Purpose of review 

Ketogenic diets, which have been used to treat drug-refractory paediatric epilepsy for over 100 years, are becoming increasingly popular for the treatment of other neurological conditions, including mental illnesses. We aim to explain how ketogenic diets can improve mental illness biopathology and review the recent clinical literature.

Recent findings 

Psychiatric conditions, such as schizophrenia, depression, bipolar disorder and binge eating disorder, are neurometabolic diseases that share several common mechanistic biopathologies. These include glucose hypometabolism, neurotransmitter imbalances, oxidative stress and inflammation. There is strong evidence that ketogenic diets can address these four fundamental diseases, and now complementary clinical evidence that ketogenic diets can improve the patients’ symptoms.

Summary 

It is important that researchers and clinicians are made aware of the trajectory of the evidence for the implementation of ketogenic diets in mental illnesses, as such a metabolic intervention provides not only a novel form of symptomatic treatment, but one that may be able to directly address the underlying disease mechanisms and, in so doing, also treat burdensome comorbidities (see Video, Supplementary Digital Content 1, http://links.lww.com/COE/A16, which summarizes the contents of this review).

中文翻译：

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生酮饮食作为精神疾病的代谢治疗

审查目的 

生酮饮食已被用于治疗难治性小儿癫痫病100多年，在治疗包括精神疾病在内的其他神经系统疾病方面正变得越来越流行。我们旨在解释生酮饮食如何改善精神疾病的生物病理学，并回顾最近的临床文献。

最近的发现 

精神病，例如精神分裂症，抑郁症，躁郁症和暴饮暴食症，是神经代谢疾病，具有几种常见的机制生物病理学。这些包括葡萄糖代谢不足，神经递质失衡，氧化应激和炎症。有强有力的证据表明，生酮饮食可以解决这四种基本疾病，现在有补充临床证据表明，生酮饮食可以改善患者的症状。

概要 

重要的是让研究人员和临床医生了解在精神疾病中实施生酮饮食的证据轨迹，因为这种代谢干预不仅提供了一种新的对症治疗形式，而且可能直接解决潜在的疾病机制，并在此过程中还可以治疗繁重的合并症（请参见视频，补充数字内容1，http：//links.lww.com/COE/A16，该内容概述了本次审查的内容）。