scholarly journals Ketosis and bipolar disorder: controlled analytic study of online reports

BJPsych Open ◽  
2019 ◽  
Vol 5 (4) ◽  
Author(s):  
Iain H. Campbell ◽  
Harry Campbell
Keyword(s):  
Bipolar Disorder ◽  
Ketogenic Diet ◽  
Positive Impact ◽  
Tricarboxylic Acid Cycle ◽  
Controlled Trial ◽  
A Priori ◽  
Analytic Study ◽  
Free Text ◽  
Omega 3 ◽  
Ketogenic Diets

Background Members of online bipolar disorder forums often report experiences of mood-stabilisation on the ketogenic diet, which has traditionally been used in the treatment of epilepsy. We examined the nature and extent of such reports. Aims To investigate associations between a ketogenic diet and mood stabilisation among individuals with bipolar disorder. Method We undertook an observational analytic study of free-text comments in online forums about mood effects of dietary interventions (ketogenic, omega-3 enriched or vegetarian) classified by a priori categories of change in mood stabilisation in 274 people with bipolar disorder. Results There were 141 (85.5%) free-text comments on ketogenic diets that reported a positive impact on mood stabilisation. Reports of significant mood stabilisation or remission of symptoms over a period were substantially higher for a ketogenic diet than for other diets (93/165, 56.4%, 95% CI 48.4–64.1) v. 14/94, 14.9%, 95% CI 8.4–23.7), odds ratio 7.4, 95% CI 3.8–14.1, P < 0.0001), many with detailed reports of the improvements experienced and several lasting for extended periods (months to years). Other reported associations included fewer episodes of depression (in 41.2%, 95% CI 30.6–52.4 of individuals); improved clarity of thought and speech (28.2%, 95% CI 19.0–39.0); increased energy (25.9, 95% CI 17.0–36.5); and weight loss (25.9%, 95% CI 17.0–36.5). Conclusions Despite the inherent limitations of the observational data based on self-reports posted online, the association strength and reports of sustained benefit support a hypothesis of a ketogenic diet being associated with beneficial effects on mood stabilisation. Caution should be exercised in interpreting this data until a controlled trial can be carried out to examine this hypothesis. These preliminary observations are generally consistent with a mitochondrial dysfunction component to bipolar disorder aetiology with ketones bypassing a block between glycolysis and the tricarboxylic acid cycle. Declaration of interest None.

scholarly journals The lived experience of healthy adults following a ketogenic diet: A qualitative study

2018 ◽  
Keyword(s):  
Focus Group ◽  
Lived Experience ◽  
Ketogenic Diet ◽  
Controlled Trial ◽  
Medium Chain Triglyceride ◽  
Well Being ◽  
Physical Symptoms ◽  
Free Form ◽  
Ketogenic Diets ◽  
Low Carbohydrate

Background. Very-low-carbohydrate ketogenic diets (VLCKDs) promote benefits for a range of health conditions. However, there is little research elucidating the ‘lived experience’ of individuals undertaking these diets, and the effects of keto-induction, during adaptation to these diets. Objective. This study aimed to evaluate the subjective experiences of people following a very low carbohydrate, ketogenic diet. Design. This paper describes the qualitative experiences of twenty-eight non-obese, non-diabetic participants, (2 males, 26 females: age ± SD: 35 ± 4 y) in a randomised controlled trial to test the effects of medium chain triglyceride (MCT) supplementation in a VLCKD on time to nutritional ketosis (NK), symptoms of keto-induction, and mood. The experience provided by the diet was rated by a free-form daily diary entry and post-study focus group. Diary entries and focus group transcription were coded inductively and grouped into common themes. Results. Twenty-three participants completed the 3-week study. Physical effects accounted for over 28% of references. Other results were categorised as; mood, energy and cognition (23%), satiety and hunger (16%), cravings and temptation (11%), and sleep (8%). Overall, 49% of references were classified as ‘positive’ with 8% neutral, and 43% negative. Positive impressions were higher after participants had achieved nutritional ketosis and negative impressions higher during keto-induction. Negative impressions, both concerning physical symptoms and feelings of mood and well-being, tended towards improvement over the course of the study, and positive impressions improved. However, there was a large variation in responses, and several respondents reported adverse effects throughout the study. Conclusion. Despite challenges, especially gastrointestinal effects, the overall perception of the diet was positive, and it provided benefits for wellbeing, mood, sleep, and sugar cravings which tended towards improvement over the course of the study. Negative experiences decreased as participants adapted to the VLCKD. Most participants continued post-study, using a lower-carbohydrate diet, due to these perceived benefits. Our findings suggest that the experience of a VLCKD is positive but variable. Further research on individual tolerance and response to low carbohydrate diets is warranted.

scholarly journals A Randomized Controlled Trial of Individual Family Psychoeducational Psychotherapy and Omega-3 Fatty Acids in Youth with Subsyndromal Bipolar Disorder

2015 ◽  
Vol 25 (10) ◽  
pp. 764-774 ◽  
Author(s):  
Mary A. Fristad ◽  
Andrea S. Young ◽  
Anthony T. Vesco ◽  
Elias S. Nader ◽  
K. Zachary Healy ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Bipolar Disorder ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Omega 3 Fatty Acids ◽  
Omega 3 ◽  
Randomized Controlled ◽  
Individual Family
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