Health

Dr. Chris Palmer, Harvard psychiatrist, discusses nutrition’s impact on mental health. His pioneering work with the ketogenic diet treats depression, schizophrenia, and epilepsy. He explains the role of mitochondria, low-​​carb diets, and gut microbiome. Topics include marijuana, alcohol, ketones, mood, sleep, and fertility.

Key Takeaways

High level takeaways from the episode.

Palmer had a first-​​hand experience of struggling with low-​​grade depression and OCD.

  • After trying the Atkins diet, noticed dramatic improvement in mood, energy, concentration, and sleep
  • Waking up before the alarm feeling rested
  • Helped friends and family, saw powerful antidepressant effect

Offered the Atkins diet as an option for some patients with treatment-​​resistant mental illness

  • Some experienced remarkable and powerful antidepressant effects

Atkins diet

  • Low to zero starch, low carbohydrate, low sugar
  • Avoided red meat

Initially used Atkins diet to achieve ketosis

  • Clinical benefits observed once patients achieved ketosis

Importance of supervised medication tapering

  • Stopping medications cold turkey can lead to severe symptoms
  • Adjustments should be made safely, cautiously, and gradually

Not every patient needs a ketogenic diet

  • For some, eliminating junk food can improve mood disorders

Ketogenic diet may be more beneficial for chronic conditions like schizoaffective disorder, schizophrenia, or bipolar disorder

  • Aim for blood ketone levels greater than 0.8 millimole for depression
  • Aim for blood ketone levels greater than 1.5 millimole for psychotic disorders and bipolar disorder

Long-​​standing use of ketogenic diet and fasting to treat epilepsy

Emerging data suggests that insulin resistance and impaired glucose metabolism are linked to chronic mental disorders

  • Applies to anxiety, depression, bipolar disorder, schizophrenia, and Alzheimer’s disease

Targeting insulin resistance and metabolic syndrome through dietary changes can improve mental health

  • For some, eliminating highly processed foods is enough
  • For others, a full ketogenic diet may be more beneficial

Ketogenic diet developed in 1921 by Dr. Russell Wilder at the Mayo Clinic to treat epilepsy

  • Based on the observation that fasting can stop seizures
  • Fasting causes shifts in metabolism, beneficial to human health
  • Mimics the fasting state to stop seizures long term

Early results of keto diet on epilepsy: 50% of patients became seizure-​​free, 35% had a 50% or greater reduction in seizure frequency

  • Resurrected in the 1970s at Johns Hopkins for treatment-​​resistant cases
  • 1/​​3 became seizure-​​free, 1/​​3 had a clinical benefit, 1/​​3 did not respond

Disorders that may benefit from the ketogenic diet:

  • Chronic depression
  • PTSD
  • Alcohol use disorder
  • Alzheimer’s disease
  • Bipolar disorder
  • Schizophrenia

Pilot study of 31 patients with treatment-​​resistant mental disorders

  • 100% had at least some improvement in symptoms
  • 46% had remission of illness
  • 64% were discharged on less medication

Ketogenic Diet’s Effects on the Brain

  • Influences neurotransmitter levels (glutamate, GABA, adenosine)
  • Changes calcium channel regulation and calcium levels
  • Alters gene expression and reduces brain inflammation

Ketogenic Diet’s Effects on the Brain

  • Changes the gut microbiome
  • Improves insulin resistance, lowers glucose and insulin levels
  • Stimulates mitophagy (removal of old/​​defective mitochondria) and mitochondrial biogenesis (creation of new mitochondria)

Epilepsy treatments are used in psychiatric patients every day

Using the ketogenic diet as a treatment for serious mental disorders is an extension of this established practice

Mitochondria have functions beyond energy production

  • Direct role in production, release, and regulation of neurotransmitters (serotonin, dopamine, glutamate, acetylcholine)
  • Provide building blocks and energy for neurotransmitter production
  • Directly related to release of neurotransmitters

Mitochondria are primary regulators of epigenetics

  • Responsible for expression of about 60% of genes in a cell
  • Manage calcium regulation and reactive oxygen species levels

Mitochondria play a role in human stress response

  • Increased cortisol, adrenaline, noradrenaline, inflammation, and gene expression
  • Involved in synthesis of steroid hormones (cortisol, estrogen, testosterone, progesterone)
  • Direct role in inflammation and immune response

Mitophagy helps remove old or defective mitochondria and replace them with new ones

Mitochondrial dysfunction is associated with aging and chronic mental disorders

Calorie restriction, fasting, and intermittent fasting can stimulate mitophagy and improve mitochondrial health

Ketogenic diet can be an effective treatment for mental health, but it doesn’t imply that carbohydrates are the cause

Mitochondrial dysfunction could be a primary driver of mental illness and metabolic illness, obesity epidemic

Sleep disruption, high levels of stress, and trauma impair mitochondrial functio

Alcohol, tobacco, and marijuana (THC) also impair mitochondrial function

  • THC directly affects mitochondria by binding to CB1 receptors, which are involved in memory impairment and lack of motivation

Studies show that adolescents who use marijuana have brain areas with high numbers of CB1 receptors that are atrophied or shrunk compared to healthy controls

Alcohol disrupts brain fuel usage, making alcohol more rewarding to drinkers

  • Also alters glucose metabolism, negatively affecting brain health

Study Examined the effects of a ketogenic diet on alcoholics during detox

  • Ketogenic diet group required fewer benzodiazepines and had fewer withdrawal symptoms
  • Reported fewer cravings for alcohol
  • Brain scans showed improved brain metabolism and reduced neuroinflammation
  • Suggests that correcting brain metabolic defects from chronic alcohol use may help with sobriety

People on a ketogenic diet should be cautious about alcohol consumption, as it could lead to higher blood alcohol levels and increased impairment

  • Study indicated that alcohol metabolism is different on a ketogenic diet

Researcher Stephen Cunnane’s studies show that ketone supplements can correct brain metabolism deficits in Alzheimer’s patients, at least short-term

  • Suggests a link between mitochondria and glucose metabolism in the brain

Research on ketone esters and salts in metabolically compromised brain cells

  • Noticed immediate changes in metabolism when given to patients on non-​​ketogenic diets

No clear evidence that exogenous ketones alone can control seizures or improve cognitive health. Ketogenic diet has multiple benefits beyond ketones

  • Lowering glucose levels, improving insulin signaling, and increasing mitochondrial biogenesis

Ketones as brain fuel

  • Some brain cells require glucose and cannot use ketones
  • Metabolically compromised cells may benefit from ketones 
    • Can help cells repair themselves when given enough energy

Ketogenic diet may help offset symptoms of Alzheimer’s and cognitive decline

  • Lack of controlled clinical trials exploring the role of ketogenic diet in Alzheimer’s treatment. Ongoing research needed.

No one-​​size-​​fits-​​all recommendation for dietary intervention

  • Assess patient’s symptoms, current diet, and willingness to change
  • Goal: induce a state of ketosis, mimicking fasting state
  • Can be achieved through fasting, intermittent fasting, or ketogenic diet


  • Carnivore diet: all-​​meat version, controversial but some swear by it
  • Vegetarian and vegan versions of the ketogenic diet also exist
  • Not about specific foods, but inducing ketosis

Patient’s current weight

  • Obese patients: focus on carbohydrate restriction, using body fat as a source
  • Thin patients: need to consume more fat to achieve ketosis

Hypomania can be a side effect of ketogenic diet in some cases.

Interactions between ketosis diets and the endocrine system are not well understood

  • Men generally have an easier time with the ketogenic diet than women
  • Female mice on a ketogenic diet had difficulty getting pregnant

Ketogenic diet may impact fertility in both men and women

  • Subcaloric diets can improve testosterone-​​estrogen ratios in obese men but may impair testosterone levels in non-​​obese men
  • Some women may experience hormonal changes that prevent pregnancy on a ketogenic diet
  • Other women have experienced increased fertility on a ketogenic diet


Science-​​based tools and supplements that push the needle.

Keto Diet for Mental Health Disorders


Ketogenic Diet Variations



We recommend using this distillation as a supplemental resource to the source material.

  • Dr. Chris Palmer: Diet & Nutrition for Mental Health

    Huberman Lab #99

    Dr. Palmer, Harvard psychiatrist, discusses the use of the ketogenic diet for mental health — depression, schizophrenia, epilepsy. Topics include marijuana, alcohol, ketones, mood, sleep, and fertility.

Full Notes

Support the Podcast