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Participants with DSM\u2010IV TR BD I or II with hypomanic or depressive symptoms were randomized, stratified on gender (<jats:italic>N<\/jats:italic>\u00a0=\u00a082). The intervention included the provision of group\u2010specific study foods and dietary counseling. Variability of mood symptoms was measured by a twice\u2010daily, 12\u2010week ecological momentary analysis (EMA) paradigm, and group differences were analyzed using multilevel models. Circulating n\u20103 and n\u20106 fatty acids were measured at baseline and after 4, 8, and 12\u00a0weeks of diet exposure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All 82 randomized participants were included in biochemical analyses. Seventy participants completed at least 2 EMA surveys and were included in primary EMA analyses. Variability in mood, energy, irritability, and pain as measured using EMA was reduced in the H3\u2010L6\u00a0group compared to the CD group. No significant differences in mean ratings of mood symptoms, or any other symptom measures, were detected. The dietary intervention effect on target PUFAs significantly differed by the group over time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A dietary intervention adjunctive to usual care showed preliminary efficacy in improving variability in mood symptoms in participants with BD.<\/jats:p><jats:p><jats:italic>Trial Registration<\/jats:italic>: ClinicalTrials.Gov NCT02272010.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bdi.13112","type":"journal-article","created":{"date-parts":[[2021,7,4]],"date-time":"2021-07-04T14:00:00Z","timestamp":1625407200000},"page":"171-184","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Adjunctive dietary intervention for bipolar disorder: a randomized, controlled, parallel\u2010group, modified double\u2010blinded trial of a high n\u20103 plus low n\u20106 diet"],"prefix":"10.1111","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7222-0828","authenticated-orcid":false,"given":"Erika F. 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