Mood & Metabolism: What Happens When Students Swap Sugar for Ketones
- Moira Newiss
- Nov 7
- 8 min read
In this blog I am going to run through a brilliant new pilot study that was completed using a ketogenic diet as a strategy for depression in college students. Firstly, I will highlight the key findings for you and then I will share some of my own thoughts about this piece of research. If you want to read the paper yourself then you can find it here. There is also a great short video made by Metabolic Mind providing a good overview of it too including interviews of some of the students who participate in it. Links are at the bottom.
The Study: Keto Diet for Depression in College Students
A new study is out which shows promise that a ketogenic diet might be an effective tool for depression in students, it known as the KIND study. Depression among university students is a serious and growing issue and it has become one of the most prevalent health problems on campus. The study reports that since the middle of 2020 the prevalence of depression spiked from 6.5–24.3% in the adult population. The study took place at Ohio State University in the US, the recruited students, and ran a 10-12 week diet intervention. They wanted to find out if it was feasible and possible to use a ketogenic diet to alleviate depressive symptoms and to see if there were measurable improvements in mood, metabolic health, cognition, and body composition.
Who Participated?
Those students recruited into the study were aged between 18 and 30 years old. They had a confirmed diagnosis of major depressive disorder (MDD) and were currently engaged in counselling and/or medication treatment for depression. They had to be willing to eat a well formulated ketogenic diet for 10 to 12 weeks. 24 students were selected to take part in the pilot trial and 16 fully completed the protocol. They were screened to ensure that they were willing participants without imminent suicidal risk, without severe metabolic or eating disorder health complications, that they were able to prepare food themselves and didn’t consume excess alcohol.
What Was the Intervention?
As mentioned, this study used a well-formulated ketogenic diet (WFKD) for 10-12 weeks as the key intervention. Before baseline, participants attended a dietary education session to understand what the diet would look like. After baseline testing the diet intervention commenced. Participants received ongoing support from a dietetic team who provided education and coaching to help implement and sustain the diet. The students were also given 10 pre-packaged ketogenic meals to help illustrate how a balanced ketogenic meal could look like. Then they were expected to choose and prepare their own meals. Additional items (shelf-stable: e.g., high-quality fats like olive oil, salad dressings, salmon/sardine packets, etc) were provided to partly offset cost and support adherence.
The aim was to achieve a blood level of the ketone β-hydroxybutyrate (BHB) in blood of > 0.5 mmol/L. To do this they were advised to keep carbohydrates < 50 g/day, so this was quite a liberal ketogenic diet. Protein at around 1.5g per kg of body weight. Fat comprised the remaining calories, with an emphasis on whole-food sources. A wide range of foods was encouraged including non-starchy vegetables, low sugar fruits (berries, olives, tomatoes, lemons/limes), meats (beef, chicken, pork, fish, lamb), nuts and seeds, oils (olive, avocado, coconut), cheese, butter, cream, eggs, and fatty fish (salmon, sardines). They were also provided with broth/LMNT electrolyte packs to help compensate for sodium and fluid losses which often happen during transition to a ketogenic diet, referred to as the ‘keto-flu’.
How About Monitoring and Adherence?
Participants were asked to check their morning fasted BHB levels using a finger prick blood test. They then reported the result via an app. At baseline, mid-point week 6, and post intervention they also attended the lab for fasting blood samples, body composition scans, surveys, etc.
Adherence was quite good among completers: they reported BHB/glucose values on 77% of days; and on days reported, BHB ≥0.5 mmol/L (just into nutritional ketosis) was achieved 73% of the time, with average BHB of 0.7 mmol/L over the duration of the pilot study.
Were There Drop-Outs from the Study?
There were 8 who dropped out of the trial, interestingly, seven of the eight reported reasons unrelated to the diet; although one did drop out before week 2 dropped citing the reason as stress about adhering to the diet.
What Exactly Did They Measure?
The study included multiple outcome domains: mood/depression, global well-being, body composition, metabolic & inflammatory biomarkers, and neurocognitive testing. Mood/Depression was measured via a self-reported via Patient Health Questionnaire‑9 (PHQ-9) administered bi-weekly. A clinician-rated via Hamilton Rating Scale for Depression (HRSD) was measured at baseline, mid-point (week 6) and post (week 10-12). The Global wellbeing via WHO‑5 Well‑Being Index (WHO-5) was administered similarly.
In addition, body composition was measured using dual-energy X-ray absorptiometry to estimate fat mass and lean body mass. Body mass was measured too.
Metabolic measures included the daily BHB and glucose blood finger-prick test. At lab visits the tests included insulin, leptin, brain derived neurotrophic factor as well as other immune and inflammatory markers. HOMA-IR was calculated for insulin resistance.
The researchers also complete a range of neurocognitive testing to assess cognition, learning, memory, and attention.
What Were the Key Findings?
Of the 16 completers, BHB levels remained ≥ 0.5 mmol/L (nutritional ketosis) on 73% of reported days; with an average BHB of 0.7 mmol/L.
Two participants reported headaches / muscle cramping in week one; resolved with electrolyte support. Three participants had flu-like symptoms that were unrelated to diet (and they were also non-adherent to the diet during those days). No participants reported serious adverse events attributable to diet.
In relation to depression, among completers the PHQ-9 showed a 37% decrease by week 2 and 69% reduction by week 10-12. When all 24 were included in the data (including the 8 dropouts) there was still a 65% improvement in symptoms. Using the Hamilton Rating Scale for Depression there was a 59% reduction at week 6 and 71% reduction at week 10-12. All participants had lower HRSD scores at week 6; by week 10-12 no participant was in moderate/severe depression range (all <10). The WHO-5 (well-being) measures showed that global well-being had increased nearly three-fold.
With regards body composition, participants lost on average 5.0 kg of weight and 13% of fat mass. Lean body mass also declined, but less markedly at around 1.1 kg giving roughly a 3:1 ratio of fat-to-lean loss.
There were no significant changes found lipids and other metabolic blood markers except for serum calcium which increased 3%, BUN (blood urea nitrogen used to assess kidney function) increased 14%, ALT (alanine transaminase, a liver enzyme) decreased 27%.
Among adipokines (which are messaging molecules secreted by fat cells) leptin (a hormone primarily produced by fat cells that signals to the brain that the body has enough energy) decreased 52%. BDNF (helps with brain plasticity, learning and memory as well as the regulation of energy metabolism) increased 32%. HOMA-IR (insulin resistance) dropped by 28% but this was not statistically significant.
The neurocognitive testing found significant improvements in Auditory Verbal Learning (episodic memory) +10%, Oral Symbol Digit Test (processing speed) +5%, Pattern Comparison Test (processing speed) +4%. Other improving trends (not statistically significant) included Dimensional Change Card Sort Test (executive function/flexibility).
Although improvements coincided with nutritional ketosis onset, the correlations between BHB levels and the change in depression were not statistically significant. Similarly, weight loss changes did not significantly correlate with depression score changes.
What Did the Researchers Say About The Study?
This study demonstrated that a ketogenic diet is a feasible intervention in young adults with depression who are already engaged in counselling/medication treatment. The adherence (nutritional ketosis for 73% of days) and tolerability (few diet-related adverse events) support this.
The magnitude of symptom reduction is noteworthy (70% reductions) and seen both in self-report and clinician-ratings. These outcomes are consistent with smaller case studies in mood disorders and align with the hypothesis that metabolic interventions may aid psychiatric conditions.
The authors discuss possible pathways by which the ketogenic diet may exert antidepressant effects:
Increase in brain-derived neurotrophic factor (BDNF) observed 32% increase. BDNF is often lower in depression; ketone bodies (β-hydroxybutyrate) appear to enhance its expression.
Decrease in leptin (−52%) & improved fat/lean composition. This may reflect improved leptin sensitivity, linking metabolic and mood regulation.
Reduced inflammation and improved brain network stability via ketone metabolism.
Improved body composition: While weight / fat loss is unlikely to fully explain mood improvements (no significant correlation), the metabolic improvements may support mental health.
Cognitive improvements: Speed, memory, executive function improved; these gains support the broader effect of diet on brain function, not just mood.
Key Message?
This study demonstrates that there is real potential that a ketogenic diet can be used alongside standard depression treatments to help college students to improve their mood, body composition, and cognitive function.
My Thoughts – Food Can Be a Powerful Medicine
I found this paper to be exciting in several way. First it is a well-structured, metabolic intervention with effectiveness measured in several different ways. The mood improvements are large, a 70% drop in depression scores is a big deal. The adherence was pretty good considering this is a student population and that many dietary studies struggle with this. The biomarker and cognition data add richness to the outcome with BDNF increase, leptin decrease, improved processing speed and memory all point to systemic rather than purely subjective mood effects
However, this was a pilot study with no control arm and the participants did get a lot of support including food provision. It is a small sample and of a selective nature (young, motivated, students). The joy of a ketogenic diet from a research point of view is that you can measure adherence, although the correlation between ketone level and mood change was not significant.
The big takeaway is that if you are a student or parent of a young adult who is struggling with low mood, then adopting a ketogenic diet could be a good strategy to add in alongside other treatments for depression. The biggest difficulty is likely to be managing adherence whilst participating in student life and the need to be able to navigate the difficulties of avoiding fast food and alcohol.
This study highlights the fact that food can be a powerful medicine if used in the right combination. This pilot study may help open a new door on the standard of care for depression. Perhaps we will be able to look through and see the benefits and perhaps services will consider opening the door fully by adding metabolic therapies alongside traditional treatments.
If this article has interested you in trying a ketogenic diet to help improve your own, or a family members, mental health then why not download my FREE Quick Start Keto Guide to see what might be involved.
You can also book a free 30-minute call with me to find out how I can help support you to achieve your health goals.
Disclaimer: Before changing your diet or lifestyle and taking any supplements always seek the advice of your doctor or another suitably qualified professional such as a nutritional therapist. The content of this blog is for informational purposes only and is not a substitute for professional medical advice. Always seek the advice of your doctor with regards to any questions you have about a medical condition.
References
Decker, D.D., Patel, R., Cheavens, J. et al. A pilot study examining a ketogenic diet as an adjunct therapy in college students with major depressive disorder. Transl Psychiatry 15, 322 (2025). https://doi.org/10.1038/s41398-025-03544-8
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