A revolutionary study published in BJPsych Open has revealed compelling evidence that a ketogenic diet can have a major impact on mental and physical well-being in bipolar disorder patients. The study, conducted by Dr. Iain Campbell, PhD, Baszucki Metabolic Psychiatry Research Fellow at the University of Edinburgh, investigates how a metabolic-based intervention might represent an exciting new strategy for treating this serious mental illness.

The research is the first in Europe to use neuroimaging methods, namely magnetic resonance spectroscopy (MRS), to investigate changes in brain metabolism in people with bipolar disorder after a ketogenic diet. The imaging findings revealed decreases in excitatory neurotransmitters, which are normally increased in bipolar disorder. This indicates that the ketogenic diet can stabilize brain activity, possibly reducing mood swings and other symptoms of the condition.

The trial involved 27 participants diagnosed with bipolar disorder, 20 of whom successfully completed the 6-8 week program. A staggering 91% of these individuals maintained ketosis, the metabolic state where the body primarily burns fat for energy instead of carbohydrates. Those who provided consistent daily ketone and mental health assessments reported notable improvements in mood, energy levels, anxiety, and impulsivity.

Dr. Campbell, who personally adheres to a ketogenic diet himself in order to treat symptoms of bipolar disorder, discussed the importance of these results:

"We saw indicators of diminished excitotoxicity in the brain regions most implicated in bipolar disorder. These findings are consistent with the metabolic overdrive hypothesis that postulates energy dysregulation within the brain as central to the disorder. Treating the dysregulation by means of a ketogenic diet could be a game-changer in treatment-resistant patients.

Aside from the scientific evidence, personal accounts of study participants underscore the life-altering effect of a ketogenic diet.

"Quite literally, for the first time in years, I felt like my brain was finally fueled correctly," explained a participant.

Another participant called the diet "a lifeline, restoring my energy and sense of hope. I felt like I was finally healing my mind, not just coping with my bipolar symptoms."

One of the very vivid accounts described the impact of ketosis in terms of a relaxing mental atmosphere:

"Applying a ketogenic diet is akin to giving my mind a nice warm bath. The edginess disappears. I am more calm, more clear, and my brain function is restored again."

Aside from the psychological benefits of the study, the ketogenic diet was also seen to have beneficial effects on participants' physical health. Nineteen out of the 20 trial completers lost a total of 9.3 pounds (4.2 kg) on average and showed improvements in body mass index (BMI) and blood pressure.

These results are noteworthy in that numerous treatments for bipolar disorder, such as mood stabilizers and antipsychotic medications, have been linked to metabolic side effects of weight gain and risk of cardiovascular disease. In contributing to the reduction of such risks, a ketogenic diet may provide a double dividend for patients with bipolar disorder.

Link Between Metabolism and Bipolar Disorder

Although the ketogenic diet has previously been known largely for its utility in treating epilepsy that is treatment-resistant, it is a somewhat new area to explore in conditions of psychiatry such as in bipolar disorder. It has come to be known that metabolic imbalance is an underlying factor in causing psychiatric disorders as energy production deficiencies have been recognized to contribute towards neural excitability and mood disruption.

One of the important findings of the study is that people with bipolar disorder tend to have sodium levels higher than usual within their cells. Lithium, a standard mood stabilizer, acts partly by reducing these sodium levels. The ketogenic diet seems to do the same thing, offering a metabolic explanation for its beneficial effect on mood stabilization.

What Is a Ketogenic Diet?

The ketogenic diet is a high-fat, low-carb diet that changes the body's main source of energy from glucose to ketones. As carbohydrate consumption is significantly decreased, the liver breaks down fats into ketones, which can be used as a substitute fuel by the brain and body.

First developed in the 1920s as a therapy for epilepsy, the ketogenic diet has been researched for its therapeutic applications in a variety of neurological and psychiatric disorders, including Alzheimer's disease, Parkinson's disease, and most recently, bipolar disorder.

There's a critical need for bigger replication studies and well-designed randomized clinical trials to follow up on these findings," added Dr. Campbell. "Our findings indicate that a ketogenic diet may be a useful adjunctive treatment for bipolar disorder, bringing new promise to patients who have difficulty with standard therapies.

In India, vegetarian food is often considered a healthier choice, and many people believe that avoiding meat automatically reduces their risk of lifestyle diseases.

The traditional Indian vegetarian diet, rich in lentils, vegetables, whole grains and legumes, has long been seen as a cornerstone of good health. Yet India faces a staggering diabetes epidemic, with over 101 million people living with diabetes and millions more at the pre-diabetic stage. This contradiction is often called the "Indian vegetarian paradox". As doctors, we need to look beyond whether someone eats vegetarian or non-vegetarian food and understand what actually goes into their daily meals.

A person can follow a completely vegetarian diet and still be at risk of developing type 2 diabetes. This does not mean that vegetarian food is unhealthy. The root of the paradox lies not in vegetarianism itself, but in what makes up the contemporary Indian plate.

Traditional diets relied on complex carbohydrates, high fibre and unrefined grains. Modern eating habits have shifted heavily towards refined carbohydrates such as polished white rice, white flour (maida) and packaged snacks. Indian vegetarian cooking also often includes generous amounts of oil, ghee, full-fat dairy and sugar in sweets and beverages.

How The Modern Indian Vegetarian Plate Can Affect Blood Sugar

Consider a typical Indian meal. A large serving of rice or chapati, accompanied by a small portion of dal and limited vegetables, may look like a regular home-cooked meal.

However, if this pattern is repeated every day, the overall carbohydrate intake can become quite high. When the diet is also low in fibre and protein, it triggers sharp spikes in blood glucose after meals. Over time, these repeated spikes overwhelm the pancreatic beta cells and accelerate insulin resistance, making blood glucose harder to manage, particularly in people who already have insulin resistance.

Interestingly, the ICMR-INDIAB dietary study published in Nature Medicine in 2025, which analysed dietary patterns among 18,090 Indian adults, highlighted the high consumption of low-quality carbohydrates and relatively low protein intake in Indian diets. Its analysis also suggested that replacing a portion of carbohydrate intake with plant-based or dairy protein was associated with a lower likelihood of type 2 diabetes.

Also read: Delhi Air Pollution: PM2.5 Exposure May Raise Type 2 Diabetes Risk By 16%, Study Finds

Why Switching To Millets Or Whole Wheat May Not Be Enough

Another misconception is that replacing white rice with millets or switching to whole wheat is enough to prevent diabetes. High-fibre millets and whole grains can certainly be part of a healthy diet, but the quantity consumed and the overall balance of the meal matter just as much. Simply changing the grain without addressing portion sizes may not make a significant difference.

We also need to pay attention to what people eat between meals. Biscuits, bakery products, packaged snacks and sweetened beverages are often considered harmless because they are vegetarian. However, many of these foods contain refined carbohydrates, added sugar, trans fats and excess calories.

Why Indians Can Develop Diabetes Even At Lower Body Weights

There is also an important Indian-specific concern. Diabetes does not affect only people who are visibly overweight.

South Asians have a distinct metabolic profile, with more fat around the abdominal organs, more fat deposited in the liver and lower muscle mass relative to body fat.

This makes them more susceptible to type 2 diabetes even at lower body weights and BMI levels. Family history, physical inactivity and poor sleep can further increase the risk.

How To Make A Vegetarian Diet More Diabetes-Friendly

The answer is not to give up vegetarian food. Instead, we should focus on improving the quality of the diet by returning to nutrient-dense, traditional patterns. Including adequate portions of dal, whole legumes, beans, non-starchy vegetables, curd, nuts and seeds, while moderating refined carbohydrates, trans fats and added sugars, can make everyday meals more balanced.

Being vegetarian is a dietary choice, but preventing diabetes requires a more thoughtful approach to what we eat, how much we eat and how consistently we maintain a healthy lifestyle. Plant-based nutrition remains powerful, but only when it is balanced for metabolic health.

By Dr Hiran S. Reddy, Consultant Physician, Diabetologist & Critical Care Specialist, Gleneagles Hospital, Lakdi-Ka-Pul, Hyderabad

From sugary mithai such as jalebi, gulab jamun, laddoo and barfi to fried foods such as puris and pakoras, Diwali is a time for gastronomic delight. While occasional indulgence is unlikely to cause lasting harm, overeating can strain the digestive system, health experts warn.

It can trigger acidity, bloating and indigestion. Excessive consumption of sugary foods can also affect blood sugar levels, particularly in people with diabetes.

Speaking to HealthandMe, two experts explain how festive overeating affects your body and how to ease digestive discomfort.

How Does Overeating Affect Your Digestive System?

Also read: Just Four Days Of High-Fat Diet May Increase Inflammation, Study Finds

Overeating stretches the stomach and may slow gastric emptying, particularly after fatty meals. This can cause heaviness, nausea and abdominal discomfort.

"Excessive consumption of samosas, kachoris, puris and rich gravies can cause heaviness, nausea, belching and abdominal discomfort," said Dr Parmeet Kaur, Chief Dietician, AIIMS.

Dr Ayush Dhingra, Chairman – Gastroenterology, Manipal Hospital, Gurugram, said large portions, eating too quickly and consuming excessive fried, fatty, spicy or sugary foods can trigger digestive discomfort.

Can Festive Binge Eating Trigger Acidity And Acid Reflux?

Large meals distend the stomach, while fatty foods can delay gastric emptying and worsen reflux. Excessive consumption of chole bhature, pakoras, spicy curries and late-night snacks can trigger heartburn, a sour taste in the mouth and the sensation of food coming back into the throat.

Dr Dhingra said an excessively full stomach can aggravate acid reflux. Recurring symptoms may indicate gastroesophageal reflux disease (GORD) and require medical evaluation.

How Do Sweets And Fried Foods Affect Blood Sugar?

Read More: New International Food Pyramid Highlights Plant Foods, Counters Trump’s Meat-Heavy Diet Advice

Festive sweets such as jalebi, gulab jamun, laddoo and barfi can rapidly raise blood glucose levels, stimulating insulin secretion. Fried foods, including puris and pakoras, may prolong glucose elevations. Excessive fat intake can also temporarily reduce insulin sensitivity.

Dr Kaur cited a controlled human study in which one day of high-fat overfeeding increased glucose and insulin responses and reduced insulin sensitivity by 28%.

Sugary foods and beverages can also cause blood sugar spikes, making portion control particularly important for people with diabetes, Dr Dhingra told HealthandMe.

Can A Few Days Of Overeating Cause Weight Gain?

Excess calories from sweets, namkeen, fried snacks, rich gravies and sugary beverages can increase body weight.

However, initial weight gain may partly reflect water retention and increased glycogen stores rather than fat accumulation.

A systematic review of 39 studies found an average festive-period weight gain of approximately 0.7 kg, although individual outcomes varied. Repeated overeating can contribute to fat accumulation and affect metabolic health.

When Should You Worry About Digestive Discomfort?

Mild bloating and indigestion may settle on their own, but persistent or severe symptoms should not be dismissed as ordinary indigestion.

Dr Dhingra cautioned that severe upper abdominal pain, particularly when it radiates to the back and is accompanied by nausea, vomiting or fever, could indicate pancreatitis.

Recurring acidity and indigestion also warrant medical evaluation rather than repeated self-medication.

How To Ease Digestive Discomfort After Festive Overeating

Returning to regular eating habits rather than following restrictive diets can help your digestive system settle.

Dr Kaur recommends balanced meals comprising dal, roti, vegetable sabzi, curd and khichdi. Adequate hydration and fibre intake can also support digestion.

Dr Dhingra suggests the following measures:

• Eat smaller meals: Choose lighter, home-cooked food for the next few days.
• Stay hydrated: Drink adequate water throughout the day.
• Take a walk: A gentle 20–30-minute walk after meals can help you avoid remaining inactive.
• Avoid lying down immediately: This is particularly important if you experience acidity or reflux.
• Limit trigger foods: Cut back temporarily on fried, oily, very spicy and sugary foods if they worsen symptoms.
• Monitor blood sugar: People with diabetes should monitor glucose levels as advised and resume their regular meal and medication routines.

Avoid crash diets or skipping meals to compensate for festive overeating. Return to balanced meals and regular eating habits instead.

Do you ever feel energetic in the morning only to feel sluggish in the afternoon? Unable to stifle the yawn at meetings or fighting to keep your eyes open in classrooms? And you find yourself inevitably reaching for that cup of coffee? You are not alone! This is called ‘post-prandial somnolence’. Medical jargon aside, let’s decode why it happens and how to beat it.

What Drives the Post-meal Drowsiness?

The body has a natural clock, called the Circadian rhythm, which drives sleep – wake cycles. This clock brings about a slight dip in alertness in the early afternoon, between 1PM to 4PM and hence the afternoon sleepiness.

But circadian rhythm isn’t the only one driving this slump. The status of digestive power and food plays an important role.

A weak digestive capacity or a weak Agni, as Ayurveda puts it, makes one sluggish after a meal. Also, the quantity and quality of the meal, that is, Matra and Guna of food, help make the distinction between being active or feeling sluggish in the afternoons. A diet rich in refined carbohydrates and fats like maida parotta, Poori, curd, buns/ breads, desserts, etc in large quantities drives this slump. These foods increase Kapha in the body, which makes a person sleepy.

Hydration plays an equally important role. Poor hydration, poor nighttime sleep, and a sedentary lifestyle can worsen the phenomenon.

How Do We Overcome It?

The trick to overcome this slump is to combine food wisely, rather than skipping food. Instead of a large bowl of polished rice with rasam and papad, one can go with a moderate amount of brown rice, a bowl of sambar, vegetable fry, sprouts, or nuts. Maida-based rotis can be replaced with barley-based chapathis with a bowl of moong dal, chana, green leafy vegetables, etc. One can also opt for millet-based khichdi, millet rotis for the same. Foods that are not heavy for digestion and in the right quantity help avoid mid- day sleepiness.

Maintaining hydration by adequate water intake is recommended. One can also opt for fresh fruit juices, water-rich fruits like melons, or water-rich vegetables. Buttermilk is another healthy option for the same.

Physical activity, or Vyayama as Ayurveda describes, is another important aspect to keep in mind. Prolonged sitting often leads to an increase in Kapha in the body, which results in sluggishness. It is especially true after meals. A short walk of 100 steps after lunch helps beat the sluggishness. Light shoulder and neck stretches in between work too shall keep one active.

However, persistent or excessive daytime sleepiness could be because of underlying medical conditions like thyroid disorders, diabetes mellitus, etc. Hence, it is important to consult the physician if one feels excessive sleepiness or an energy slump during the day.

One need not let the post–meal drowsiness define the rest of the day. A combination of the right food, hydration, and exercise can go a long way in restoring energy without the caffeine!

(By Dr Meghana K A, Assistant Professor, SDM College of Ayurveda, Hospital & Research Center, Udupi)