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.

Sorbitol is often seen as a healthier alternative to sugar. The sugar alcohol is widely used in sugar-free chewing gum, candies and other low-calorie foods, offering sweetness with fewer calories than regular sugar.

But new research suggests that sorbitol may not just pass through the digestive system as it was previously assumed.

Scientists have found that after reaching the liver, sorbitol may be converted into a compound related to fructose, where it could trigger metabolic changes associated with fatty liver disease.

How Sorbitol Interacts With The Body?

Researchers from Washington University in St. Louis used zebrafish models to analyse what happens to sorbitol after it enters the body.

They found that after eating a meal, sorbitol can be produced naturally in the intestine from the glucose. What happens next depends partly on the bacteria residing in the gut.

Certain bacteria, including Aeromonas strains that degrades sorbitol, can consume sorbitol and convert it into a harmless bacterial byproduct. This may act as a protective filter, preventing the compound from reaching the liver.

But when those bacteria are absent, more sorbitol may pass through to the liver. Researchers found sorbitol can be converted into a derivative of fructose.

The researchers describe sorbitol as being “one transformation away from fructose”, because of how closely the two compounds are connected through metabolism.

Also read: Should You Really Cut Out Rice And Roti To Lose Weight? Expert Explains The Truth About Carbs

Could Sorbitol Affect Liver Health?

The metabolism of fructose in the liver has been linked to steatotic liver disease, a condition in which excess fat accumulates in liver cells. The new findings suggest that sorbitol may have some of the same metabolic effects.

The researchers found that sorbitol could contribute to processes linked with liver fat accumulation when the gut's ability to break it down was impaired.

However, this does not mean that eating sugar-free gum or food containing sorbitol will automatically and mandatorily cause fatty liver disease.

The research was conducted in zebrafish, and the study is exploring a biological mechanism rather than demonstrating that ordinary dietary sorbitol causes liver disease in humans.

Also read: Bill Ackman’s Daughter Gets Experimental Treatment For Vision Loss: When Can Mitochondrial Transplants Help?

Gut Bacteria May Make A Difference

One of the more unexpected findings was the potential role of the gut microbiome in preventing this scenario. At relatively low levels, including amounts naturally obtained from fruit, researchers found that bacteria appeared capable of breaking down sorbitol.

Problems may surface when the amount of sorbitol becomes too high for these microbes to process efficiently. That could happen through consuming large quantities of products that contain sorbitol. High glucose intake may also increase the amount of sorbitol produced inside the intestine.

The researchers therefore suggest that how much sorbitol is consumed and the composition of an individual's gut bacteria could influence what happens to the compound and thus shape the risk of liver disease.

The study does not establish that sorbitol is harmful for humans even when consumed in moderate amounts. In fact, sorbitol occurs naturally in fruits such as stone fruits, and the researchers noted that relatively low amounts are generally handled effectively by gut bacteria.

The findings challenge the assumption that sugar substitutes are automatically metabolically healthy simply because they contain less sugar or fewer calories.

Carbohydrates have unfortunately become one of the most misunderstood parts of the diet, particularly when it comes to weight loss.

Cutting out rice, roti or other carbohydrate-rich foods completely is not necessarily the answer. Carbohydrates are an important source of energy, and the issue is more about the quality, quantity and overall balance of the diet than the nutrient itself.

Why Cutting Carbs Completely May Not Be The Answer

For Indians, this becomes particularly relevant because staples such as rice, roti, poha, idli and other grain-based foods are an integral part of our traditional diets.

Removing them completely can sometimes make a diet unnecessarily restrictive and difficult to sustain. It may also mean missing out on foods that provide fibre, vitamins, minerals and other nutrients, particularly when whole grains and minimally processed sources are chosen.

Also read: The New Nutrition Gap: Why Knowing What To Eat Doesn't Mean We Actually Eat It

Not All Carbohydrates Are Created Equal

What matters is understanding the difference between refined and high-quality carbohydrate sources. A diet dominated by refined flour, sugary foods, sweetened beverages and highly processed snacks is very different from one that includes whole grains, millets, legumes, vegetables and appropriately portioned rice or roti.

The Bigger Picture Behind Weight Loss

Another common mistake is replacing carbohydrates with excessive amounts of protein or fat without considering the overall nutritional balance.

Weight loss ultimately depends on overall energy intake, dietary quality, physical activity, sleep and several other factors—not simply whether carbohydrates are present on the plate.

Also read: Protein Is In Everything, But Is Every Source Actually Healthy? Experts Explain

How To Build A More Balanced Indian Plate

A practical approach is to focus on portions and pair carbohydrates with protein, vegetables and healthy fats. For example, roti with dal and vegetables or rice with dal, vegetables and curd can form a balanced meal. Choosing less-refined carbohydrate sources and paying attention to portion sizes can make the diet both nutritious and sustainable.

Carbohydrates do not need to be feared or completely eliminated. The goal should be to eat the right kind, in appropriate portions, as part of a balanced diet rather than following the latest anti-carb trend.

Healthy eating is something every individual is aware of, not only because of various online conversations around it but also because it is one of the subjects that is being discussed widely amongst individuals today.

From taking up diet charts with the help of AI to taking details from social media reels shared by several wellness influencers – information about food and health is readily available for all age groups at any time and it is customised according to their preferences, thanks to our algorithms.

Most people are aware that a healthy diet includes vegetables, fruits, home cooked meals, adequate water intake, and most importantly, limited consumption of outside food like fried and processed foods.

Unhealthy Eating Habits Continue To Rise Despite Awareness

Also read: From Pickles to Papad: Which Everyday Indian Foods Could Be Worth Rethinking for Cancer Prevention?

Despite growing awareness amongst the population, unhealthy eating habits continue to rise, which is eventually contributing to various lifestyle diseases like obesity, diabetes, cardiovascular diseases, and other health issues.

For most people, lack of information and knowledge about nutrition is not a challenge anymore, but the inability to act on that knowledge and consistently following through the habits and incorporating them into day-to-day life is. This growing gap between knowing what to eat and not being able to follow through is called the new nutrition gap.

Many individuals understand what a healthy diet is? yet struggle due to busy schedules, long working hours, and stress. Also, the convenience of ordering food often leads to dietary choices, that do not support long-term health. It is common for individuals to skip meal preparation, rely heavily on packaged food and snacks or food from restaurants, and beverages during stressful times despite being aware of their harmful impact on health.

“Social settings” add another challenge to sticking to one’s diet as planned. Office celebrations, family gatherings, and social outings are often centred around calorie dense foods and sugary treats. In addition, many people follow an all or nothing approach to eating, believing that a single indulgence has undone all their progress. This mindset can also make healthy eating feel difficult and unsustainable in the long run.

Also read: Protein Is In Everything, But Is Every Source Actually Healthy? Experts Explain

Closing this gap does not require restrictive diets or unrealistic rules. It is about building small, practical and healthy habits that can follow consistently over time. To maintain the same, some of the following small habits can be helpful:

1. Make healthy the easy option

2. Stop punishing yourself

A healthy lifestyle is not determined by a single meal. Occasionally eating a vada pav or enjoying a dessert, festive treats are not going to harm long-term health when it is balanced with nutritious meals throughout the day. Instead of feeling guilty after eating an unhealthy food and worrying over its impact your progress, one should simply focus on continuing the prioritising balanced eating habits with their next meal.

3. Make it personal

Don't eat healthy because an influencer said so. Eat healthy because you want to feel lighter, sleep better, and not feel acidity every evening. It is important to take guidance from a professional like a Certified Registered Dietiian when you are not able to follow through with your diet or are facing any other challenge instead of depending solely on unreliable nutrition advice and social media trends.

Healthy eating becomes easier when one makes conscious choices of maintaining a balanced diet, regular meal planning, mindful eating, and realistic lifestyle changes.

By Vidisha Parekh, Chief Dietician at Lilavati Hospital and Research Centre, Mumbai