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, over half of adolescent girls and women are anaemic; one-fifth have low Body Mass Index, while micronutrient deficiencies like Vitamin D and Vitamin B12 affect 60% and 53% of girls and women, respectively. The resulting lack of energy, poor ability to concentrate, bone pain, chronic fatigue, insomnia, and a variety of other health challenges cause significant loss of quality of life, poor productivity, and high morbidity among women.

The multifactorial causation theory of nutrition effectively defines that, alongside nutrition-specific factors, nourishment depends on nutrition-sensitive factors, including socio-economic and cultural factors, that are often shaped by communities.

Although women almost universally prepare food at home, gender norms compel women to prioritise serving food to family members before themselves, resulting in smaller portions and nutritionally inferior diets for themselves. This is particularly harmful to women when the demands of the body are high, such as during adolescence, pregnancy, breastfeeding, and peri-menopause. To break such harmful practices reinforced through generations, focused social and behaviour change (SBC) strategies that foster community action are essential.

Re-Positioning Women’s Nutrition for Effective Behaviour Change

The objective of SBC is to change knowledge, attitudes and practices of target groups and stimulate social change at the local and national level. Good SBC efforts can encourage community engagement, influence social norms, support policy advocacy, promote service uptake, reach underserved populations and foster a media environment that resonates with downstream engagement. Community Action can be an outcome of a good SBC effort.

An SBC approach meant to centre a woman’s nutrition needs within a household must target all decision makers within that family and community such as husband, mothers-in-law, elders, local leaders and other influencers. Rather than adopting a narrow woman-centred approach, messages that position the health and nutrition of a woman as central for the well-being of the entire family are more effective.

Communication strategies that emphasise outcomes that are valued by families, such as better nutrition leading to a reduction in sickness-related income loss, decreased healthcare expenditure, increased savings and improved productivity, are more appealing and acceptable in Indian and other similar societies. Such framing aligns women's nutritional needs with aspirations families are motivated to achieve.

Behaviour change rarely occurs after a single exposure to a message. New ideas gain acceptance when repeated consistently by trusted community sources like ASHAs, Anganwadi Workers, SHG leaders, Panchayat representatives, faith-based leaders, community elders, and frontline health workers. Consistent messaging across platforms builds trust, creates social acceptance, and gradually shifts expectations regarding women's health.

Also read: Eating 4–6 Servings of Whole Grains Daily May Lower Heart Disease Risk

Fostering Community-Led Collective Action

Evidence demonstrates that community-led collective action effectively shifts entrenched norms. Women's collectives provide safe spaces for discussion, peer learning, and collective problem-solving, becoming agents of social change rather than mere beneficiaries. Sustainable improvements require interventions operating simultaneously across multiple levels:

• Individual level: Knowledge, confidence, and agency for informed nutritional choices.
• Household level: Positioning women's health as essential for effective caregiving, household productivity, reduced healthcare costs, and overall family well-being.
• Community level: Women's collectives, SHGs, youth groups, Panchayats, and faith-based organisations fostering dialogue and establishing healthier behaviours as socially desirable.
• Institutional level: Frontline workers requiring training, supervision, and culturally appropriate tools for consistent messaging.
• Policy level: Integrating nutrition with livelihoods, women's empowerment, social protection, and primary healthcare rather than isolated sectoral programmes.

Also read: Can An Overweight Child Be Malnourished? Signs Of Hidden Malnutrition In Kids

Lessons from Implemented Programmes

JEEViKA, Bihar's State Rural Livelihoods Mission, demonstrates effective change. Rather than presenting maternal and child nutrition as isolated health issues, JEEViKA positioned nutrition within household well-being. Messages focused on how improved food practices enhance productivity, increase income, and strengthen family well-being. This framing resonated with household priorities and encouraged wider family participation, contributing to substantial improvements in dietary practices without directly challenging cultural norms. Messages were discussed during SHG meetings, reinforced through peer support, and complemented by frontline health services.

Alive & Thrive, implemented by FHI 360, generated important evidence on culturally grounded social and behaviour change communication in Bihar. Formative research found poor maternal diets driven less by food scarcity than by household norms regarding meal frequency, food allocation, and perceptions about eating during pregnancy. Importantly, many pregnant women were willing to consume more diverse diets when household members supported changes and messages addressed prevailing beliefs rather than simply providing nutritional advice. The programme emphasised repeated interpersonal communication, practical counselling, engagement of influential family members, and community-based reinforcement.

Food fortification provides a cost-effective population-level complement to this goal. Fortified staples can help bridge micronutrient gaps; however, they are complementary to, and not a substitute for, a balanced and diversified diet.

A comprehensive review across India, Bangladesh, and Vietnam concluded that integrating social and behaviour change interventions into community-based women's groups improves maternal and child nutrition practices through peer support, collective efficacy, and existing social capital.

The Way Forward

Improving women's nutrition requires moving beyond food distribution, supplementation, and knowledge-sharing. The challenge is fundamentally social as much as nutritional. Food availability creates opportunity, but social norms determine utilisation. Lasting improvements depend on transforming beliefs, behaviours, and relationships governing food allocation within households, demanding culturally grounded communication, repeated reinforcement from trusted actors, and sustained collective action through women's groups.

Women's nutrition should be recognised as a strategic investment in household resilience, economic productivity, community development, and national human capital, not solely a maternal and child health issue. When women are well-nourished physically and mentally, benefits extend far beyond individual health.

Future programmes should move beyond information dissemination towards community-owned social norm transformation, using collective action as catalysts for sustained behavioural change. This represents one of the most promising pathways for improving women's nutrition at scale while strengthening family health, livelihoods, and community resilience.

By Dr Amrita Misra, Visiting Professor, Azim Premji University

Whole grains are becoming more popular day by day because of their nutritional benefits, and a recent study has highlighted another major advantage of eating four to six servings. According to the study published in the European Heart Journal, eating four to six servings of whole grains every day may help lower the risk of heart disease. As heart disease is arguably one of the most fatal ailments, these findings, if true, can give hope to millions.

The research shows that eating a diet rich in whole grains may help to prevent heart disease. The study emphasizes that these foods reduce body weight, blood pressure, cholesterol levels, and glucose in the blood, which in turn play a major role in lowering the risk of heart disease overall.

The lead researcher Dr. Helda Tutunchi from Tabriz University of Medical Sciences, Iran said, "Although higher whole-grain intake has long been linked to better heart health in population studies, clinical trials have produced mixed findings. This left an important practical question unanswered: How much whole grain should people eat to meaningfully improve cardiovascular health?"

"To address this, we systematically combined and analyzed all available randomized controlled trials to identify the amount of whole grain associated with the greatest benefits." She added.

The findings came after trials conducted across Asia, Europe, the United States, Canada, Australia, and Brazil. Notably, more than 6,500 people took part in these trials. The thorough analysis showed that whole grains significantly reduced people's body weight, waist circumference, and blood pressure, as well as levels of total cholesterol and low-density lipoprotein cholesterol, triglycerides, glucose, and interleukin-6, a sign of inflammation in the blood.

The study suggested that these benefits might be seen in those who eat 30 to 40 grams of whole grains per day, but the maximum benefits were found in people eating 60 to 100 grams per day. This amounts to around four to six servings of whole grains a day—for instance, oatmeal, a sandwich made with whole-grain bread, and a serving of brown rice.

In an accompanying editorial, Dr Cecilie Kyrø of the Danish Cancer Institute in Copenhagen and her colleagues noted that more than 50 years ago, Sir Denis Burkitt and his fellow researchers suggested that refining staple carbohydrates—and removing the cereal fibre in the process—could contribute to a wide range of Western diseases by affecting stool volume, bowel transit time and the environment within the colon.

Whole grains are cereal grains that retain all three major components—bran, germ and endosperm—in the same proportions found in the intact grain. They can be consumed as whole kernels or flakes, or ground into flour and used to make bread and other foods.

When we think of malnutrition, we often picture a child who is thin or underweight. But malnutrition can sometimes look very different. An overweight child can also be malnourished.

A child may consume enough—or even too many—calories and still not get the nutrients needed for healthy growth. Diets high in processed foods, sugary drinks and refined carbohydrates can lead to excess weight while being poor in iron, calcium, vitamin D, vitamin B12, protein and other essential nutrients.

This is particularly important today, when childhood overweight and obesity are increasing alongside micronutrient deficiencies. A child’s weight alone therefore cannot tell us whether the child is adequately nourished.

Parents need to look at the overall picture—growth pattern, height and BMI for age, dietary habits, physical activity and, when required, blood tests for specific deficiencies.

Parents should also remember that “eating more” does not always mean “eating better”. A balanced diet containing adequate protein, vegetables, fruits, whole grains and other nutrient-rich foods is essential.

The goal should not simply be a healthy weight, but a healthy, well-nourished child.

Dr. Ashish Gautam, Principal Director, Robotic Surgery, Laparoscopic & Minimal Access Surgery, Max Hospital, Patparganj