coma therapy to drive down circulating
glucose in the hope that this would improve
the symptoms of patients with a variety of
mental illnesses. They found that patients
with schizophrenia required much more
insulin to achieve the same effect. This
supports the notion that some sort of
insulin resistance is involved in schizo-
phrenia.
One hundred years later, researchers
using modern analytical tools and diag-
nostic criteria have reported that unmed-
icated patients experiencing their irst
episode of schizophrenia showed resistance
to the effects of insulin. This also suggests
that there might be a problem with glucose
metabolism in and beyond the brain.
This all makes a lot of sense. The brain
is an extremely energy-hungry organ that
uses a disproportionately high amount of
glucose compared with other parts of the
body, such as the heart and the muscles.
Glucose in the brain is converted into
chemical energy in the form of adenosine-
triphosphate (ATP) molecules in order to:
- maintain communication between nerve
cells; - synthesise the main excitatory neuro-
transmitter, glutamate; - synthesise the main inhibitory neuro-
transmitter, gamma-amino-butyric acid
(GABA); and - synthesise molecules that deal with toxic
free radicals produced by normal
neuronal activity.
If the utilisation and processing of
glucose is abnormal, neurons cannot func-
tion properly, will not communicate ei-
ciently and their connections may get
damaged due to high levels of toxic free
radicals. If these changes occur in brain
areas that underlie key cognitive functions
such as the prefrontal cortex, the symp-
toms of schizophrenia may emerge. These
include hallucinations, delusions, impaired
attentional and other cognitive functions.
Here Comes the Diet
If schizophrenia is driven, at least partly,
by abnormal glucose metabolism, we
hypothesised that we might be able to
normalise the disease process if we provide
energy sources in a way that circumvents
glucose metabolism. If this energy supply is
adequate, nerve cells would be able to
communicate properly through the synapse
and remove harmful free radicals more ei-
ciently.
One such roundabout way of feeding
nerve cells with molecules that can be used
for the production of energy and the key
neurotransmitters glutamate and GABA
is the use of fatty acids instead of glucose.
In the absence of glucose and other carbo-
16 | MAY 2016
The ketogenic diet is preferred by
bodybuilders who need a high energy
intake that doesn’t promote the
conversion of fat from excess
carbohydrates. Credit: tankist276/adobe
DO
Dairy:
✓ butter
✓ mayonnaise
✓ heavy whipping cream
✓ cheese
✓ eggs
Oils:
✓ olive oil
✓ canola oil
Meat:
✓ bacon
✓ chicken
✓ ground beef
✓ tuna
✓ frankfurts
✓ sausages, salami
Fruit & Veg:
✓ green vegetables
✓ lettuce
✓ spring onions
✓ mushrooms
✓ celeriac
✓ strawberries
✓ blueberries
✓ avocado
✓ macadamia nuts
✓ almonds
Artificial sweeteners
DON’T
Sugar and high-sugar content
products:
malt sugar
corn syrup
chocolate, lollies, etc.
ice cream, etc.
tropical fruits
grape and grape juice
fruit extracts and juices
carrot
Flour and high-starch content
products:
bread and related products
pasta
potato, fries, chips
rice
A Ketogenic Diet