Can Ketogenic Therapy Help Autism and Mental Health? | Dr. Eline Dekeyster on Mechanisms & Hope

Eline: 
Where ketosis comes in, of course, is on one hand it offers an alternative fuel source. So you can bypass many of these problems, but there’s actually more to it. And I also want to stress that because you can even, of course, reverse the the problems in the biochemistry.

Bret: 
Welcome to the Metabolic Mind Podcast. I’m your host, Dr. Bret Scher. Metabolic Mind is a nonprofit initiative of Baszucki Group where we’re providing information about the intersection of metabolic health and mental health and metabolic therapies such as nutritional ketosis as therapies for mental illness.

Thank you for joining us. Although our podcast is for informational purposes only, and we aren’t giving medical advice. We hope you will learn from our content and it will help facilitate discussions with your healthcare providers to see if you could benefit from exploring the connection between metabolic and mental health.

Could ketogenic therapy or nutritional ketosis be a treatment for autism spectrum disorder? And what do we learn about the mechanisms that could apply to other psychiatric diagnoses or brain-based diagnoses? Cognitive impairment or ADHD? Or ,of course, other forms of mental illness? I’m joined by researcher Dr. Eline Dekeyster, and she goes through all the research she’s doing with the mechanisms, but also the really important parts about helping people adhere to a ketogenic diet, the social structures, what’s needed with that. And she talks about her own personal journey as well, which I think is so fascinating.

if you or a loved one or somebody with autism spectrum disorder and want to consider the potential benefits of ketogenic therapy, this is an amazing discussion, not medical advice, not giving direct advice, but such an important discussion about what could be and what the future may break.

Dr. Eline Dekeyster, thank you so much for joining me today at Metabolic Mind. 

Eline: 
Thank you for your invitation. It’s a pleasure to be here. 

Bret: 
Yeah. I’m really excited to get into this paper that you co-authored about ketogenic interventions for autism spectrum disorder. But before we get into that, give us some background.

Tell the audience who you are, just so they we’re on the same page. 

Eline: 
Yes. So my name is Eline Dekeyster, difficult to pronounce. I’m an assistant professor at Lion University in the Netherlands where I’m the Head of the Lifestyle Brain Interaction research group. I’ve done my PhD in Leuven and in Belgium, and that was more basic neuroscientific research.

But then after finishing my PhD, actually I wanted to move closer to patients and do translational research, and that was when I moved to the pharmaceutical industry. So I have been working in the industry for about eight years. Those were wonderful years. I learned a lot. But a couple of years ago, I realized that I really missed the academic vibe and working with students. And I also have very high idealistic values.

And that was actually the main reason to come back to academia and to build my research group. There we are, yeah, and the name of our research group is Lifestyle Brain Interaction. So it speaks for it, but the main focus at this moment is really the field of metabolic psychiatry. And the reason for that actually is a personal experience for myself.

I have a history of repeated depression, and I’ve also experienced some periods of hypermania. And when I’m in ketosis, I noticed that this really helps me to stay out of this negative spiral that can draw me into depression. So that was where my personal interest came from, and then when I got the chance to have an academic position, I decided to really build a team around that and to join that research field.

Bret: 
Yeah. Wow. There’s so much in that introduction about your personal history and just the fact, I just love that there even is a Brain and Lifestyle Interaction research group. Just the name of that itself is so inspiring, and how you wanted to make sure that the research you’re doing translates back to the patients, to the individuals.

And I’m sure that stems from your personal experience. So let’s take a minute to talk about your personal experience, though. How did you learn about or even find ketogenic therapy for your yourself? 

Eline: 
Yeah. I think like with many of us, it was more coincidence. I have been trying, like I have been interested in lifestyle and diets for like my whole life.

I’ve been doing a vegan diet, like protein, the rich protein diets and things like that. And I always had some gastrointestinal issues and that was how I came like in contact with a nutritionist who actually put me on a gluten-free, casein-free diet. And I felt so much better. Like my intestine problems disappeared.

But apart from that, I had so much mental energy and I, when I started looking into it, then I actually came to the conclusion, this actually is a ketogenic diet. So I wanted to understand, and that is when as a scientist, what do you do? You dive into literature and I read about epilepsy, and I have never heard of ketogenic diet for epilepsy.

So that is what’s what actually sparked me. 

Bret: 
Yeah, it’s inspiring and unfortunate all at the same time that we hear these stories of individuals who found it by accident and it’s amazing. It’s so wonderful that you found this by accident, but how do we make it so other people don’t have to find it by accident, but they find it on purpose as prescribed by their healthcare team?

And a big part of it is research that’s being done. Now the paper you wrote focused on autism spectrum disorder, and I know you have other work that you’re doing, but let’s talk about that for a minute. So, yeah, give us a little background why you chose autism spectrum disorder as a field to dive into.

Eline: 
Yeah, until about one and a half years ago, actually, we were only focusing on ADHD, MCI, and depression. But in 2023, I was contacted by a nutritionist, who asked my help for a specific case. And this was a case of a 4-year-old boy, who was diagnosed with autism spectrum disorder, and his main symptoms were that he never made eye contact and he barely spoke.

The father of this boy actually came across information on keto and autism, and he wanted to give this a try with his kids. So the father went to the GP to tell about it, to ask for support, but the GP actually send them away. Like, okay, this is not evidence-based. This is not safe. We are not going to do this.

Luckily, the father persisted, and together with the nutritionist, they managed to get the kid into ketosis and like they saw improvement, subjective, of course. The father saw improvement in his child. I think that none of the scientific measurements is better than a father feeling connection with his child.

And the boy started making eye contact every now and then, and he started talking more. So this father was so enthusiastic that he went back to the GP sharing the experiments, everybody needs to know this works. But of course the GP was very cautious and said, okay, we’re going to do some blood work.

We are going to do some tests, which is a very good reaction, I would say. They also measured keto values, and those were just in a normal nutritional range, but as we know, they’re more conservative. Medical education talks about ketoacidosis when it comes to ketones. So the GP was triggered and he said, okay, this can be dangerous.

You have to stop this. But of course the, yeah, but the father was happy with the results. So they continued, and what happened next was with the best intentions I’m sure of that, but the GP called social services and that was the moment… 

Bret: 
are you kidding me? They called social services because they thought this was because he was putting his son at in danger?

Eline: 
Yeah. Exactly because it was irresponsible of the parents. That was actually a moment, I wasn’t involved in the case until then, but that was the moment that a nutritionist called me. I had been working with her on other projects before, okay, we need your help. Can you please put a scientific basis together for this that we can put forward with this case?

And so that triggered me to start looking at keto and autism. And I found a handful of case reports, not that much, some very small pilot studies, but what was described was promising only clinical, not a mechanistic. Then I also started looking into the animal studies and there actually, there was quite something that was described and very promising.

And we could explain the underlying mechanism, or at least try to explain what on the, in the clinical cases was described. And if you even take it a step further and you let go that it has to be an autism model with a pathogenic diet, and you look a bit more broad and you then I looked at the biology, the underlying biology of autism. And we look at what we know from pathogenic interventions, from epilepsy research and other fields, there’s such a clear link.

There actually was enough also to build the case and to let it go for that father and the boy. But it triggered me because, yeah, there was something in there and it seemed like nobody was researching it. So I thought we need to fill this gap to avoid things happening again in the future that we can avoid just by providing the data that are needed.

Bret: 
Yeah. Wow. Such an important role for that one individual, but like you said, to make sure nobody else has to go through this as well, to have something in the literature to support it. Let’s take a step back for a second though. And what is, what is treatment for autism spectrum disorder now?

What exists? Yeah. And how good is it? 

Eline: 
Yeah. Maybe what is important to mention first is a bit like what is autism spectrum disorder? Before I start using the terms, or I have been using them already in the conversation, I want to highlight that I really respect everybody, and I know that these terms sometimes are sensitive, like people don’t really relate with the diagnosis or some things like that.

So I want to have said that I absolutely respect neurodiversity and inclusivity. However, I will be using the terms autism just because of the conversation and see it as a scientific term. when you look at the term autism spectrum disorder, it’s a spectrum disorder. So this means that there are many different symptoms that show up in different rates and different combination in different people that all can have the same diagnosis.

The basics, however, is that there are four areas of symptoms: difficulties with social interaction, difficulties with language development and communication. You can, we can see restrictive behavior and also repetitive behavior. With OCD like behavior, we also see a lot of comorbidities. So you have the autism symptoms itself, but also typically we also see epilepsy, OCD, depression, anxiety.

We often see suicide in this group and also self-harming behavior. So it’s a ton of symptoms linked to autism directly, but also the comorbidities are very severe. And then when we look at the current treatments. Actually, we should also look at the developments of the brain because there are two systems that are very important in the brain when we develop, when the brain is developing.

The first system is the social-emotional system. And the other system is actually the system that is responsible for sensory gathering, sensory inputs, perception, and cognition. So, those are the two main systems in the brain. And what we see with neurotypical children is that the social-emotional system develops first.

So when a baby is born, it actually has to learn to deal with what do I feel and what are the people around me? And how you can describe that? For instance, is the first time that a child or a baby feels hunger, it actually doesn’t know what it is. So this can trigger a stress response, an emotion of stress and fear.

So, the baby will cry. And then, of course, we assume that the caregiver will come in and will soothe a baby and will feed it. So this way the caregiver co-regulates the physical needs and the emotional need from the child. And this is how actually this social-emotional network in the brain is built. Micro-expression, a facial expression, but also the tone of voice is very important in this development. And if you look a little bit later, like with toddlers, you also see that they express their emotion, typically very expressively. I have to voice myself so I can really relate to that. If one of them is upset, they are upset and also there it’s like they cannot really regulate that yet.

So they need their parents to learn them like couldn’t be that you’re upset and what happened and things like that. Okay, so that actually happens first. Slightly in parallel, but actually a little bit later, we see that perception and cognitive system developing. It takes until the year of that, takes until you are six years old to really having for instance, fully develop your visual system.

So that’s quite a slow process, and it starts a little bit later in neurotypical children. What we see in children that’s later in life, typically, are at from the year of four year, like from an age of four years old, can be diagnosed with autism, it’s that it’s the opposite way. So the cognitive system and the perceptual system develops first very fast and very detailed.

So they have a very strong analytical mindset and cognitive minds. But the social-emotional skills develop later. It’s not a totally delayed development, but it’s just different in a different order and the focus is different. And what we see that typically these kids, but also adults later in life struggle with, is that they can analyze everything that they see because they have such a strong perception system and analytical system that everything comes in.

That’s a huge talent because they can see things that other people don’t. But it also costs an extreme amount of energy to take it all in. That can be overwhelming. But even if it’s not overwhelming and you have people that can capture it costs so much energy to analyze all of that and to bring this to your cognitive level.

And at the same time, your social-emotional skill development is actually lacking behind a bit from your age-matched peers. So there you also spend a lot of energy to sustain in a world that you don’t really understand. And I think that just shows the struggle, and that’s also where the current therapy to come to your question focuses on.

Bret: 
So if I can interrupt for one second. The model in medicine for treatment is often, okay, let’s find the cause and develop a treatment to treat that cause. But the way you’re, you explained the difference in the brain development and on, and all the different comorbidities and the symptoms.

it’s hard to imagine that there’s one cause with one treatment for that cause. So instead the treatment has to be for different specific aspects of the manifestation of autism spectrum disorder, which can be very different for individuals. 

Eline: 
Yeah. 

Bret: 
Also, so tell us more about that. 

Eline: 
That’s already a bridge toward ketogenic intervention because I think there you actually tackle a broad, like multiple pathways at once, and I think that’s absolutely what we need.

Because otherwise you would need to do a hundred treatments on one person. But so current treatments mainly focus on psychotherapy and cognitive therapy, like to understand their own minds and how it works. But also behavioral therapy like, and then the best forms or the best way to do that would be to learn the person to build a bridge between how their mind works and how they are with society to be able to live in society, and preferably with staying authentic to themselves.

Unfortunately, we also sometimes see that they are teach, like I teach them to behave in a way that is expected, but it’s not really hold onto who they are. And that can, of course, trigger more problems. When we look at the comorbidities, then we often see that those are treated separately. And if you could think of depression, for instance, with drugs or with specific treatment, psychotherapy treatment that is developed for depression specifically, however, we see that the success rates for these therapies in people with who are also diagnosed with autism are lower than in people that have only have depression or depression with other comorbidities.

I was a bit surprised when I heard that, but then I talked to a colleague of mine who’s a neuropsychologist also, working with patients, and she said, yeah, that’s not so surprising because their mind just works differently. Their social-emotional system is differently wired. So if you put a treatment on that was developed for neurotypical people, how can you expect it to have the same outcomes?

And then, okay, then I understood better, but I think, so there are two problems here in the treatment. It’s on the one hand that the current psychotherapy treatments typically doesn’t solve everything, and you still see the people struggling. And on the other hand, the treatment of the comorbidities also doesn’t seem to work as you would expect it to work. 

Bret: 
Yes. I think that shows how it’s not necessarily mechanism-focused or cause-focused, but we know from ketogenic therapy, from epilepsy like you alluded to, and even with mental illness or cognitive impairment, any brain-based intervention that ketogenic therapy improves metabolic health.

It can change the GABA glutamate ratios. It can decrease neuroinflammation. It provides a different fuel source. So these same potential mechanisms for epilepsy and mental health, in general, are those the ones that apply to autism spectrum disorder as well? 

Eline: 
Yes, absolutely. There’s a clear overlap there.

Maybe I can zoom in on some examples and link them to what we know from from autism, if that’s would be interesting. I think, so if we start with brain energy because that’s, I think the best known, if we think of ketosis. We already talked about the fact that it’s cost so much energy for people with a different wired brain to just process everything, but also to hold onto social-emotional connection while that’s difficult for them, but there’s actually more.

We also know that there’s a disturbance in, biological disturbance, in the energy metabolism in people diagnosed with autism, and there are some indications for that. Like we see elevated levels of BPH and lactates, which of course, is an indication for mitochondrial dysfunction.

We also see a decreased expression in electron transport chain proteins, which also is an indication for mitochondrial dysfunction. We see on PET scans, those were mainly done in children with autism, we see that the glucose metabolism in the brain is different from age-matched controls. And it’s not that it’s everywhere it’s lower, but we see some areas where you see hypermetabolism and in other areas we see hypometabolism compared to age-matched control.

And then another thing that we see in many mental disorders, of course, is that there’s many people with autism also have insulin resistance. And, of course, that’s important for the glucose metabolism and for the cells to take up glucose to be able to burn it as a fuel. But it’s also super important.

Insulin plays a very important role in synaptic plasticity. And synaptic plasticity means like forming the networks in your brain and reshaping that also during developments. And so then we come back to the fact that autism is actually neurodevelopmental disorder. And it’s actually in the development that it starts being different from neurotypical problems, or from neurotypical people. Sorry.

Yeah. and where ketosis comes in, of course, is on one hand it offers an alternative fuel source, so you can bypass many of these problems. There’s actually more to it. And I also want to stress that because you can even, of course, reverse the problems in the biochemistry and we, that’s well known from insulin resistance, that a ketogenic diet can reverse insulin resistance.

But if we specifically want to look at autism spectrum disorder, there’s also a problem with the morphology of the mitochondria. So they’re a bit shrinkled and we know that from human postmortem studies as well. But we also see that in genetic mouse models for autism. And there was a study in which they took those, this genetic mouse model for autism, and they put them on a ketogenic diet only for two weeks.

And the result was that this, like a small formation of the mitochondria like was turned back to normal so they got a normal shape. So that really shows that it can really reverse the biological problem. 

Bret: 
Yeah. that’s pretty dramatic. And I mean something you could probably really only do well on animal studies like that, but to actually microscopically see these very important tiny organelles to heal and to normalize their structure.

It’s pretty dramatic and, yeah, I remember when we first started talking about mitochondria and my initial thought was, ah, nobody’s going to really be interested in mitochondria because you can’t see them, you can’t touch them, you can’t feel , you can’t test for them. But they’re so important.

They’re so important. And really people are now starting to understand the importance of mitochondria health and function with the concepts of brain energy. So I’m so glad you brought that up because it really is, it can be a unifying mechanism or cause or treatment for so many different brain-based disorders.

Before we continue, I want to take a brief moment to let our practitioners know about a couple of fantastic free CME courses developed in partnership with Baszucki Group by Dr. Georgia Ede and Dr. Chris Palmer. Both of these free CME sessions provide excellent insight on incorporating metabolic therapies for mental illness into your practice.

They’re approved for a MA category one credits, CNE nursing credit hours, and continuing education credits for psychologists, and they’re completely free of charge on mycme.com, there’s a link in the description. I highly recommend you check them both out. Now, back to the video.

Let’s get back to the case reports, the clinical experience. What does exist? One question is always, yeah, but can they stick to the diet? It’s so hard to do. Yeah. And are they going to be able to stick to it? And so what’s your experience there? 

Eline: 
Yeah, that’s a super important thing. That’s also one of the focuses in our research actually, because if you look at the current pilot studies, there’s a huge dropout.

And, of course, you see that in any diet study but specifically for autism. I want to stress that restrictive behavior because that’s also what we observe linked to food behavior. And I, for instance, know somebody with a diagnosis of autism and that person only wants to eat white food. They also, we also see this hypersensitivity, so there’s this really perceptual hypersensitivity, and you can see that people, for instance, really have hypersensitivity to texture or smell or specific colors of foods.

And I think that it’s key to take that into account when you expect people to like change their diets, especially in this target group. And we actually have the plan to set up, we’re actually working on it already to set up focus groups to see like what does this specific group needs or this specific individual needs to be able to sustain it.

And one thing is you can make a meal plan with only white foods and stay in ketosis, even if it’s just for one month to get going. You can make like keto bars or thing like that just to get over the first period. And other things we are looking into is a gamification, for instance, that you could develop a game where you keep your ketone levels in a certain level.

The Think Smart tool that was developed by Metabolic Mind and Baszucki Group is amazing, I think, but it’s a matter of checking on an individual basis what suits them and what they need to sustain it. Something else we are working on is really focusing on psychoeducation and not only learning them how to do the diet, but also really learning them about biological mechanisms behind it.

And not only the person itself, but really do a kind of a companion training and build a community around that person to help to implement it. And I think that is just, what we need to learn and look at an individual basis, like what do you need? If we look a bit further in the future, actually I really believe in like a holistic treatment team where I don’t think the medical specialist should understand everything on the diet, but should just follow up on the symptoms and the medication.

A GP should look at safety and blood work and things like that, but then I think you need a dietician and nutritionist for the diet and to avoid nutritional deficiencies. I also see a very important role for more a practical coach or a mentor to really help with the implementation and with making it tailor made in grocery lists and things like that.

Bret: 
Yeah, I think that’s such a crucial point, and I really like how your focus is mechanisms, but also implementation and adherence in strategies to make that happen because the research on mechanisms isn’t going to do any good if it doesn’t translate to the individual and helping them get better.

So I really appreciate that part of your work. And so it sounds like you’re, you’ve got your hands in a lot of different pots here doing different, looking at different things. So how many studies do you have going or do you think we’ll be going soon to look at this? 

Eline: 
Specifically for autism?

Bret: 
Yeah. 

Eline: 
We, at this moment, we are actually working on retrospective case reports. So people who have experience with it can contact us, and we are trying to collect everything that’s out there to make it as objective as possible. On the other hand, we actually have a study running now that we call single case experiments in which actually we don’t do a group treatment or an intervention, but we talk to that individual person.

Prospectively, and we look at, okay, what would you want to try? What suits you? And we build a personalized experiment for that person. And then we will follow up on specifically the symptoms and with neuropsychological assessments, with cognitive tests, also with imaging, et cetera. But we design it together with that person, and I think that’s quite unique.

We see that as kind of citizen science to really make it a real world experiment. We do have a protocol developed for a little bit, a larger pilot study in adults because all the current publication are in children. But we really want to also contribute to the data about adults.

And in that we actually want to do those enablers, combine them with biomarker screening because I think that’s also very important part that we miss currently is that we can do outcome prediction. And I believe that if you can show the metabolic problem maybe at baseline that we can predict that for those people, the chance of success, or of an efficacy effect of the diet is higher.

So we have a study on the shelf, that at the moment, that we find resources to do that we already to go. But at least we have two smaller studies ongoing right now and with what is possible with the resources we have. 

Bret: 
Yeah, and I mean it’s frustrating to hear, if we had the resources, we would do this.

If we had the resources, we would do this because the big pharma, the big drug companies aren’t funding these research projects. So we need other sources of funding and that’s where we hope to set an example for philanthropic-based funding that other philanthropists will jump into the ring and realize that this critical research will not get done without it, unfortunately.

So hopefully just people hearing this and thinking about this will get people saying, no, I know somebody who might be interested in drawing the connections. I think that’s so important. 

Eline: 
Yeah. On one hand it’s frustrating. And on the other hand, I’m also quite proud and thankful, grateful for what we are able to do with the little resources we have. And that’s partially because we also did some crowdfunding and that people really believe in it. And like those skate experiments, they’re, not that expensive. That’s just because the people want to be involved. We are not paying the participants for these studies, so they just really want to contribute themself.

And I think that is just beautiful. We also get keto coaches and nutritionists who want to do the coaching of our participants for free just because they believe in it. And I think that’s also, on one hand it’s frustrating, and on the other hand you see the creativity of people, and what you can do together as long as you believe in it.

Bret: 
I look, there’s so much about mechanisms and about support and adherence and the practical side of things. But one thing we didn’t talk about that you had mentioned you wanted to talk about was genetics. So tell us your input on genetics as well. 

Eline: 
Yeah, in autism there’s a huge heritability factor, like a very hard, high heritability range.

That means that genes contribute and there’s not something like a single autism gene, but it’s more like multiple variations in different parts of the genome contribute a little bit and you get a cumulative effect. To study this, actually, scientists have developed genetic mouse models. How that works is that you actually modulate one of the genes that we know from the human information, from people with autism diagnosis.

And then we see autism-like behavior in these mice. How, like I often get the question, how do you see that a mouse has autism? But typically mice like groom and they scratch, and what we see in those mouse models for autism is that they do that more and a little bit more repetitive, a bit more compulsive.

So that’s one of the observations we can do. Another beautiful test to test social interaction in mice is actually a maze with two chambers. And you first let the mouse explore the maze. Then after a while, the researcher puts a new mouse in one of the rooms or one of the chambers and just a foreign object, a neutral object, like a pencil or something in the other chamber.

And then you will see that a non-autistic mouse will just explore and typically go towards the new mouse because it wants, who are you, what are you doing in my chamber? They want to sniff each other, they will communicate in their own way. While those genetic mouse lines, those mice typically avoid that chamber.

And if they enter, clear stress responses in behavior, but also biologically like cortisol levels go up, et cetera. And those mice will really typically go to the other chamber, avoiding the new mouse. Now what we see in those models is if you put these mice on a ketogenic diet, we see a change in behavior, like more social interaction and less repetitive behavior.

So that’s very intriguing because that means that even the genetic basis can be tackled in an epigenetic way by ketone ketosis and ketogenic therapy. And there’s another very beautiful mouse study that I want to highlight. And what they did there was also mouse lying that shows autistic-like behavior CD1 mice.

There they took the modern mice when they were pregnant. And then they put a, conception took place already, then they put the mother mouse on a ketogenic diet until gestation and lactation and when the pups were weaned, so they were put away from the mom. Then they got a normal diet, so only ketogenic diet during gestation and lactation.

And then the pups grow up, and then those adult pups actually they showed less autistic behavior. So this is, for me, this is really striking. This is, these are striking results because this shows that even the genetic underlying components can be targeted in an epigenetic way, in an expression controlling way by ketosis.

Bret: 
Yeah. That is fascinating. 

Eline: 
So that was something striking that I really wanted to share. 

Bret: 
Yeah. we, learned so much about genetics aren’t everything. It’s the expression of the genes and how can you modulate that? And, in that kind of model, it’s really elegant to show how you can model it.

So thank you for bringing up that example. But since you mentioned ketosis in pregnant mice, I want to transition to you personally if you don’t mind. You mentioned you have young kids, and that you use ketogenic therapy for your own mental health and we talked about adherence and difficulties sometimes of with adhering to a keto diet.

And one period that we hear some people say adherence is particularly difficult is pregnancy, the postpartum period with young kids. Life can be chaotic. Diets and food intake are chaotic. So I’m just curious about your personal experience. How have you been able to navigate that and if you have any advice or tips for people who are going through the same? 

Eline: 
Yeah, we also often get the questions that’s safe. And I must say, I want to share my personal experience, but it’s not stimulating other people to do this as well because I think we, there are no real studies on this, but my, I personally, look, I had been in ketosis a bit in and out, but rather stable already for eight years the first time that I got pregnant.

So I was super well adapted and I think that’s a huge difference when you just start. It’s true that I had more cravings at the beginning, and actually I also do intermittent fasting, and that was something that I immediately stopped because I do believe that you just need a continuous energy input for the baby to grow.

So I stopped fasting, but apart from that, I stayed actually following ketogenic diet. Maybe I added a little bit more carbs, and it could have been a little bit more a low carb diet. But I still stayed in ketosis just because the baby was taking the energy that I took extra off from the carbs. And actually even, especially postpartum, I didn’t really had an issue with sticking to a ketogenic diet.

What I did notice was then when the kids grow older a little bit and they start eating bread, for instance. It’s quite hard if they have a sandwich with peanut butter and they say, mommy, do you also want to bite then to say no. And so for me, that was actually the most challenging period. And then I also slipped off.

But, yeah, I must say that Immediately get feedback that if I’m out for too long, if I’m out of ketosis for too long, I really feel that depression coming in. I also had a postpartum depression from the first kid. The second time I really, I just didn’t want that. And yeah, they know just, no. Mommy drinks coffee in the morning.

We have sandwiches. Yeah. And that’s just normal for them. Yeah, but I struggled with that before and like in the evening I just cook the same, but I have a side dish. If in the evening, I don’t do that anymore, I used to have a side dish for them with rice or something. And I just didn’t take that.

And for the rest it was ketogenic, but now I even don’t do that anymore. They just have their carbs during the day and in the evening, the whole family eats a kind of a ketogenic diet, but with a bit more vegetables than what you would do in a very strict diet. 

Bret: 
Thank you. Yeah, thank you so much for sharing your personal experience.

And as you mentioned, none of this is advice for anybody else or medical advice. There’s not much research about this, but just so fascinating to hear people’s individual experiences and what they do and what works for them. So thank you for sharing that and thank you for this whole discussion about the mechanisms about the research, about all the work you’re doing. If people want to learn more about your work or just about your thoughts in general, where can you direct them to find more about you? 

Eline: 
We have a website on our research groups. So the research group is Lifestyle brain Interaction, and the website is LBIResearch.nl.

We also have an Instagram page only recently set up by my students and that’s at lbi.research. So there you can also find us. 

Bret: 
That’s a great use of students. Have them work on your social media and your Instagram. I love that. That’s perfect. Thank you so much. I really appreciate you taking the time and, again, thank you for all your work.

Eline: 
Thank you for having me. It was a pleasure. 

Bret: 
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