Interview by psychiatrist Efthimios Nathanailidis
The interview was conducted by Efi Zerva
Thousands
of years have passed since the time when people were foragers – hunters,
wandering here and there gathering seeds and fruits from trees and searching
the soil for bulbs and roots. They had made tools to hunt the animals and eat
their meat and hooks to fish in the rivers and the sea. Prehistoric humans ate
a ketogenic diet, i.e. lots of gizzards (they ate mammoths), fatty fish,
moderate protein and minimal carbohydrates. And our food may have changed a lot
since then, but our bodies are slightly different from those of the forager and
the hunter, with the result that the modern diet is linked to serious mental
and physical ailments.
The
ketogenic diet is a strict, mathematically calculated high-fat,
low-carbohydrate, normal-protein diet that directs the intermediate metabolism
to use fat as its primary energy source. It is used in the treatment of
resistant forms of childhood epilepsy. In recent years it has been associated
with the treatment of mental illness.
What is the
ketogenic diet? Is it nutrition or is it therapy?
Both of
them. It was originally created as a treatment for epilepsy by two American
doctors, Woodyatt and Wilder in 1922. Essentially, it was invented as a
treatment for metabolism. Because this particular treatment changes the process
of our body's metabolism and this change in metabolism brings about changes in
many other functions as well. For example, it affects glucose, insulin,
inflammatory markers, neurotransmitters, induces autophagy and mitophagy, (and
so many more that are being discovered every day) resulting in the treatment of
physical and mental disorders. There has been intensive research in the last
two decades that is constantly growing at an exponential rate in this field.
Because during the application of this treatment the catabolic part of the
metabolism, i.e. the total burns, increases a lot, that is why it is also used
as a diet and that is why it is particularly effective in rapid weight loss. It
is also used as a type of food, that is, as a way of life, by many people,
mainly for the multiple benefits that one obtains, but also as a prevention to
avoid future diseases that may appear. Peoples who eat like prehistoric people
(Maasai, Bushmen, Aborigines, Eskimos, etc.) eat ketogenically and their health
is incomparably better than the health of Western civilized people. The
ketogenic metabolic therapy or diet involves increased fat intake, moderate
protein and minimal carbohydrates. This is exactly how prehistoric people ate
before the agricultural revolution. Therefore, the human metabolism and genome
are adapted and function optimally in this way of eating. Man gets sick when he
eats foods that do not suit him because he has not evolved to adapt to them
(processed carbohydrates, sugar, seed oils, etc.) and soon heals when he is
deprived of them. Note that the fruits eaten by prehistoric people had minimal
amounts of carbohydrates and were not sweet like modern fruits. Their amount of
carbohydrates was increased by the crosses and modifications made to them by
the first growers.
Would you
like to tell us a little about the history of the ketogenic diet?
Throughout
the ancient world absolute abstinence from food, often also from water, for
several days, was used as a dominant therapeutic means, but also as an attempt
at purification and purification, with the ultimate goal of union with the
divine. Hippocrates used it a lot, as did the priests in Asklepiia. The same
happened to other peoples and to all ancient religions. We mention them
together because usually the role of the doctor and the priest were identical.
Let's also remember the words of Jesus Christ that "this demon can only
come out with prayer and fasting", when he was referring to the treatment
of a "possessed" patient.
Wilder
noticed that his poor, malnourished patients responded better to standard drug
treatments than his richer, fatter counterparts. So he suspected the potential
healing power of fasting (starvation-drought) and the ketogenic diet. Having
therefore studied the writings of Hippocrates, who mentioned that with absolute
abstinence from food for about 20 days epilepsy is completely cured, he decided
to apply it. He experimented with epileptic patients and cured them with
absolute fasting. He then put other epileptics on a ketogenic diet and had the
same and better results.
This is how
the ketogenic diet was popularized and widely used as a treatment for epilepsy
for the next two decades or so. With the discovery of the first anti-epileptic
drugs, the diet fell into decline. It started to be studied and used
experimentally by various universities in the last 3 decades again. This time
it became clear that it can be applied to many other conditions as well.
Various doctors have used it to treat several ailments in the past, such as the
Greek professor of pediatrics Constantinos Choremis, and some Italian
psychiatrists, but their work has remained obscure.
Could we
say that this particular diet mimics fasting?
Woodyatt
observed that in absolute fasting, i.e. complete deprivation of food, the body
will first consume the existing amounts of carbohydrates (glycogen) and
immediately after that it will begin to consume the stored fat. The burning of
adipose tissue produces ketones. He also noted that a diet high in fat and low
in carbohydrates will cause ketones to be produced. Therefore, the ketogenic
diet has the same metabolic effects as absolute fasting.
When did
the ketogenic diet become associated with the treatment of mental disorders?
It is
something that happened gradually over the course of many years and not on a
specific date, unlike the discovery of the diet that happened specifically in
1921. Perhaps the first of all who applied it was Konstantinos Choremis. Also,
the Greek professor of pediatric neurology Athanasios Evangeliou twenty years
ago thought and applied it to autistic children as well as to children with
intellectual disabilities and had excellent results. People who underwent the
diet to treat epilepsy reported improved mood and other mental benefits. The
same was reported by people undergoing the diet to lose weight. Some Italian
psychiatrists a few decades ago applied the diet to schizophrenic patients and
completely cured them with it. 10 years ago, some American psychiatristssubmitted a severely schizophrenic patient to this diet to lose weight, andwithin a few months she was completely cured of her schizophrenia. This was
also confirmed by Harvard professor Chris Palmer who, a few years ago, put a
person suffering from schizoaffective disorder on a diet to lose weight and was
finally completely cured of the serious mental illness. The ketogenic diet has
been found to be extremely effective in treating the more severe forms of
mental illness that do not respond to any of the usual pharmaceutical or other
treatments just like epilepsy. Palmer has extensively studied the phenomenon
and last year published the first book, entitled Brain Energy, in which he
analyzes the application of the ketogenic diet to psychiatric diseases as well
as the mechanisms of its therapeutic action. In his book he argues that mental
illnesses are essentially metabolic diseases, that is, they have the same
origin as obesity, heart disease, diabetes.
Many people
who implemented the diet reported their experiences on the Internet and thus a
significant body of knowledge was created that subsequently led psychiatrists
and neuroscientists to seriously deal with these phenomena.
What
happens to our brain when we don't eat?
We should
note that absolute fasting has been applied to the treatment of mental
disorders in patches and not always with good results. Often the side effects
are very serious and cause a great deterioration of the mental illness. That is
why it is not widely used as a treatment for mental disorders. With absolute
fasting, beneficial processes occur in the brain and the rest of the body, such
as the clearance of old and worn-out cells and the clearance of old and
worn-out mitochondria (mitochondria are the energy-producing organelles).
However, negative changes also occur. Perhaps the deprivation of vitamins and
trace elements strongly affects the brain and that is why this deterioration
that we mentioned occurs. For example zinc and vitamin B6 are absolutely
necessary as catalysts (coenzymes) for the production of serotonin, dopamine
and gaba. Amino acids such as tryptophan, tyrosine and phenylalanine are
precursors for the production of neurotransmitters and are therefore essential
for proper mental functioning. With absolute fasting (deprivation of food) the
brain is also deprived of all these necessary components. This is where the
ketogenic diet excels, which covers them.
For which diseases
is the ketogenic diet recommended?
It is
traditionally recommended in the treatment of refractory forms of childhood
epilepsy, that is, in cases where the epilepsy does not respond to multiple
drug treatments. From this we also understand how effective it is. Gradually
(and for now mainly research) it began to be recommended by many doctors and in
the treatment of type 2 diabetes, autoimmune diseases, gynecological problems,
Alzheimer's, Parkinson's, brain cancer and other forms of cancer alongside the
usual treatment , in mental illnesses and elsewhere. It is tested in more and
more diseases and seems to be effective in most of them. In my opinion, it
seems to be the greatest discovery in the history of medicine. That is why in
the future it is certain that it will become a common treatment just like
cortisone, aspirin and antibiotics.
What are
the disadvantages of the ketogenic diet?
The main
disadvantage is that strict discipline is required when following the diet and
therefore people with strong feelings of bulimia may not be able to implement
it. This is somewhat limited by the feeling of fullness that ketones bring to
the body. To put it simply, we often lose our appetite when introduced to the
diet, so it's quite easy to stick to it. People who are unstable and impulsive
have a hard time. Another big problem is the cost of the meals and the many
supplements that the patient has to take at the same time. Schizophrenics or
depressives who are unable to work and living on welfare cannot afford the cost
of this treatment. Also due to low vitality, motivation and abilities they may
have difficulty doing it properly (cooking, weighing, refusing to take
supplements). The diet also has some side effects, such as some electrolyte
disturbances, dehydration, vitamin deficiencies, etc., which are however easily
corrected with proper medical monitoring. And let's note that increased fat
consumption during the diet does not cause damage to the heart and blood
vessels as most people fear, the opposite is the case, the diet has a
beneficial and therapeutic effect on the cardiovascular system, however
paradoxical this may seem at first glance .
Do you
think that proper nutrition can protect us from disease?
An organism
that lacks the necessary trace elements and vitamins will definitely develop
diseases in the future. Hypovitaminosis is much more common in the western
world than is believed and is due to many factors. Nutrition with processed
foods, such as processed carbohydrates and bad quality fats (seed oils) causes
a variety of diseases such as inflammation, cancers, etc.
Our food is
full of heavy metals (fish) and other poisons used in crops (insecticides,
herbicides) and all of these reach and are stored in our bodies almost forever.
They also cause serious ailments, mental and physical. Every organism
evolutionarily adapts to its environment in order to survive. The same thing
happens with his diet. In other words, it adapts its metabolism and its genome
to the food provided to it by its environment. The human body to function
optimally must be nourished just like prehistoric man. Then he will be free
from the diseases of civilization. Here it is worth noting that great weight,
justifiably, is given to the role of the genome in the manifestation of
physical and mental disorders. In other words, there are pathological genes
that are responsible for the manifestation of diseases: schizophrenia genes,
depression genes, cancer genes, etc. Recent studies have shown that the
ketogenic diet has the unique power to deactivate the function of pathological
genes and thus allow the optimal functioning of healthy ones genes. Therefore,
proper nutrition can not only protect us but also heal us even from serious
diseases.
Just as Hippocrates said, "Food should
be your medicine and your medicine should be your food".
Read more about the ketogenic diet here
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