A pilot study examining a ketogenic diet as an adjunct therapy in college students with major depressive disorder.
Level 4 - case-series / case-control
Single-arm pre-post pilot study without a control group
PubMed 40925905 · doi:10.1038/s41398-025-03544-8
What was done
A 10–12 week pilot intervention evaluated a ketogenic diet as an adjunct therapy in 24 college students with major depressive disorder receiving standard-of-care counseling and/or medication. The protocol included partial provision of ketogenic foods, frequent dietary counseling, and daily morning tracking of capillary R-beta-hydroxybutyrate. Primary outcomes were the Patient Health Questionnaire (PHQ-9) and Hamilton Rating Scale for Depression (HRSD). Additional outcomes included body composition, neurocognitive function, and blood hormonal and inflammatory markers.
What was found
Sixteen of 24 students completed the intervention (mean age 24 years). Nutritional ketosis (R-BHB > 0.5 mM) was achieved 73% of the time. Depressive symptoms decreased by 69% on the PHQ-9 and 71% on the HRSD (p < 0.001 for both), with improvements occurring within 2–6 weeks. Global well-being increased nearly 3-fold (p < 0.001). Participants lost body mass (-6.2%, p = 0.002) and fat mass (-13.0%, p < 0.001). Serum leptin decreased (-52%, p = 0.009), brain-derived neurotrophic factor increased (+32%, p = 0.029), and cognitive performance improved across several tasks.
Why it matters
This study provides preliminary feasibility data suggesting that an adjunctive ketogenic diet may reduce depressive symptoms and alter relevant metabolic and neurotrophic markers in young adults with depression.
Limits
The study lacked a control group, preventing distinction between diet effects, concurrent standard care, natural recovery, or placebo effects. The sample size was small (n = 24 enrolled, 16 completed), with a 33% dropout rate, and results in young college students may not generalize to wider clinical populations.
Cited by
- supports Dr. Jeff Volek published research demonstrating that nutritional ketosis can reduce symptoms of major depression.