Let's talk about energy.
Bipolar Disorder (BD) is commonly viewed as a condition caused by an imbalance of neurotransmitters.
But what if the severe circadian and energy shifts in BD point to a more fundamental problem of energy dysregulation in the brain?
There is increasing evidence that the normal function of the cellular engines in neurons "mitochondria" are disrupted in people with BD.
Several lines of evidence indicate that they are unable to effectively utilize glucose -the body's primary fuel source- to create stable energy in the brain.
What would happen if we could provide an alternative fuel source for the bipolar brain?
This study funded by the Baszucki Brain Research Fund, and carried out by a multi-disciplinary team at Edinburgh University, will be the first European study of a Ketogenic Diet for bipolar disorder...
1. Medications and Ketogenic Diet
Ketogenic Diets (KD) have been in use for nearly 100 years as an effective metabolic therapy for epilepsy [1].
A KD is a diet which is high in healthy fats and low in carbohydrate. This kind of diet can shift the brain's energy metabolism to run on an alternative fat-derived fuel source known as "ketones".
Bipolar Disorder (BD) is treated by many of the same anti-convulsants used in the treatment of epilepsy, however there have been few studies on the effects of a KD in BD [2].
This study will use brain imaging, metabolomics and mood assessments to find out if the diet may also benefit those with BD.
3. Insulin Resistance and Bipolar Disorder
Over 50% of those with BD have some form of insulin resistance (IR) - a condition where the body cannot use glucose effectively as a fuel source. In many people with BD this leads to type 2 diabetes. Increasing evidence indicates a key role of IR and impaired glucose metabolism in BD. [4].
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Ketogenic diets have been demonstrated to reduce or ameliorate IR by reducing blood glucose and insulin levels [5].​
2. Case Studies of a Ketogenic Diet
There are emerging case studies documenting mood stabilising effects of a ketogenic diet for BD and schizophrenia patients [3].
The case studies describe mood stabilising effects of the diet and improvements in energy; sometimes accompanied by significant weight-loss.
4. Mitochondrial Dysfunction and Bipolar Disorder
Glucose is converted into a fuel source used by cellular "engines" in the brain called mitochondria. There is considerable evidence that this process is impaired in BD [6].
On a ketogenic diet an alternative mitochondrial "fuel source" called "ketones" are generated and used by the brain [7].
If energy to the brain is restored then this may allow the brain to self-regulate more efficiently.
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David Baszucki, Founder and CEO Roblox, Co-Founder, Baszucki Group
Jan Ellison Baszucki, Author, Co-Founder and President, Baszucki Group
"Those living with bipolar disorder have historically made outsized contributions to science, academia, government and the arts, yet bipolar research has been tragically underfunded. Our dream is that by spotlighting and accelerating the work of the most promising researchers in the field, we can bring hope to patients and families who will benefit from transformative new treatments."
Professor Harry Campbell, MBE
Chief Investigator
Professor of Genetic Epidemiology and Public Health,
University of Edinburgh
Professor Daniel Smith
Principal Investigator
Chair of Psychiatry and Head of Division of Psychiatry, University of Edinburgh
Dr. Iain Campbell
Principal Investigator
Centre for Clinical Brain Sciences,
University of Edinburgh.
Dr. Nicole Needham
Research Coordinator
Centre for Clinical Brain Sciences,
University of Edinburgh
Join one of the world's first scientific studies of a ketogenic diet for bipolar disorder.
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From March - 15th October 2022, participants will be recruited through the charity Bipolar Scotland and social media channels.
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A dietician experienced with delivering a ketogenic diet will support participants throughout the 8 week study.
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Mood will be self-measured and assessed by a psychiatrist throughout the trial.
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Blood tests and brain imaging will be used to find out how a ketogenic diet affects energy metabolism in the brain and body.
To be eligible to take part in the pilot study the following must apply to you:
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You must be living in Scotland.
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You must have a diagnosis of bipolar disorder type 1 or 2.
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You must have had 3 months with no major mood episodes (major depression lasting at least 2 weeks or hypomania/mania lasting at least 1 week).
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You must be aged 18 to 70 years.
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You must be able to provide informed consent to take part in the study.
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You must be able to able to speak, read and understand English.
What is involved?
25
Participants
8
Weeks of Ketogenic Diet
<20g
Carbohydrate Per Day
70%
of Diet as Healthy Fats
