Social and Economic Challenges to Implementing the Ketogenic Diet: A Case Series

Lynch, Sloan; Barry, Catherine; Douglass, Laurie M.

doi:10.1055/s-0040-1713908

Cited by 2 publications

(5 citation statements)

References 23 publications

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“…Previous research on the ketogenic diet for children demonstrated the impact on family members, for example through nonacceptance of the diet or disruption of family routines, including mealtimes [48, 65]. Our findings extend knowledge by uncovering similar patterns within the context of adults with bipolar disorder.…”

Section: Resultssupporting

confidence: 73%

“…But this time I went via Lidl to get a particular Greek yoghurt that was important in the diet, and they just got so agitated, they nearly had a meltdown in the supermarket, because we'd gone off our normal (Participant 2). Previous research on the ketogenic diet for children demonstrated the impact on family members, for example through nonacceptance of the diet or disruption of family routines, including mealtimes [48,65]. Our findings extend knowledge by uncovering similar patterns within the context of adults with bipolar disorder.…”

Section: Social Pressuressupporting

confidence: 73%

“…This reflects research that argues providing consistent interpersonal support from family and delivery teams is pivotal for ketogenic diet interventions [48–50]. Some participants reported that close monitoring by the research clinicians gave them confidence in the study’s procedures.I thought the support was really good.…”

Section: Resultsmentioning

confidence: 76%

“…Things like raspberries are quite expensive (Participant 4). Generally, the ketogenic diet is considered to be expensive for consumers compared to other diets [48,63]. Participants recognised this as a potential barrier to those struggling with the cost-of-living, as food prices increased by 9.2% in the year to December 2022 [68].…”

Section: Keto In a Cost-of-living Crisismentioning

confidence: 99%

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Pilot study of a ketogenic diet in bipolar disorder: a process evaluation

Rigby,

Needham,

Grossi

et al. 2024

Preprint

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Background: Bipolar disorder is a serious mental illness, which requires new strategies for prevention and management. Recent evidence suggests that a ketogenic diet may be an effective intervention. This research aimed to explore the feasibility and acceptability of a ketogenic diet intervention for bipolar disorder, fidelity to its behavioural components and the experiences of the participants and research clinicians involved. Methods: A mixed-methods process evaluation was conducted. Semi-structured telephone interviews were carried out with 15 participants 1-2 months after completing a 6-8 week modified ketogenic diet intervention, and 4 research clinicians from the study team following the completion of data collection. Data were thematically analysed. Fidelity checklists completed by research dietitians were analysed using descriptive count and percentage statistics. Findings are reported post-hoc, following the analysis and publication of the main pilot study findings. Results: Qualitative data indicated that participants had various motives for taking part in the study, including weight loss. It was important to support people's motives while facilitating clear and realistic expectations. Despite the challenges of initiating and maintaining a ketogenic diet, including for some its disruptive effects on daily living, many participants perceived physical and psychological benefits (e.g. significant weight loss, mood stability and an enhanced ability to focus). A range of behavioural (e.g. goal setting), social (e.g. family and dietitians) and technological (e.g. apps for monitoring) support mechanisms were generally considered key facilitating factors. Meanwhile, dietary preferences, concerns about the diet and its impact, the testing burden and capacity of the delivery team were perceived as barriers for some. The importance of wider contextual influences (e.g. the cost of living and sociocultural expectations) were highlighted. Overall, descriptive analyses indicated moderate-to-good fidelity to the behaviour change components of the study. Conclusion: We provide novel insight into the experiences of people living with bipolar disorder initiating and following a ketogenic diet, as well as those of research clinicians who support the intervention. Future trials may benefit from increased clinical research capacity, better-defined entry and exit routes, additional interpersonal support, and greater understanding of how social and societal factors impact participation.

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Section: Resultssupporting

confidence: 73%

Section: Social Pressuressupporting

confidence: 73%

Section: Resultsmentioning

confidence: 76%

Section: Keto In a Cost-of-living Crisismentioning

confidence: 99%

See 2 more Smart Citations

Pilot study of a ketogenic diet in bipolar disorder: a process evaluation

Rigby,

Needham,

Grossi

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…Individuals from diverse ethnic backgrounds, for whom family and holiday gatherings are centered around traditional foods, have highlighted the unique challenges they face in their social groups. Some have found that educating family members over an extended period and taking proactive steps, such as bringing their KMT-friendly dishes to events, can help ease the transition and maintain familial bonds ( 17 , 18 ).…”

Section: Real-world Challengesmentioning

confidence: 99%

From theory to practice: challenges and rewards of implementing ketogenic metabolic therapy in mental health

Laurent

2024

Front. Nutr.

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This perspective article delves into the implementation of Ketogenic Metabolic Therapy (KMT) by a mental health counselor who attempts to bridge the gap between emerging research and real-world clinical application. Grounded in the author’s clinical experiences, the article communicates the potential of KMT in mental health care, highlighting both its therapeutic promise and the insights gained from hands-on patient interactions. While the adoption of KMT necessitates adjustments in societal, emotional, and dietary domains, especially within diverse mental health contexts, these challenges are surmountable with appropriate guidance and support. The article encourages the capture of qualitative data alongside quantitative measures and advocates for an approach that considers the broader implications of improved mental well-being on families and communities. As the field advances, interdisciplinary collaborations between researchers and clinicians will be pivotal in refining and expanding the application of KMT, ultimately enhancing patient outcomes and elevating the standard of mental health care.

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Social and Economic Challenges to Implementing the Ketogenic Diet: A Case Series

Cited by 2 publications

References 23 publications

Pilot study of a ketogenic diet in bipolar disorder: a process evaluation

Pilot study of a ketogenic diet in bipolar disorder: a process evaluation

From theory to practice: challenges and rewards of implementing ketogenic metabolic therapy in mental health

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