Nutrition mental health

Can a Ketogenic Eating Pattern Help With Depression in College Students?

Depression is among one of the top mental health concerns among college students (1).  Today, studies suggest that nearly 50% of college students are now navigating some form of depression(2).

We conducted a study with OSU’s Dr. Jeff Volek from the Volek Low-Carbohydrate Laboratory in conducting the KIND (Ketogenic Intervention in Depression) study: a pilot evaluating the potential of a well-formulated ketogenic diet as an adjunctive therapy for college students living with major depressive disorder (3).

Here is what you need to know about a well-formulated ketogenic eating pattern:

  • This dietary intervention was originally developed at the Mayo Clinic in 1921 as a treatment for pediatric epilepsy and now has over a century of safety and efficacy data supporting its use in this population.
  • Numerous studies show the potential benefit of well-formulated ketogenic diets for a variety of physical health conditions. (4), with more studies ongoing.
  • Key studies from Stanford School of Medicine and Edinburgh University highlight the positive psychiatric effects of the ketogenic diet, supporting its potential as an exciting therapeutic option for various mental health conditions(5, 6).
  • A well-formulated ketogenic eating pattern (WFKD) is a nutritionist-guided, personalized eating pattern that uses whole foods such as fruits, vegetables, healthful fats, proteins and minerals in a manner that is low-carbohydrate and prioritizes healthful fats and proteins, which promotes ketone production. There is no calorie restriction. These ketones offer the brain an alternative energy source to glucose, and emerging research indicates this switch positively impacts both metabolic and mental health, providing new hope for people living with serious mental illness.

What was the study? (3)

  • We conducted a pilot study in 24 college students aged 18-30, diagnosed with major depressive disorder, BMI >/=20, and no eating disorder, pregnancy, or other contraindications, who are currently receiving treatment in the form of talk therapy and or medication (3).
  • The goal of the study was to assess whether college students with major depressive disorder could adhere to a nutritionist-guided, well-formulated ketogenic diet and what impact the diet could have on their depression symptoms and quality of life.
  • After baseline testing for mental and general health, participants were assisted in adopting a well-formulated ketogenic diet for 10-12 weeks. Nutritionist support was available throughout the study on an as-needed basis.

What were the results? (3)

  • WFKD was feasible: 

Most participants completed the study (67%)

7 out of 8 participants who dropped out did so for reasons unrelated to the diet

Participants were in ketosis the majority of the time (73%)

  • All participants who completed the study saw clinically significant improvements in depression as measured using validated instruments such as the Patient Health Questionnaire 9 (PHQ) and the Hamilton Depression Rating Scale (HDRS).
  • Participants experienced rapid, significant improvements in depressive symptoms:

2 weeks: 37% improvement (PHQ-9), near 2x increase in global wellness

6 weeks: 59% improvement (HDRS)

  • Final improvements in depression were robust:

69% improvement (PHQ-9)

71% improvement (HDRS)

Nearly a 3x improvement in WHO-5, a measure of global wellness 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

While the results are impressive, even more inspiring were the individual stories from participants in the study:

  • One participant shared: “After the second week, my depression symptoms were gone. They were gone” 
  • Another participant reported: “I felt great about myself, and I noticed that I would never really slip into those dark thoughts before I started the keto study.” 
  • Remarkably, some participants who were strong candidates for medication based on symptom severity before the study showed such improvements that they no longer met the criteria for medication by the end of the study.

What are some caveats and precautions?

  • This was a small study. To confidently apply these findings to a broader population, larger randomized controlled trials comparing this intervention to a control diet are needed.
  • Participants followed what is referred to as a “well-formulated ketogenic diet” consisting primarily of whole foods, unlike other mainstream versions of ketogenic diet, which may not yield such strong outcomes.
  • It is always best to implement a new mental health strategy under the care of a licensed healthcare provider.

What does this mean for you?

  • If you’re struggling with depression or even anxiety, it’s important to consider the impact what you do and don’t eat has on your mental well-being.
  • Our findings suggest that, for appropriately selected patients (See inclusion and exclusion criteria), a well-formulated ketogenic eating pattern can be a low-risk intervention that may complement existing mental health strategies to provide greater depression symptom relief, improve quality of life, and improve brain function.

The KIND study was funded by Baszucki Group, a non-profit aiming to deliver fundamental improvements in metabolic and mental health. Metabolic Mind is an education and resource platform created by the Baszucki family after their son recovered from a five-year battle with bipolar disorder using a therapeutic ketogenic diet. 

Want more strategies to support your mental health?

Visit Metabolic Mind’s website to learn more about metabolic psychiatry and well-formulated ketogenic eating pattern. Looking to get started with ketogenic therapy? Check out THINK+SMART, a free community-inspired framework that helps individuals employ metabolic therapies to improve mental health. 

 

By Ryan S Patel DO, FAPA
OSU-CCS Psychiatrist
Contact: patel.2350@osu.edu

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes.  With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References:

  1. American College Health Association. American College Health Association-National College Health Assessment III: Reference Group Executive Summary Spring 2025. Silver Spring, MD: American College Health Association; 2025.
  2. Luo MM, Hao M, Li XH, Liao J, Wu CM, Wang Q. Prevalence of depressive tendencies among college students and the influence of attributional styles on depressive tendencies in the post-pandemic era. Front Public Health. 2024 Jan 25;12:1326582. doi: 10.3389/fpubh.2024.1326582. PMID: 38333740; PMCID: PMC10850216.
  3. Decker, D.D., Patel, R., Cheavens, J. et al. A pilot study examining a ketogenic diet as an adjunct therapy in college students with major depressive disorder. Transl Psychiatry 15, 322 (2025). https://doi.org/10.1038/s41398-025-03544-8
  4. Masood W, Annamaraju P, Khan Suheb MZ, et al. Ketogenic Diet. [Updated 2023 Jun 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499830/
  5. Shebani Sethi, Diane Wakeham, Terence Ketter, Farnaz Hooshmand, Julia Bjornstad, Blair Richards, Eric Westman, Ronald M Krauss, Laura Saslow, Ketogenic Diet Intervention on Metabolic and Psychiatric Health in Bipolar and Schizophrenia: A Pilot Trial, Psychiatry Research,Volume 335, 2024, 115866, ISSN 0165-1781, https://doi.org/10.1016/j.psychres.2024.115866. (https://www.sciencedirect.com/science/article/pii/S0165178124001513)
  6. Campbell IH, Needham N, Grossi H, et al. A pilot study of a ketogenic diet in bipolar disorder: clinical, metabolic and magnetic resonance spectroscopy findings. BJPsych Open. 2025;11(2):e34. doi:10.1192/bjo.2024.841

Can omega 3’s improve sleep?

College students can take many steps in their everyday lives to improve their mental health, one of the main factors is sleep (1). A previous post looked at poor sleep and worsening stress levels (2).

Poor sleep in college students can also impact tension, irritability, depression, confusion, reduced life satisfaction, or poor academic performance (3).

Yet more than 75% of students report getting less than 8 hours of sleep on average on weeknights over the last 2 weeks according to the Fall 2024 ACHA-NCHA IIIb Reference Group survey of 33,763 college students across 48 institutions (4).

A recent study looked at of impact of omega 3s on sleep.

What was the study? (5)

  • This was a randomized, placebo-controlled, double-blinded, parallel-grouped study (5)
  • 66 healthy males and females, mean age 52.8 years (5)
  • Participants received 576 mg DHA and 284 mg EPA per day (n = 33), or corn oil (placebo group, n = 33), for 12 weeks (5)
  • Sleep was measured using a self reported scores (OSA-MA and POMS-2 tests) and objective sleep monitoring via a device (monitor that evaluates the sleep state by collecting breath, pulse, and body movement data) (5)
  • Blood omega 3 levels and dietary survey was also done.

What were the results? (5)

  • The study showed that 576 mg DHA and 284 mg EPA per day improved sleep quality (5)
  • Frequent dreaming also improved (5).
  • They theorized that the mechanism might be related to impact on serotonin and melatonin levels (5)

What are some caveats?

  • This is one of the first studies to show that low dose omega 3s can improve sleep quality (5).
  • This was a well designed randomized, double blind, placebo controlled, parallel grouped study with objective and subjective measures (5).
  • There are many other studies showing benefit from omega 3’s and sleep quality. (6)
  • While this study involved healthy participants, individuals with health conditions may need a higher dose of omega 3’s to find benefit (5).
  • Check with your health professional to ensure that Omega 3’s are appropriate for you as they may not be suitable for everyone.
  • Plant based omega 3’s may be an option for those who do not or cannot eat fish.
  • While this study was in middle aged adults (5) and a separate study found benefits in young adults (7) findings may not be generalizable to other populations with health conditions.
  • Further study in specific populations  with specific health conditions is needed.

 

Strategies to manage stress can be found here: https://u.osu.edu/emotionalfitness/2014/08/15/stress-and-what-to-do-about-it/

Strategies for sleep can be found here: https://u.osu.edu/emotionalfitness/2017/12/31/poor-sleep-and-poor-grades-might-go-together/

Please enter your email above if you want to be notified of future posts.

By Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

Contact: patel.2350@osu.edu

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes.  With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References:

  1. Patel R. Mental Health For College Students Chapter 7. Sleep strategies to improve mental health.
  2. https://u.osu.edu/emotionalfitness/?p=846
  3. Buboltz WC Jr, Brown F, Soper B. Sleep habits and patterns of college students: a preliminary study. J Am Coll Health. 2001 Nov;50(3):131-5. doi: 10.1080/07448480109596017. PMID: 11765249.
  4. American College Health Association. American College Health Association-National College Health Assessment III: Reference Group Executive Summary Fall 2024. Silver Spring, MD: American College Health Association; 2025.
  5. Yokoi-Shimizu, K., Yanagimoto, K., & Hayamizu, K. (2022). Effect of Docosahexaenoic Acid and Eicosapentaenoic Acid Supplementation on Sleep Quality in Healthy Subjects: A Randomized, Double-Blinded, Placebo-Controlled Trial. Nutrients, 14(19), 4136. https://doi.org/10.3390/nu14194136
  6. Dai Y., Liu J. Omega-3 long-chain polyunsaturated fatty acid and sleep: A systematic review and meta-analysis of randomized controlled trials and longitudinal studies. Nutr. Rev. 2021;79:847–868. doi: 10.1093/nutrit/nuaa103.
  7. Watanabe, N., Matsuoka, Y., Kumachi, M., Hamazaki, K., Horikoshi, M., & Furukawa, T. A. (2018). Omega-3 fatty acids for a better mental state in working populations – Happy Nurse Project: A 52-week randomized controlled trial. Journal of psychiatric research, 102, 72–80. https://doi.org/10.1016/j.jpsychires.2018.03.015

 

Breakfast foods and memory

Previous posts have discussed nutrition strategies for depression.  This study looked at breakfast consumption and subsequent performance on memory afterwards (1).

Who was studied? (1)

100  healthy college students

What was the intervention? (1)

A toasted sandwich of about 400 calories with high saturated fat and high sugar, did worse than a similar calorie toasted sandwich with lower saturated fat and low sugar; similar carbohydrate and high protein, about 30 grams vs 10grams).

What were the results? (1)

Just 4 days of a breakfast of high saturated fats and high sugars led to worse performance on memory tests taken after breakfast when compared to as higher protein, moderate carb, lower sugars and lower saturated fat breakfast.

The effect size of this change was significantly associated with the change in blood glucose across the experimental meals.

What does this mean for college students?

  • This study replicated what was initially seen in animal models, but this is just 1 small study and further study is needed.
  • According to this study, college students may remember their class material better if they consumed a breakfast that was high protein, moderate carbohydrate and lower in added sugars, lower in saturated fats.
  • More practically, it may be a good idea to become mindful of your mental performance after you eat various types of meals.
  • An optimized and personalized approach to nutrition can help with both physical and mental health (see resources below like nutrition coaching).

Any other resources to improve nutrition?

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By Ryan S Patel DO, FAPA ,OSU CCS Psychiatrist

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

Reference:

  1. Attuquayefio T, Stevenson RJ, Oaten MJ, Francis HM. A four-day Western-style dietary intervention causes reductions in hippocampal-dependent learning and memory and interoceptive sensitivity. PLoS One. 2017 Feb 23;12(2):e0172645. doi: 10.1371/journal.pone.0172645. PMID: 28231304; PMCID: PMC5322971.