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Yeni bir araştırmaya göre, düşük karbonhidratlı ve yüksek yağlı gıdalardan oluşan ketojenik bir diyet, ciddi akıl hastalıklarının semptomlarını hafifletebilir ve bu hastalıkların tedavisinde kullanılan ilaçların kilo alımı gibi diğer yan etkilerini azaltabilir.
Stanford Medicine’daki araştırmacılar tarafından yürütülen bir klinik çalışmaya şizofreni ya da bipolar bozukluk tanısı konmuş 23 hasta katıldı. Bu hastalara yüzde 10 karbonhidrat, yüzde 30 protein ve yaklaşık yüzde 60 yağdan oluşan bir diyet uygulamaları talimatı verildi. Araştırmacılar, ciddi akıl hastalıklarını tedavi etmek için reçete edilen ilaçların insülin direnci ve kilo alımı gibi “önemli metabolik yan etkilere” neden olabileceğini ve incelenen tüm hastaların bu durumlardan en az birinden muzdarip olduğunu söylüyor. Dört ay ketojenik diyet uygulandıktan sonra, katılımcıların yüzde 79’u psikiyatrik semptomlarda “klinik olarak anlamlı bir iyileşme” gösterdi.
Çalışma küçük ve nispeten kısa süreliydi. Bu nedenle diyet değişikliklerinin şizofreni veya bipolar bozukluğu olan hastalar üzerinde anlamlı ve uzun vadeli bir etkisi olup olmadığını belirlemek için daha fazla araştırmaya ihtiyaç var. Ancak bulgular, beyin sağlığı ve diyet arasında güçlü bir bağlantı olduğunu düşündüren ve giderek artan araştırmaların bir parçası. Ketojenik diyet, Alzheimer hastalığı ve epilepsi tedavisinde de incelendi.
Ketojenik diye beyne fayda sağlıyor
Araştırmacılar, diyetin metabolik sorunları düzelterek psikiyatrik semptomları iyileştirebileceğini teorize ediyor. Stanford Medicine’da psikiyatri ve davranış bilimleri alanında klinik doçent olan çalışmanın başyazarı Shebani Sethi, Washington Post’a yaptığı açıklamada “Teoriye göre metabolik eksiklikleri giderip beyne enerji sağlıyoruz” dedi. Sethi, araştırmacıların ketojenik diyetin beyne fayda sağlayabileceğini bildiklerini, ancak diyetin özellikle şizofreni veya bipolar hastalığa ne kadar yardımcı olabileceğinin “yeni yeni ortaya çıktığını” söyledi.
Araştırmadaki adımlar
Hastalara karbonhidrat alımlarını günde 20 grama düşürmeleri; günde bir kase sebze ve iki kase salata yemeleri ve günde sekiz bardak su içmeleri söylendi. Sethi, hastaları avokado, hindistancevizi ve zeytinyağı kullanmaya ve tereyağından korkmamaya teşvik ettiğini söyledi. Kalori sayımı yapmaları istenmedi. Hastalar reçete edilen ilaçları almaya devam etti ve hepsine bir sağlık koçu atandı.
Diyete ne kadar sadık kaldıklarını belirlemek için hastalar haftalık kan testleriyle izlendi. Katılımcılardan on dördü diyete bağlı kalırken altısı “yarı bağlı” kaldı. Bir kişi diyete bağlı kalmadı ve iki kişi de çalışmayı bıraktı.
Katılımcılar, Klinik Global İzlenim ölçeği adı verilen ve akıl hastalığının ciddiyetine ilişkin psikiyatrik bir değerlendirmede ortalama yüzde 31 oranında iyileşme gösterdi.
Ketojenik diyete devam edenler ortalama olarak vücut ağırlıklarının yüzde 12’sini kaybetti, bel çevreleri yüzde 13 inceldi ve visseral yağ dokuları (iç organların etrafındaki yağ) yüzde 36 oranında düştü.
Diyete başlamadan önce, katılımcıların yüzde 29’u metabolik sendromun beş belirtecinden en az üçüne sahipti: Kalp hastalığı, diyabet ve diğer kronik hastalıklar için riski artıran bir dizi durum. Dört aylık diyetin ardından katılımcıların hiçbirinde metabolik sendrom görülmedi.
Diğer uzmanlar ne diyor?
Beslenme psikiyatristi Uma Naidoo, klinik araştırmanın bulgularının “umut verici” olduğunu, ancak bunun küçük bir katılımcı grubu olduğunu ve sonuçların daha büyük çalışmalarda tekrarlanması gerektiğini söyledi. Naidoo “Bu herkese uyan tek bir yöntem değil. İyi düşünülmüş bilime dayanan küçük bir klinik çalışmada bu bireyler için işe yaramış olması, herkes için işe yarayacağı anlamına gelmiyor. Beslenme psikiyatrisi, insanların dikkat etmesi gereken gelişmekte olan bir alandır ancak bu, doktorları öneriyorsa ilaç almamaları gerektiği anlamına gelmez” dedi.
Başka bir beslenme psikiyatristi Drew Ramsey, pilot çalışmanın “iyi belgelenmiş, düşünceli bir deneme” olduğunu, ancak kontrol grubu veya randomizasyon olmadığı için fazla sevinilmemesi gerektiğini söyledi. Ramsey “Keto ve ciddi akıl hastalığı olan hastalarla ilgili en büyük sorular uyum, sürdürülebilirlik ve potansiyel olumsuz metabolik etkilerle ilgilidir” dedi.
Ketojenik diyetin arka planı
Yüksek yağlı bir diyet, vücudunuzun enerji için glikoz yerine yağ yakmasına neden olur. Bu süreç, vücut yağı parçaladığında ortaya çıkan bir asit olan ketonların üretimine yol açar. Sethi, ketonların vücudun glikozu enerjiye dönüştürmek için kullandığı aynı “metabolik mekanizmaya” dayanmadığını açıkladı.
Ketojenik (ya da keto) diyetler bir asırdan daha uzun bir süre önce doktorlar tarafından epilepsi tedavisinde kullanıldı. Ekmek, makarna ve nişastalı meyve ve sebzelerden kaçınan bu kısıtlayıcı diyet, son on yılda, özellikle TikTok ve Instagram’da, kilo kaybını sağladığı iddiasıyla popülerleşti. Ancak bazı uzmanlar diyetin faydaları hakkında yaygın yanlış bilgiler olduğunu söylüyor ve diyetin genellikle LDL kolesterol seviyelerinde artışa neden olabileceği vurgulanıyor.
Bazı yan etkileri var
Ketojenik diyete geçmenin yaygın yan etkileri arasında baş ağrısı, yorgunluk ve kabızlık yer alıyor. Araştırmacılar, bazı katılımcıların diyetin ilk üç haftasında bu yan etkileri yaşadığını söylüyor. Araştırmacılar, ketojenik diyetin psikiyatrik hastalıkları nasıl etkileyebileceğine ilişkin araştırmaların “henüz erken aşamalarda” olduğunu söylüyor. Keto diyeti obezite, Tip 2 diyabet ve epilepsi tedavisi için zaten incelendi. Klinik çalışmayı yürüten araştırmacılara göre, “çok sayıda çalışma” ketonun epilepsiyi tedavi edebileceğini gösterdi. Sethi, “Beyindeki nöbetleri azaltmada işe yaradığını düşündüğümüz yol, nöral membranları stabilize etmesi ve inflamasyonu azaltmasıdır. Aynı zamanda glikoza alternatif bir yakıt sağlıyor çünkü enerji için ya glikoz yakıyoruz ya da keton yakıyoruz” dedi.
Sethi, ketojenik diyetin “herkes için olmadığını” ve bir kişinin ketojenik diyete yalnızca “bir doktorun gözetimi altında” başlaması gerektiğini vurguladı. Sethi’nin bir sonraki hedefi ise daha fazla katılımcıyla randomize kontrollü denemeler yapmak.
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