A Metabolic and Nutritional Approach to Mental Health – References

Georgia Ede

Current: Nutritional and Metabolic Psychiatrist, Consultant, Researcher, Speaker, and Author

Past: Harvard University, Smith College

Dr. Georgia Ede is a pioneering researcher, author, educator, speaker, and globally recognized expert in nutritional and metabolic psychiatry. Her

Learn more
References

A Metabolic and Nutritional Approach to Mental Health – References

  1. Mental Disorder. Fact Sheet, World Health Organization. Updated June 2, 2022. https://www.who.int/news-room/fact-sheets/detail/mental-disorders; Mental Health By the Numbers. National Alliance on Mental Illness. Updated April 2023. https://www.nami.org/about-mental-illness/mental-health-by-the-numbers/ 
  2. Mental Health: Burden. World Health Organization. Published December 19, 2019. https://www.who.int/health-topics/mental-health. 
  3. UNICEF Innocenti. Worlds of Influence: Understanding What Shapes Child Well-Being in Rich Countries. UNICEF Office of Research; 2020. Innocenti Report Card 16. https://www.unicef.org 
  4. Child and adolescent mental health. In 2022 National Healthcare Quality and Disparities Report. Agency for Healthcare Research and Quality (US); 2022. Report No.: 22(23)-0030. https://www.ncbi.nlm.nih.gov/books/NBK587174/ 
  5. Mental illness. National Institute of Mental Health. Last Updated September 2004. https://www.nimh.nih.gov/health/statistics/suicide 
  6. Zeidan J, Fombonne E, Scorah J, et al. Global prevalence of autism: A systematic review update. Autism Res. 2022;15(5):778-790. doi:10.1002/aur.2696; Talantseva OI, Romanova RS, Shurdova EM, et al. The global prevalence of autism spectrum disorder: A three-level meta-analysis. Front Psychiatry. 2023;14:1071181. Published 2023 Feb 9. doi:10.3389/fpsyt.2023.1071181; 
  7. Abdelnour E, Jansen MO, Gold JA. ADHD diagnostic trends: increased recognition or overdiagnosis?. Mo Med. 2022;119(5):467-473
  8. Ayano G, Demelash S, Gizachew Y, Tsegay L, Alati R. The global prevalence of attention deficit hyperactivity disorder in children and adolescents: an umbrella review of meta-analyses. J Affect Disord. 2023;339:860-866. doi:10.1016/j.jad.2023.07.071
  9. Gunja MZ, Gumas ED, Reginald D. Williams RD II. Mental health needs in the U.S. compared to nine other countries. The Commonwealth Fund. May 31, 2024. https://www.commonwealthfund.org/publications/2024/may/mental-health-needs-us-compared-nine-other-countries 
  10. Alzheimer’s Association. 2024 Alzheimer’s Disease Facts and Figures. Alzheimers Dement 2024;20(5). https://www.alz.org/getmedia/76e51bb6-c003-4d84-8019-e0779d8c4e8d/alzheimers-facts-and-figures.pdf 
  11. Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021 and 2022. Table 6.35B. SAMHSA; 2023; Modi H, Orgera K, Grover A. Exploring Barriers to Mental Health Care in the U.S. AAMC; 2022. https://doi.org/10.15766/rai_a3ewcf9p 
  12. Wang S, Li Q, Lu J, et al. Treatment rates for mental disorders among children and adolescents: a systematic review and meta-analysis. JAMA Netw Open. 2023;6(10):e2338174. doi:10.1001/jamanetworkopen.2023.38174
  13. Mental health by the numbers. NAMI. Updated April 2023. https://www.nami.org/about-mental-illness/mental-health-by-the-numbers/ 
  14. Abramson B, Boerma J, Tsyvinski A. Macroeconomics of mental health. National Bureau of Economic Research; 2024. Working paper No. 32354 doi:10.3386/w32354
  15. Zablotsky B, Terlizzi EP. Mental health treatment among children aged 5–17 years: United States, 2019. U.S. Department of Health and Human Services; September 2020. NCHS Data Brief No. 381. https://www.cdc.gov/nchs/data/databriefs/db381-H.pdf 
  16. Terlizzi EP, Norris T. Mental health treatment among adults: United States, 2020. U.S. Department of Health and Human Services; 2021. National Center for Health Statistics Data Brief No. 419. https://www.cdc.gov/nchs/data/databriefs/db419.pdf 
  17. Chen, M-H, Huang, K-L, Hsu, J-W, Tsai, S-J. Treatment-resistant attention-deficit hyperactivity disorder: clinical significance, concept, and management. Taiwan J Psychiatry. 2019;33(2):66-75. doi: 10.4103/TPSY.TPSY_14_19
  18. McCormack J, Korownyk C. Effectiveness of antidepressants. BMJ. 2018;360:k1073. doi:10.1136/bmj.k1073
  19. Ahn SW, Baek JH, Yang SY, et al. Long-term response to mood stabilizer treatment and its clinical correlates in patients with bipolar disorders: a retrospective observational study. Int J Bipolar Disord. 2017;5(1):24. doi:10.1186/s40345-017-0093-5
  20. Perlis RH, Ostacher MJ, Patel JK, et al. Predictors of recurrence in bipolar disorder: primary outcomes from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Am J Psychiatry. 2006;163(2):217-224. doi:10.1176/appi.ajp.163.2.217
  21. Leucht S, Leucht C, Huhn M, et al. Sixty years of placebo-controlled antipsychotic drug trials in acute schizophrenia: systematic review, Bayesian meta-analysis, and meta-regression of efficacy predictors. Am J Psychiatry. 2017;174(10):927-942. doi:10.1176/appi.ajp.2017.16121358
  22. Marcus SC, Zummo J, Pettit AR, Stoddard J, Doshi JA. Antipsychotic adherence and rehospitalization in schizophrenia patients receiving oral versus long-acting injectable antipsychotics following hospital discharge. J Manag Care Spec Pharm. (2015) 21:754–68. doi: 10.18553/jmcp.2015.21.9.754
  23. Shahidullah JD, Roberts H, Parkhurst J, Ballard R, Mautone JA, Carlson JS. State of the evidence for use of psychotropic medications in school-age youth. Children (Basel). 2023;10(9):1454. doi:10.3390/children10091454
  24. Morris G, Puri BK, Carvalho A, et al. induced ketosis as a treatment for neuroprogressive disorders: food for thought?. Int J Neuropsychopharmacol. 2020;23(6):366-384. doi:10.1093/ijnp/pyaa008
  25. Federation of American Societies for Experimental Biology. Highly processed foods dominate U.S. grocery purchases. ScienceDaily, March 29, 2015, https://www.sciencedaily.com/releases/2015/03/150329141017.htm.
  26. Amick KA, Mahapatra G, Gao Z, et al. Plasma glycocholic acid and linoleic acid identified as potential mediators of mitochondrial bioenergetics in Alzheimer’s dementia. Front Aging Neurosci. 2022;14:954090. doi:10.3389/fnagi.2022.954090; Schönfeld P, Reiser G. Why does brain metabolism not favor burning of fatty acids to provide energy? Reflections on disadvantages of the use of free fatty acids as fuel for brain. J Cereb Blood Flow Metab. 2013;33(10):1493-1499. doi:10.1038/jcbfm.2013.128
  27. Monnier L, Mas E, Ginet C, et al. Activation of oxidative stress by acute glucose fluctuations compared with sustained chronic hyperglycemia in patients with type 2 diabetes. JAMA. 2006;295(14):1681-1687. doi:10.1001/jama.295.14.1681
  28. Fujigaki H, Yamamoto Y, Saito K. L-Tryptophan-kynurenine pathway enzymes are therapeutic target for neuropsychiatric diseases: focus on cell type differences. Neuropharmacology. 2017;112(Pt B):264-274. doi:10.1016/j. neuropharm.2016.01.011; Stone TW, Darlington LG. The kynurenine pathway as a therapeutic target in cognitive and neurodegenerative disorders. Br J Pharmacol. 2013;169(6):1211-1227. doi:10.1111/bph.12230 ; Brietzke E, Mansur RB, Subramaniapillai M, et al. Ketogenic diet as a metabolic therapy for mood disorders: evidence and developments. Neurosci Biobehav Rev. 2018;94:11-16. doi:10.1016/j.neubiorev.2018.07.020
  29. Gray SM, Meijer RI, Barrett EJ. Insulin regulates brain function, but how does it get there?. Diabetes. 2014;63(12):3992-3997. doi:10.2337/db14-0340
  30. Watson KT, Simard JF, Henderson VW, et al. Incident major depressive disorder predicted by three measures of insulin resistance: a Dutch cohort study. Am J Psychiatry. 2021;178(10):914-920. doi:10.1176/appi.ajp.2021.20101479
  31. Coello K, Vinberg M, Knop FK, et al. Metabolic profile in patients with newly diagnosed bipolar disorder and their unaffected first-degree relatives. Int J Bipolar Disord. 2019;7(1):8. doi:10.1186/s40345-019-0142-3; Tomasik J, Lago SG, Vázquez-Bourgon J, et al. Association of insulin resistance with schizophrenia polygenic risk score and response to antipsychotic treatment. JAMA Psychiatry. 2019;76(8):864-867. doi:10.1001/jamapsychiatry.2019.0304
  32. Janson J, Laedtke T, Parisi JE, O’Brien P, Petersen RC, Butler PC. Increased risk of type 2 diabetes in Alzheimer disease. Diabetes. 2004;53(2):474-481. doi:10.2337/diabetes.53.2.474
  33. Araújo J, Cai J, Stevens J. Prevalence of optimal metabolic health in american adults: National Health and Nutrition Examination Survey 2009-2016. Metab Syndr Relat Disord. 2019;17(1):46-52. doi:10.1089/met.2018.0105; O’Hearn M, Lauren BN, Wong JB, Kim DD, Mozaffarian D. Trends and Disparities in Cardiometabolic Health Among U.S. Adults, 1999-2018. J Am Coll Cardiol. 2022;80(2):138-151. doi:10.1016/j.jacc.2022.04.046
  34. Lange KW, Lange KM, Nakamura Y, Reissmann A. Nutrition in the Management of ADHD: a review of recent research. Curr Nutr Rep. 2023;12(3):383-394. doi:10.1007/s13668-023-00487-8
  35. Khoshbakht Y, Moghtaderi F, Bidaki R, Hosseinzadeh M, Salehi-Abargouei A. The effect of dietary approaches to stop hypertension (DASH) diet on attention-deficit hyperactivity disorder (ADHD) symptoms: a randomized controlled clinical trial. Eur J Nutr. 2021;60(7):3647-3658. doi:10.1007/s00394-021-02527-x
  36. Bizzozero-Peroni B, Martínez-Vizcaíno V, Fernández-Rodríguez R, et al. The impact of the Mediterranean diet on alleviating depressive symptoms in adults: a systematic review and meta-analysis of randomized controlled trials. Nutr Rev. 2025;83(1):29-39. doi:10.1093/nutrit/nuad176
  37. Barnes LL, Dhana K, Liu X, et al. Trial of the MIND diet for prevention of cognitive decline in older persons. N Engl J Med. 2023;389(7):602-611. doi:10.1056/NEJMoa2302368
  38. Sethi S, Ford JM. The role of ketogenic metabolic therapy on the brain in serious mental illness: a review. J Psychiatr Brain Sci. 2022;7(5):e220009. doi:10.20900/jpbs.20220009
  39. Evangeliou A et al. Application of a ketogenic diet in children with autistic behavior: pilot study. J Child Neurol. 2003;18(2):113-118. doi:10.1177/08830738030 180020501; El-Rashidy O et al. Ketogenic diet versus gluten free casein free diet in autistic children: a case-control study. Metab Brain Dis. 2017;32(6):1935-1941. doi:10.1007/ s11011-017-0088-z; Lee RWY, Corley MJ, Pang A, et al. A modified ketogenic gluten-free diet with MCT improves behavior in children with autism spectrum disorder. Physiol Behav. 2018;188:205-211. doi:10.1016/j.physbeh.2018.02.006
  40. Wiers CE, Vendruscolo LF, van der Veen JW, et al. Ketogenic diet reduces alcohol withdrawal symptoms in humans and alcohol intake in rodents. Sci Adv. 2021;7(15):eabf6780. doi:10.1126/sciadv.abf6780
  41. Grammatikopoulou MG, Goulis DG, Gkiouras K, et al. To Keto or Not to Keto? A systematic review of randomized controlled trials assessing the effects of ketogenic therapy on Alzheimer Disease. Adv Nutr. 2020;11(6):1583-1602. doi:10.1093/advances/nmaa073
  42. Phillips MCL, Deprez LM, Mortimer GMN, et al. Randomized crossover trial of a modified ketogenic diet in Alzheimer’s disease. Alzheimers Res Ther. 2021;13(1):51. Published 2021 Feb 23. doi:10.1186/s13195-021-00783-x
  43. Danan A, Westman EC, Saslow LR, Ede G. The ketogenic diet for refractory mental illness: a retrospective analysis of 31 inpatients. Front Psychiatry. 2022;13:951376. doi:10.3389/fpsyt.2022.951376
  44. 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
  45. Sethi S, Wakeham D, Ketter T, et al. Ketogenic diet intervention on metabolic and psychiatric health in bipolar and schizophrenia: a pilot trial. Psychiatry Res. 2024;335:115866. doi:10.1016/j.psychres.2024.115866
  46. Research. Metabolic Mind. Accessed March 26, 2025. https://www.metabolicmind.org/research 
  47. Anderson, Jacey & Ozan, Elif & Chouinard, Virginie-Anne & Grant, Garrison & MacDonald, Aaron & Thakkar, Leah & Palmer, Christopher. (2024). The Ketogenic Diet as a Transdiagnostic Treatment for Neuropsychiatric Disorders: Mechanisms and Clinical Outcomes. Current Treatment Options in Psychiatry. 12. 10.1007/s40501-024-00339-4.

Related topics