Does a Ketogenic Diet Help with Anxiety?
Anxiety disorders are the most common mental illness in the United States, affecting 40 million adults every year, according to the Anxiety and Depression Association of America. Generalized anxiety disorder (GAD) affects 6.8 million adults, and 6 million adults are dealing with panic disorder (PD). [1]
While medication is helpful for many people, others choose not to use it or don’t respond well. It’s no secret that a ketogenic diet has long been used therapeutically for obesity, epilepsy, Alzheimer’s, cognitive function, and inflammatory disorders, but can a ketogenic diet help with anxiety? Let’s look at the anecdotal and scientific evidence.
What Is Anxiety?
Anxiety is an emotion or feeling of turmoil, discomfort, and unease, the sense that something isn’t right or something bad could happen in an instant at any time. Anxiety is a normal part of the fight-and-flight response to a stressful event, like a new job interview or an academic test in the modern world.
Occasional anxiety is normal, particularly during periods of change or uncertainty. Sometimes anxiety can motivate you to make necessary difficult decisions or alert you to something that isn’t right or warrants attention.
Frequent and/or severe anxiety, social anxiety, and panic attacks are another story, and they can have devastating consequences in your daily life. If your anxiety persists, worsens, and doesn’t go away after the short-term stressor, you might have an anxiety disorder. An anxiety disorder is usually characterized by excessive, worrisome thoughts about numerous parts of life persisting for six months or longer.
Some people have anxiety over being on time, fitting in with their colleagues or peers, or living up to certain expectations. Others obsess over potential catastrophic events like nuclear war.
Symptoms of anxiety could include:
- Fatigue
- Tense muscles
- Feeling wired or restless
- Feeling overly alert
- Sweating
- Constant worry
- Difficulty sleeping
- Irritability
- Difficulty concentrating
Anxiety disorders might be influenced by culture, the environment, toxicity, and brain chemistry. People who had a troubled childhood or lived through a negative or traumatic event are more likely to develop anxiety disorders. [2]
Untreated anxiety can interfere with your life goals and lead to complications, such as:
- Headaches and migraines
- Depression
- Chronic pain
- Insomnia
- Illness
- Digestive problems
- Cardiovascular issues
Fortunately, you can reduce your anxiety by making powerful lifestyle changes such as switching to a nutritious keto diet.
Factors That Affect Anxiety Levels
There are lots of lifestyle, nutrition, and even genetic factors that influence feelings of anxiety. Here are some of the biggest ones.
GABA
GABA is your brain’s primary calming neurotransmitter. It puts you at ease and helps you feel everything is okay. Anti-anxiety medications like Xanax and Valium increase GABA activity, which calms your brain. Glutamate is your brain’s excitatory neurotransmitter. An imbalance of these neurotransmitters and a lack of GABA can cause or accelerate anxiety. Inflammation, stress, and obesity can also cause or worsen these brain chemical imbalances. [3] [4]
When you’re in ketosis, your body uses ketones as fuel. Your body naturally produces ketones when you’re on a high-fat, low-carb diet, and you can also take ketone supplements. A popular ketone supplement is beta-hydroxybutyrate (BHB), which raises GABA levels in your brain and increases the expression of brain-derived neurotrophic factor (BDNF). [5] [6]
Your brain repairs itself and creates new connections using BDNF. Elevated GABA and BDNF calm down brain activity and protect against depression and anxiety. [7] [8] The ketone beta-hydroxybutyrate could improve anxiety by reducing brain inflammation. [9]
You can also raise your ketone levels with medium-chain triglycerides (MCTs)—fatty acids in powder or oil form typically derived from coconuts. Your body easily uses these MCTs to fuel your brain with clean energy. When animals ate MCTs, the research showed a significant reduction in anxious behavior. [10] Many keto dieters supplement with MCTs and cook with coconut oil.
Inflammation
People dealing with frequent anxiety tend to have higher levels of inflammation in their bodies, which also increases the risk of cardiovascular disease. Inflammation is involved with a range of chronic conditions and autoimmune diseases. [11]
The ketogenic diet has been shown to reduce inflammation, particularly if you’re eating a well-formulated diet high in nutritious whole foods.
Serotonin
Increasing serotonin can also reduce anxiety. Serotonin is a feel-good neurotransmitter that sends signals between nerve cells and enables you to feel calm and relaxed. Low serotonin is linked to weight gain, depression, sleep disorders, and anxiety. Serotonin can also be converted into the important sleep hormone, melatonin. Low serotonin usually means trouble sleeping, too, which can worsen anxiety.
Your body produces and uses the amino acid 5-hydroxytryptophan (5-HTP) to make serotonin. To make 5-HTP, your body needs the amino acid tryptophan, which is found in various foods, including seafood, meats, eggs, and seeds. These tryptophan-containing foods are commonly consumed as part of a healthy, balanced ketogenic diet. If you’re not getting enough tryptophan from natural whole-food sources, you could be lacking in serotonin and those feel-good chemicals.
Serotonin is mostly produced in your gut, so if you have digestive issues and your gut isn’t functioning properly, you might end up feeling more anxious.
Problem with Sugar
Not only is a high-sugar diet inflammatory, but it also contributes to anxiety by altering your gut bacteria. Your gut bacteria, or microbiome, is crucial for optimal health, and these bacteria have a direct communication highway to your brain. Your gut bacteria actually make neurotransmitters like GABA and glutamate that can influence how anxious you might feel. [12] [13]
Fried and processed foods, sugary products, and refined grains are the staples of the standard Western diet, but they’ve been associated with heightened anxiety. [14]
High-carb diets also lead to insulin resistance—a condition linked to obesity, metabolic syndrome, and type 2 diabetes. Insulin resistance in brain cells correlates with heightened anxiety levels. A ketogenic diet is effective for reversing insulin resistance and improving metabolism. [15]
Food Allergies and Sensitivities
Food sensitivities can also cause anxiety, and there could be a delayed reaction for up to 72 hours. You might eat gluten on Wednesday and have a migraine on Friday. Many people don’t even know they have a food sensitivity causing their headaches, irritability, or anxiousness. [17] [18]
Eating problem foods activates your immune system, which can start attacking your own body, triggering inflammation. Inflammation of the brain is a key cause of anxiety.
Food sensitivities or intolerances mean that you can’t properly break down or digest the food or the food irritates your digestive system. A full-blown food allergy is more serious, and you need to avoid the food entirely to prevent possible severe and life-threatening reactions like anaphylactic shock.
Among the most prevalent food sensitivities and allergies are gluten, wheat, soy, peanuts, eggs, and the lactose in dairy and milk products. These common allergens are also widely used and cheaply available. Genetic components might play a role in food allergies and sensitivities.
Autoimmune disorders like multiple sclerosis and rheumatoid arthritis also cause brain inflammation that could trigger anxiety. [18]
How Does Keto Help Anxiety?
Going keto has positive effects on your nervous system and brain and could relieve anxiety in various ways. In mounting scientific literature, the keto diet has successfully improved mood disorders, including depression. [19]
In addition to removing or minimizing inflammatory foods that trigger anxiety (such as sugar and refined carbs), going keto improves anxiety by:
- Lowering insulin
- Stabilizing blood sugar
- Lowering inflammation
- Reducing oxidative stress
- Balancing neurotransmitters
Most keto diets include plenty of tryptophan-rich foods that help you produce serotonin — your feel-good neurotransmitter that relieves anxiety.
Because ketogenic diets kick sugar to the curb, the health of the gut microbiome (friendly bacteria) improves. Eating excess sugar feeds opportunistic bacteria in your gut, and the good bacteria start dying off over time. You need that good bacteria to produce those feel-good neurotransmitters like serotonin, so you feel less anxious.
Keto is also one of the most effective ways to lose weight and keep it off. Overweight people who lose weight usually experience a drastic drop in anxiety. [20]
Indirect research, anecdotal evidence, and animal research all suggest that a keto diet could make you less anxious, but more human studies are necessary to understand further how a ketogenic diet could relieve anxiety.
Check out Jennifer’s story of defeating anxiety and anger with keto here at Ketogenic.com.
Have you dealt with anxiety? How did going keto affect your anxiety? Share your stories and diet tips with the community here at Ketogenic.com.
References
Anxiety and Depression Association of America (ADAA). Anxiety Disorders Facts & Statistics. Facts & Statistics | Anxiety and Depression Association of America, ADAA
Grinde, B. (2005). An approach to the prevention of anxiety-related disorders based on evolutionary medicine. Prev Med, 40(6), 904-9. DOI: 10.1016/j.ypmed.2004.08.001
Salim, S., Chugh, G., & Asghar, M. (2012). Inflammation in anxiety. Adv Protein Chem Struct Biol, DOI: 10.1016/B978-0-12-398314-5.00001-5
Michopoulos, V., Powers, A., Gillespie, C. F., Ressler, K. J., & Jovanovic, T. (2017). Inflammation in fear- and anxiety- based disorders: PTSD, GAD, and Beyond. Neuropsychopharmacology, 42(1), 254-270. DOI: 10.1038/npp.2016.146
Hu, E., Du, H., Zhu, X., Wang, L., Shang, S., Wu, X., Lu, H., & Lu, X. (2018). Beta-hydroxybutyrate promotes the expression of BDNF in hippocampal neurons under adequate glucose supply. Neuroscience, DOI: 10.1016/j.neuroscience.2018.06.036
Paoli, A,. Bosco, G., Camporesi, E. M., & Mangar, D. (2015). Ketosis, ketogenic diet, and food intake control: A complex relationship. Front Psychol, DOI: 10.3389/fpsyg.2015.00027
Martinowich, K., Manji, H., & Lu, B. (2007). New insights into BDNF function in depression and anxiety. Nat Neurosci, 10(9), 1089-93. DOI: 10.1038/nn1971
Mohler, H. (2012). The GABA system in anxiety and depression and its therapeutic potential. Neuropharmacology, 62(1), 42-53. DOI: 10.1016/j.neuropharm.2011.08.040
Yamanashi, T., Iwata, M., Kamiya, N., Tsunetomi, K., Kajitani, N., Wada, N., Litsuka, T..Kaneko, K. (2017). Beta-hydroxybutyrate, an endogenic NLRP3 inflammasome inhibitor, attenuates stress-induced behavioral and inflammatory responses. Sci Rep, DOI: 10.1038/s41598-017-08055-1
Hollis, F., Mitchell, E. S., Canto, C., Wang, D., & Sandi, C. (2018). Medium chain triglyceride diet reduces anxiety-like behaviors and enhances social competitiveness in rats. Neuropharmacology, DOI: 10.1016/j.neuropharm.2018.06.017
Renna, M. E., O’Toole, M. S., Spaeth, P. E., Lekander, M., & Mennin, D. S. (2018). The association between anxiety, traumatic stress, and obsessive-compulsive disorders and chronic inflammation: A systematic review and meta-analysis. Depress Anxiety, 35(11), 1081-1094. DOI: 10.1002/da.22790
Malan-Muller, S., Valles-Colomer, M., Raes, J., Lowry, C. A., Seedat, S., & Hemmings, S. M. J. (2018). The gut microbiome and mental health: Implications for anxiety- and trauma-related disorders. OMICS, DOI: 10.1089/omi.2017.0077
Foster, J. A., & Neufeld, K-A. M. (2013). Gut-brain axis: How the microbiome influences anxiety and depression. Trends Neurosci, 36(5), 305-12. DOI: 10.1016/j.tins.2013.01.005
Jacka, F. N., Pasco, J. A., Mykletun, A., Williams, L. J., Hodge, A. M., O’Reilly, S. L…Berk, M. (2010). Association of Western and traditional diets with depression and anxiety in women. American Journal of Psychiatry, 167(3), 305-11. DOI: 10.1176/appi.ajp.2009.09060881
Thota, P., Perez-Lopez, F. R., Benites-Zapata, V. A., Pasupuleti, V., & Hernandez, A. V. (2017). Obesity-related insulin resistance in adolescents: A systematic review and meta-analysis of observational studies. Gynecol Endocrinol, DOI: 10.1080/09513590.2016.1273897
Shaker, M. S., Schwartz, J., & Ferguson, M. (2017). An update on the impact of food allergy on anxiety and quality of life. Curr Opin Pediatr, DOI: 10.1097/MOP.0000000000000509
Losurdo, G., Principi, M., Lannone, A., Amoruso, A., Lerardi, E., Leo, A. D., & Barone, M. (2018). Extra-intestinal manifestations of non-celiac gluten sensitivity: An expanding paradigm. World J Gastroenterol, 24(14), 1521-1530. DOI: 10.3748/wjg.v24.i14.1521
Salim, S. (2017). Oxidative stress and the central nervous system. J Pharmacol Exp Ther, DOI: 10.1124/jpet.116.237503
Brietzke, E., Mansur, R. B., Subramaniapillai, M., Balanza-Martinez, V., Vinberg, M., Gonzalez-Pinto, A…McIntyre, R. S. (2018). Ketogenic diet as a metabolic therapy for mood disorders: Evidence and developments. Neurosci Biobehav Rev, DOI: 10.1016/j.neubiorev.2018.07.020
Paoli, A., Rubini, A., Volek, J. S., & Grimaldi, K. A. (2013). Beyond weight loss: A review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets. European Journal of Clinical Nutrition, DOI: 10.1038/ejcn.2013.116
