Overview
- The U.K.-based randomized DIME trial enrolled 88 adults with treatment-resistant depression and compared a ketogenic diet to a phytochemical control over six weeks.
- At six weeks, PHQ-9 scores fell by a mean of 10.5 with the ketogenic diet versus 8.3 with the control diet (P=0.05), with remission in 25% versus 9%.
- By 12 weeks, between-group differences in depression severity and other secondary outcomes were no longer significant.
- Adherence relied on prepared meals and weekly dietetic support, and few participants continued the ketogenic diet after support was withdrawn.
- Urine ketone levels did not correlate with symptom improvement, no serious adverse events were reported, and investigators call for more pragmatic, longer studies to clarify benefit and safety.