Modern medicine tends to compartmentalize each illness. A typical patient might, for example, be diagnosed separately and at different times with high blood pressure, arthritis, gout, and depression. But increasingly, it is becoming clear that many of these diseases are in fact all downstream of the same few root causes, namely visceral fat, insulin resistance, and systemic inflammation. And while genetics do play an important role in our health (some people for example just never seem to develop diabetes no matter how poorly they eat or how obese they get; others do become diabetic after just a modest weight gain), lifestyle is by far the biggest driver of these issues.
So rather than viewing a patient as having several different chronic illnesses, it is more accurate to look for root causes, and understand that things like high blood pressure, high blood sugar, arthritis, and so forth are in turn downstream of those. Fix the root causes, and all of the other issues get better.
The area of medicine that most underscores this point is emerging science in the field of mental health. Diagnoses such as depression, anxiety, and even schizophrenia have for decades now been viewed as disorders of imbalanced brain chemistry, and treated therefore with medications (Prozac and Zoloft being just two prominent examples) that seek to alter brain chemistry in a more favorable way. And certainly there are many cases in which these medications do help. But studies in recent years have shown that once underlying metabolic dysfunction in the body is fixed, the brain chemistry often self-regulates and mental health symptoms can improve, often quite dramatically.
There have been a number of similar such studies involving the keto diet over the past few years, though it’s worth pointing out that it may not be only the keto diet that improves mental health. It’s very plausible that either eliminating processed junk food or losing weight (or both) are good for mental health and that any diet that achieves these would be helpful. Or, there may be something extra special about keto that is particularly good for the brain. The question is still up for debate, and is too complicated to cover in this post. For now, I simply want to make the point that eating well, exercising, and managing one’s weight are not just about losing weight or reducing heart attack risk: everything seems to get better once metabolic health improves.
And on that note, I want to link here to a podcast episode that I have frequently recommended to patients over the years, in which Stanford professor Andrew Huberman interviews Dr. Chris Palmer, a Harvard psychiatrist who has done some very interesting research about keto diets and mental health. It’s about four years old now and is long – roughly three hours. But I promise: it’s very worth a listen.
