You do not state why you are doing Keto. For some, it is a protocol to be used to address a variety of issues and once resolved, move to a less restrictive way of eating for others, they continue doing the keto diet as they fear falling back to their old patterns. Dr. Chris Palmer, is a psychiatrist, researcher, and expert in using the keto diet as a medical treatment FOR SOME treatment-resistant patients. He specializes in treatment-resistant mental health patients. Dr. Palmer
theorizes that there is a direct connection between metabolic health and mental health.
You are on a Keto forum, what do you think we are going to say? In todayâs world, you can have Ivy league doctors on either end of the food spectrum. Everyone has their own biases. Just because one doctor or researcher says so, does not mean it is the gospel. They all can produce a study that âprovesâ their way is best. Nonsense. It is impossible to design a study on what is the best way for humans to eat. Why? Not enough time and too many variables to control. Do what works for you. If it is mental health you are looking for, then speak to a psychiatrist and have them prescribe the proper medications that help.
Plant or meat based diets for mental health?
Iâve just gone back up and re-read the thread from the start.
I think 4:1 (or 80/20) can be useful in some circumstances. Iâve been reading a lot about therapeutic GKI levels, which is something that most here are not looking at - because for most people, itâs unnecessary.
But, I didnât start on 4:1. I think it would be incredibly difficult to start on 4:1. Going from standard diet to keto is often hard enough.
My path was: keto > carnivore > fat first carnivore > 80/20 carnivore - and that was over 2 and a half years.
I would suggest going keto and keeping to 20g of carb. Cut down dramatically on processed food and seed oils. Iâd choose meat/fish that are enjoyed, and pair them with added fat (butter, mayo, olive oil etc). Try to cut out sugar where possible. Personally, I found more success with cutting down on sugar when I also cut out sweetener - but other people find they canât cut out both.
Once keto eating is established, then if needed, you can start to look at ratios - sometimes you need to add much more fat than you think to a meal, but when increasing fat, increase slowly so as not to shock your system.
Rather than aiming for 4:1, you can monitor your glucose and ketones and see exactly what ratio is right for your body to achieve therapeutic GKI.
Eating a lower ratio might work, it depends on your body - but there are other ways, e.g. eating meals of different portion sizes, eating less or more frequently, fasting, intermittent fasting etc - these things all have a bearing.
For this reason, people following therapeutic GKI often test their glucose and ketones to see what is happening in their individual circumstances. I found that a useful measure, but it might also be unappealing to use a pin prick monitor.
Lots of people find mental health benefits with keto on lower ratios - so I think itâs worth getting onto keto and then slowly increasing fat as you go along, if needed. It might be that 2.5:1 is sufficient, and that would be a lot easier than 4:1.
(I keep saying you and your, but I realise itâs not you that youâre asking for.)
Now I start to lose the plot⌠I have read back. So the fat and carbs in grams are 4 times as much as protein, right? (Way, way more extreme where 80/20 as that is for calories and itâs about 2:1 in weight.)
Okay, I just ignored the carbs as one can easily go down to near zero 
Donât eat omelet with such a lot of carbs - or simply eat 0 carb for the rest of the day.
I honestly donât understand why only 6g carbs would be beneficial but itâs very much doable, even I had way lower-carb daysâŚ
6g carbs, 57g protein, 252g fat, yeah, this is one of the more extreme diets, it may work temporarily as the protein isnât THAT low (my body would disagree but it still enough for many people as far as I know), I am not sure that we can get all the nutrients longer term from this while feeling okay with over 90% fat (in calories)âŚ
Is it for temporal use for mental health?
Who advices SUCH a super high-fat diet?
Yeah, I keep saying 80/20 in my posts as thatâs what I was originally aiming for - but more often than not, my calories have been coming out at 90/10.
This week has been:
4 days at 4:1 and then the other 3 days at 3.9, 3.7 and 3.4 to 1.
Iâm sorry, I get easily confused. Just to clarify, when you write this, are you talking about 80%/20% of calories (which is about 1.78:1 by weight), or 80 g/20 g of weight (which is 90%:10% of calories)?
This one.
I clarified it above (sorry, I know Iâm not being super clear at the moment):
Okay, itâs clear now I usually see 80/20 for 80% calories from fat, I use it that way myself.
4:1 is still extreme⌠I couldnât do my usual 1-1.2:1 in the very beginning of carnivore, it made me nauseous⌠It didnât last long, maybe several days, I love fat but 2:1 was too high for me to enjoy for a very long time. But itâs not good for me anyway. 4:1 sounds better as that gives me a fat fast type day where I finally stop overeating protein (and fat too, interestingly). If I can pull that off. No mental reasons except when I go crazy looking at my macrosâŚ
I like experimenting anyway, it can be quite informative and helpful.
Thanks everyone for adding your perspectives. I do really appreciate this forum!
To quickly recap, my education and postings are to help my 21 year old who suffers from major depression and nothing we have tried so far (medications, therapy, ketamine, TMS, âŚ) has helped lift the depression. Not at all so far.
He has been in ketosis for two weeks now and itâs going alright. Itâs not an easy diet when you are used to and like carbsâŚ
I am going to transition to keto next week as well. To be there with him and give him support, but also to see if it would give me more energy and better sleep. Two things I could definitely use more of.
On the ratio. I get the limiting of carbs. But however you turn it you will have some carbs unless you only eat meat.
The bigger issue to get to 3:1 or 4:1 appears to be the protein angle. When you want to add more fat and eat more meat, you are also pushing up your total protein intake.
I am still learning here but that is kind where I am today.
Thank you again!
A little, yes (even with meat. I often eat liver, thatâs 10g carbs on some days). 6g is unusually low but doable if one eats close to carnivore and focus on meat and fat.
Indeed. Today I went for fat and it went well until I started to eat pork shoulder No problem, I am fine with my result but I got 77% fat, not 90. As pork shoulder may be fatty but not so very fatty as needed for 4:1. The properly fatty meat is my precious pork jowl with its 96-98% fat according to the label (I could buy the fattiest pork belly and cut most of the meat off tooâŚ). If you go for 90% fat, you shouldnât focus on fatty meat, you should focus on FAT. Either fat tissue with a tiny bit of meat for fun that I do (I didnât have it today, hence my lower fat percentage despite I added more added fat than I normally do) or just pure fat. I hardly can eat pure fat so I add some protein source but the result still may be fatty enough. I spread some tasty fat on my eggy sponge cakes (they are 100% egg and I can use more yolks than whites if I want but then I probably canât handle so much fat on it) and voila, 90% fat is no problem. I tried that today and it worked. The buns are a bit fatty too, 66% but it doesnât feel fatty so it handles a lot of fat without the result becoming gross, at least for me. Itâs nothing like eating a big piece of pure fat tissue or a stick of butter or two. No matter how tasty butter is, I wouldnât enjoy that.
Some creativity (and knowing what we may be able to handle) can help in situations like this.
Good luck!
That is how I discovered I had a gluten intolerance. Many years ago, when my daughter was 3, she was having asthma trouble and mood swings. I had read that wheat allergy could cause asthma trouble so we decided to give gluten-free a go to see if it improved her asthma symptoms. The entire family went gluten-free because we didnât think (especially for dealing with a three year old) it would be fair for the rest of us to eat gluten containing foods and then say to her, âSorry, you canât have this.â
Well, stopping gluten didnât help her asthma, but it totally got rid of her mood swings. Boy, was that a pleasant surprise! Turns out she had other symptoms that went away with removing gluten from her diet including morning stomach aches. They usually struck just before school so I thought she just didnât want to go to school. 
Anyway, both my husband and I noticed a whole host of improvements when we stopped eating gluten. Little things that I always thought, "Oh, thatâs just how it is. Itâs just my genetics since my parents have these problems, too "
I think it is great you will be following keto along with your son. It really will make it easier for him to have a buddy, and you may reap great benefits for yourself as well.
If your son/you can tolerate dairy, it is easy to up the fat content with butter. I save bacon fat and will dollop on an extra blob of bacon fat if something isnât fatty enough. I try to avoid most vegetable oils but I do use avocado and olive oils. There is mayonnaise made with avocado oil, so adding mayonnaise based sauces can add fat without adding protein. Olive oil and vinegar poured over greens is low carb but high in the fat. Also, look up recipes for fat bombs. They can be savory or sweet and can definitely help ease the transitioning when giving up desserts.
Wishing healing to your son.
Thank you! All very valid points. I am with you iâm not being able to really ingest that much pure fat. And I know my son is right there with me!
Plant based if you want guaranteed mental health, hormonal & metabolic problems.
We ate just meat for 300k years. Straying off our evolutionary past will cause issues.
I see keto as a fantastic stepping stone to carnivore.
Trying to cut down on carbs straight to 0 will be extremely hard. Thatâs where keto comes in handy. I did keto for 3~ months before I went carnivore.
Iâd recommend watching this legendâs videos for all things carnivore science:
https://www.youtube.com/@bart-kay
Hi Paul (and others) I have a follow-up question on this. Quick background: my 21 year old suffers from Major Depression with accompanying poor sleep and very low energy. So we are now trying keto for mental health (in line with Chris Palmer and Georgia Ede).
We have a nutritionist we use and she tells us that my son needs to have high ketones for keto to positively impact mental health. He initially had .8 to 1 (which he did for about 4 weeks); she told him to bring it up by focusing on much more fat vs protein (do a 2:1 diet). He is now (for last two weeks) ranging between 2.3 and 3.4 (measured 1 1/2 hours after a meal). So far - not change in his mental health nor energy level. My son also doesnât like the diet at all. Doesnât feel like he is feeling satiated and doesnât really like to eat all this fat. Can make his stomach feel a bit sick and off.
So we reached out to another nutritionist and he told us last night that A) if he isnât feeling satiated he likely has one or more of the foods he eats not agreeing with him B) he should entertain restricting his diet more and C) should consider going 100% cow or lamb meat (which is what this particular nutritionist apparently has been doing for 4 years, D) that this will work for everyone, as long as you get the particular Keto diet meal plan tuned in right for you.
Here are my questions related to that, for which I would greatly appreciate your perspectives:
- Does it resonate with you that not all keto diets are alike and that he is not having a positive impact because some foods he is eating are not agreeing with him? The nutritionist mentioned almonds as a potential inflammatory food.
- What is more important for mental health improvements? High ketones (which a 2:1 gives), or a narrower diet with a lot (or solely) meat, which will result in lower ketones since cow meat is typically 1:1 or around there?
- If you go so strict on meat only, wouldnât you lack the necessary dietary fibers?
- My son is really wanting answers on A) what ketone level he should shoot for as far as mental health benefits (if e.g. 1.5 is enough, that would allow him to add some foods he would enjoy more), and B) how long - on average - one should try keto to see if it is actually working on mental health
- Anyone have a good recommendation for a nutritionist that has experience with keto for mental health? I looked on the Georgia Ede list, but open to others.
I donât know how important the ketone level is for mental health issues. The people to follow on this are Dr. Chris Palmer at Harvard, and Dr. Georgia Ede at www.diagnosisdiet.com. (She may still be at Smith College; I donât know.)
For regular metabolic health, ketones above 0.5 are fine. (And sometimes even less, in the case of fat-adapted athletes.) It used to be thought that a ketogenic diet for epilepsy had to be almost entirely fat, but that provided inadequate protein and stunted the growth of some kids; fortunately, it has been shown that a more normal protein intake still allows the diet to be therapeutic.
As far as your son is concerned, you may need to tinker with the relative proportions of fat and protein. Because of their caloric values, a ratio of 1:1 by weight is 69:31 (fat:protein) by calories. Start there, and adjust. If heâs not getting enough protein, no amount of fat will satisfy him.
If heâs feeling nauseated, the problem is too much vegetable oil; so give him less of the vegetable oils and more butter, lard, tallow, bacon grease. The healthiest fats are saturated and mono-unsaturated (I know, exactly the opposite of what they tell us, right?).
All all-meat diet, particularly an all-beef diet, is the standard elimination diet, so you can try that. Add back other meats, first, one by one, and give the new food plenty of time to have an effect (if any).
As for your specific questions:
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Everybodyâs different, but the main thing about a keto diet for everyone is that it lowers insulin. That alone is often sufficient to see real changes. Some foods are inflammatory (dairy, certain nuts), which is where an elimination diet can help.
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You need fat in the diet or from adipose tissue to provide the raw material for ketones. Fats are too large to cross the blood-brain barrier, so the brain needs ketones, if weâre not going to give it lots of glucose and therefore lots of insulin. See above about the proportion of protein to fat. Youâll have to experiment. If your son feels he needs more protein, he should listen to his body and go with more protein.
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Dietary fibre is a myth. A lot of people find that it actually makes their bowels worse, not better. And the big benefit of fibre, which is supposed to be the butyrate produced by the intestinal bacterica, is supplanted by β-hydroxybutyrate, one of the three ketone bodies the liver produces. So donât worry about it. Note that the frequency of bowel movements drops considerably on an all-meat diet; this is perfectly normal. Constipation (which is defined as having to strain, not as infrequency of need) can usually be prevented by getting enough salt, so he should salt his food to taste. Fat also helps keep food moving through the bowel. It âgreases the skids,â so to speak.
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For depression, sorry, no one knows. Dr. Palmer may have some guesses. I believe his book is now available; you might want to check it out. Or Dr. Edeâs site might have some information. I know that for Alzheimerâs disease (and probably for epilepsy, too), you want ketones as high as you can get them, but I think keto can work for depression without worrying about ketone levels. However, you couild try exogenous ketone esters, and see if they prove worth the cost.
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We used to have a list on this site, but I donât believe itâs been updated for some time.
As another possibly thought. MCT oil directly raises ketones independent of the rest of the diet. They do not work for everyone, and I have little experience so I am not the best resource, but I know many do use them to increase ketone levels while allowing for more flexibility in the food choices.
If you can buy very fatty meats, he could still get the level of fat desired from just meat without to much protein (which does indeed lower ketone levels as compared to higher fat). I am currently doing a carnivore OMAD with higher fat compared to last year. Previously ketones between 0.1 to 0.5 range for the day. Now 0.5-2.0 range with much less protein and 80% fat. Point being I could modify more fat to get higher ketones and still be eating just meat.
Thank you as always, Paul! Very helpful insights.
I have read Chris Palmerâs book. He mentions needing higher ketones for mental health, but I donât believe he goes into specifics. And he does not go into detail on ketogenic diets either. Which he says upfront - not a keto book, but rather a scientific explanation of what is happening when we feed mitochondria the right fuel.
Good to know on the dietary fibers. On the ratio, his nutritionist was suggesting he go up to a 2:1. Which is what he has been trying to solve for. As you said, a 1:1 by weight can be 69:31 calorically. But with her suggesting a 2:1 by weight he cut out the chicken he was eating since itâs too high in protein vs fat (in weight).
He is not a big meat eater. And I am sure the idea of supplementing with lard and bacon fat does not appeal to him.
I hadnât heard of ketone esters. Not sure if that could help for mental health.
Thanks for the response! Yes he is taking MCT and I am sure that helps in pushing ketones up. He has been getting 2.5 to 3.4. Thatâs pretty high. In fact, we are wondering if it would make a difference to lower it a bit since it would make his diet a bit easier. And if we introduce beef it will since most beef has a weight ratio of 1:1 or maybe slightly higher.
Itâs ketones in a pretty available form, better than ketone salts, from what I understand. Normally, we consider exogenous ketones to be a waste of money, but there are certain situations where the extra ketones can be useful, and brain function is one of them.
MCT oil is fatty acids that get turned into ketones, whereas exogenous ketones are already ketones and donât need to be converted. If MCT oilâor any other fat sourceâis good because they get turned into ketones, then actual ketones ought to be good, as well. (Ketones are partially metabolised fatty acids, in the same way as charcoal is partially burnt wood.)
You donât need to add extra lard and bacon fat; I was suggesting using them and butter to cook with, instead of supposedly âheart-healthyâ industrial seed oils. These oils (soybean, cottonseed, sunflower, safflower, corn, canola, etc.) are bad for us, for a number of reasons.