Interest in the ketogenic diet has exploded over the past decade—not just for weight management or metabolic health, but increasingly for its potential impact on the brain. A newly published systematic review and meta-analysis in JAMA Psychiatry adds meaningful clarity to this conversation, examining whether ketogenic or very low-carbohydrate diets can influence symptoms of depression and anxiety.

What the Study Looked At

Researchers analyzed 50 studies involving over 41,000 adults across a wide range of clinical and nonclinical populations. The review included randomized controlled trials, quasi-experimental studies, and case reports, allowing a comprehensive look at how ketogenic interventions may affect mental health.

1. Ketogenic Diets Show Modest Benefits for Depression

Across randomized trials, ketogenic diets produced small to medium reductions in depressive symptoms. Notably:

• Greater benefits appeared when participants achieved measurable ketosis, confirmed through biochemical markers.
• Very low-carbohydrate versions of the diet tended to have stronger effects.
• Non-obese participants experienced more improvement than obese participants.
• When compared to high-carbohydrate control diets, the positive effects weakened.

Quasi-experimental studies—although less rigorous—also showed moderate improvements in depression over time.
What this suggests: Nutritional ketosis may play a role in mood regulation, though the exact biological mechanisms require more investigation.

2. Evidence for Anxiety Is Less Clear

The findings for anxiety were mixed:

Quasi-experimental studies suggested some within-group reductions in anxiety, but these cannot confirm a true treatment effect.

Randomized trials found no significant improvements in anxiety symptoms.
The current evidence isn’t strong enough to claim that ketogenic diets reliably reduce anxiety.

3. Case Reports Show Promise for Severe Mood and Psychotic Disorders

While limited and anecdotal, several case reports described:

• Improved mood stability in bipolar disorder
• Reduction in psychotic symptoms in schizophrenia

These findings highlight the possibility of therapeutic benefit, but they are far from definitive.

So—Should You Try a Ketogenic Diet for Mental Health?

The authors caution against jumping to conclusions. While the data on depression is encouraging, studies varied widely in design, quality, and duration. Follow-up periods were generally short, and controlled trials remain limited.

However, the review does support further research into ketogenic diets as a potential adjunctive strategy—not a replacement for standard mental-health treatments.

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✅ Final Takeaway
This new meta-analysis contributes valuable evidence to a growing field. The key takeaway: ketogenic diets may modestly improve depressive symptoms, but evidence for anxiety remains inconsistent. Anyone considering dietary changes for mental health should do so under the guidance of a healthcare professional, especially because ketogenic diets are restrictive and may not suit everyone.

If future research continues to point in a positive direction, the ketogenic approach could become a meaningful tool in the broader mental-health toolkit.

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