Mental Health

Behavioral and Mental Health Benefits of Fasting and Ketosis

Effects of ketones on the brain and heart, decreasing anxiety, tension, anger, confusion, and mood disturbances

Introduction

Even though it has been confidential in mainstream healthcare for a long time, many medical doctors, including psychiatrists and psychologists, have been using both short and long-term fasting in their practices as a therapeutic intervention and for longevity purposes.

As a result, the research on fasting proliferates. Fast-mimicking diets are hitting the mainstream.

I follow many medical doctors who advocate and practice fasting in their patients. For Examples, cardiologist Dr Pradip Jamnadas, nephrologist Dr Jason Fung, associate director of the Massachusetts General Hospital Weight Center, obesity medicine, internal medicine, and pediatrics Dr Angela Fitch, and the founder of TrueNorth Health Center, Dr Alan Goldhamer, are few to mention.

We now know that ketones are metabolically cleaner energy sources. This has been proved in several studies especially related to heart conditions and metabolic syndrome. For example, this study suggests ketosis induces a moderate uncoupling state and less oxidative efficiency compared to glucose oxidation.

For example, this study points out that “Although a number of important questions remain regarding the use of therapeutic ketosis and mechanism of action in heart failure (HF), current evidence suggests potential benefit, particularly in HF with reduced ejection fraction, with theoretical rationale for its use in HF with preserved ejection fraction. While early in its study and development, therapeutic ketosis across the spectrum of HF holds significant promise.”

My impetus to pen this article is to create awareness of short and long-term fasting and its by-product, ketosis, on the brain and the body, affecting mental health, mainly contributing to positive behavioral changes.

I introduced the cognitive effects of ketosis on the brain in this story: Rewiring Your Brain by Activating BDNF & β-Hydroxybutyrate: How to initiate neurogenesis and enhance cognitive reserves with simple lifestyle habits.

I also shared my experience on various aspects of fasting, ketogenic diet, OMAD, and ketosis in general in this article titled Why & How Eliza Lost 30 Pounds of Fat in Six Months? In this story, I focus on the behavioral and mental health aspects of fasting.

Fasting and ketosis are tightly related, as ketosis is a by-product of fasting. While fasting has many effects on our biology, health, and fitness, ketones as alternative energy sources affect the brain and impact our behavior. Brain metabolism during fasting has been researched since the 1960s.

Mental Health and Behavioral Aspects

Animals fed by ketones behave better. As confirmed by this study titled “Nutritional Ketosis Affects Metabolism and Behavior in Sprague-Dawley Rats in Both Control and Chronic Stress Environments.” The study points out that “nutritional ketosis may enhance cerebral energy metabolism and has received increased interest as a way to improve or preserve performance and resilience.”

Interestingly the study concluded that “endogenous ketosis improved behavioral and metabolic parameters associated with energy metabolism and cognition while ketone supplementation replicated the biochemical effects within the hippocampus but only showed modest effects on behavioral improvements.”

In addition to scientific papers, some practitioners use the ketogenic diet for mental health. For example, Psychiatrist Dr Christopher Palmer observed 25–40% of patients with mental health disorders, including personality and psychotic disorders, chronic depression, bipolar disorder, schizophrenia, anxiety, depression, and alcoholism, experience dramatic improvement on the ketogenic diet.

We need to understand endogenous and exogenous ketones. Endogenous ketones are produced by the body using tools such as fasting, a ketogenic diet, and intense exercise. Exogenous ketones are supplements that we ingest.

The body produces ketones when liver glycogen is consumed. We consume liver glycogen when we practice nutritional ketosis (high fat, low carbs diets), intermittent and prolonged fasting, and intense exercises such as high-intensity training, heavy weight lifting, and running.

Exogenous ketones are ketone salts manufactured through a chemical process. They are readily available without prescription and included in several sports drinks.

The efficiency of exogenous ketones is tested in animal studies. For example, this study in the International Journal of Cancer, confirms that “ketone supplementation decreased proliferation and viability of the VM-M3 cells grown in vitro, even in the presence of high glucose. Dietary ketone supplementation with BD and KE prolonged survival in VM-M3 mice with systemic metastatic cancer by 51 and 69%.”

Some of my friends in fitness circles use exogenous ketones to improve their performance. Even though they take these supplements for sports performance, they mention the positive behavioral effects. In addition to boosting their energy and motivation, they also feel a sense of calmness.

I don’t take exogenous ketones regularly. I try them occasionally. However, I stay in mild ketosis naturally and have deep ketosis occasionally, such as once every fortnight with a long-term fasting and zero carbs diet. We shouldn’t confuse deep ketosis with Diabetic Ketoacidosis, which is in order of magnitude when there are problems with the pancreas.

I witnessed behavioral changes after experiencing both mild and deep ketosis. As soon as noticing 1.5 nmol ketones in my bloodstream, I felt significant mental clarity and optimism. Fasting helped me cope with anhedonia efficiently: Unbearable Feeling of Anhedonia: How Can We Enjoy Life Again?

When I experienced more profound ketosis through extended fasting, like 3 to 7 days, I experienced substantial improvement in my behavior. For example, I felt calmer, more tolerant, and usually stayed in a flow state. I even experienced natural euphoria, as pointed out in this story: The Meaning of Euphoria in Mental Health and Spirituality.

Ketosis is only one aspect of fasting for behavioral changes. Even though fasting creates some irritability for beginners, it induces a sense of calmness and composure for fat-adapted individuals. When I am in a fasted state, I find myself in the flow state, remain motivated at work, and produce more than when I was in a fed state.

In the fasted state, I feel more mindful. My self-compassion and compassion for others are significantly enhanced. Living with empathy and compassion improves my physical and mental health. Therefore, I include intermittent fasting daily and prolonged fasting occasionally in my mental health first aid kit.

From a mental health perspective, this study points out that “recently, increasing experimental evidence demonstrated the effects of calorie restriction in the neuroendocrine system and in depression. Both basic and clinical investigations indicated that short-term calorie restriction might induce an antidepressant efficacy in depression, providing a novel avenue for treatment.”

According to this paper, “clinicians have found that fasting was frequently accompanied by an increased level of vigilance and a mood improvement, a subjective feeling of wellbeing, and sometimes of euphoria. Therapeutic fasting, following an established protocol, is safe and well-tolerated.”

Another study included 31 subjects, as reported in this paper titled Efficacy of fasting and calorie restriction (FCR) on mood and depression among aging men. The study observed significant decreases in tension, anger, confusion, and total mood disturbance and improvements in vigor in participants in the FCR group compared to the control group.

Conclusions

Fasting has both physical and mental health benefits. One of the benefits relates to ketosis as a by-product of fasting. Ketones provide an alternative source of energy to the brain. Many organs can use ketones as an energy source.

I have been fasting for decades successfully. Initially, it was difficult in the beginning; however, after being fat-adapted, it just turned out to be a pleasant lifestyle habit. Fasting is ideal for addressing metabolic syndrome and insulin resistance.

While eating one meal a day is an excellent lifestyle habit, I also practice extended fasting occasionally to gain additional benefits. Thus, I added fasting and ketosis to my 12 Bullet Proof Life Hacks That Helped Me Thrive.

Fasting is, of course, not for everyone. Healthy people usually tolerate intermittent fasting and even prolonged fasting.

However, it is always essential to obtain guidance from healthcare professionals before starting to fast. Even though intermittent fasting has more minor side effects, long-term fasting requires medical supervision due to its risks.

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