{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T22:53:41Z","timestamp":1793141621231,"version":"4.5.0"},"reference-count":42,"publisher":"Royal College of Psychiatrists","issue":"2","license":[{"start":{"date-parts":[[2025,2,25]],"date-time":"2025-02-25T00:00:00Z","timestamp":1740441600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:sec id=\"S205647242400841X_sec_a1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Preliminary evidence suggests that a ketogenic diet may be effective for bipolar disorder.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S205647242400841X_sec_a2\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To assess the impact of a ketogenic diet in bipolar disorder on clinical, metabolic and magnetic resonance spectroscopy outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S205647242400841X_sec_a3\" sec-type=\"methods\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      Euthymic individuals with bipolar disorder (\n                      <jats:italic>N<\/jats:italic>\n                      = 27) were recruited to a 6- to 8-week single-arm open pilot study of a modified ketogenic diet. Clinical, metabolic and MRS measures were assessed before and after the intervention.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S205647242400841X_sec_a4\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 27 recruited participants, 26 began and 20 completed the ketogenic diet. For participants completing the intervention, mean body weight fell by 4.2 kg (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001), mean body mass index fell by 1.5 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001) and mean systolic blood pressure fell by 7.4 mmHg (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.041). The euthymic participants had average baseline and follow-up assessments consistent with them being in the euthymic range with no statistically significant changes in Affective Lability Scale-18, Beck Depression Inventory and Young Mania Rating Scale. In participants providing reliable daily ecological momentary assessment data (\n                      <jats:italic>n<\/jats:italic>\n                      = 14), there was a positive correlation between daily ketone levels and self-rated mood (\n                      <jats:italic>r<\/jats:italic>\n                      = 0.21,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001) and energy (\n                      <jats:italic>r<\/jats:italic>\n                      = 0.19\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001), and an inverse correlation between ketone levels and both impulsivity (\n                      <jats:italic>r<\/jats:italic>\n                      = \u22120.30,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001) and anxiety (\n                      <jats:italic>r<\/jats:italic>\n                      = \u22120.19,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001). From the MRS measurements, brain glutamate plus glutamine concentration decreased by 11.6% in the anterior cingulate cortex (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.025) and fell by 13.6% in the posterior cingulate cortex (\n                      <jats:italic>P<\/jats:italic>\n                      = &lt;0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S205647242400841X_sec_a5\" sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings suggest that a ketogenic diet may be clinically useful in bipolar disorder, for both mental health and metabolic outcomes. Replication and randomised controlled trials are now warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1192\/bjo.2024.841","type":"journal-article","created":{"date-parts":[[2025,2,25]],"date-time":"2025-02-25T02:01:28Z","timestamp":1740448888000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":39,"title":["A pilot study of a ketogenic diet in bipolar disorder: clinical, metabolic and magnetic resonance spectroscopy findings"],"prefix":"10.1192","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8756-1326","authenticated-orcid":false,"given":"Iain 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