Fig. 2.

Schematic illustration of potential impact of low carbohydrate and ketogenic diets (LC/KD) on mood symptoms.

Symptoms may improve as carbohydrate (CHO) intake drops, for example when intake is <25–50 g/day for >4 days, inducing nutritional ketosis, although further evidence is required. Adverse effects may be challenging for some, causing discontinuation of the diet and relapse of mood symptoms. Some individuals may make further attempts at a low carbohydrate (LC) or ketogenic diet (KD). Clinical supervision is required to manage potential adverse effects and adherence problems across all phases of ketogenic dietary interventions.