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.

Studies have found that fermented foods directly increase the diversity of the gut microbiome, improve blood sugar control, and lower systemic inflammation.

From yogurt to sauerkraut to kimchi and kefir, almost every culture on earth has fermented foods in its traditional cuisines. Fermentation originated naturally, long before human civilization, when wild yeasts and bacteria accidentally encountered sugars, spontaneously triggering chemical transformations.

Now, fermented foods are re-emerging as research is demonstrating their nutritional pros. They are preserved using an age-old process that not only boosts the food's shelf life and nutritional value, but can give your body a dose of healthy probiotics, which are live microorganisms crucial to healthy digestion, according to Dr. David S. Ludwig, a professor of nutrition at the Harvard School of Public Health.

Fermented foods are packed with probiotics that serve a plethora of purposes. Other benefits include:

1. Improves immune function
2. Protects against hostile bacteria
3. Improves digestion and absorption of food and nutrients.
4. Produce essential nutrients like vitamins K and B
5. Synthesize short-chain fatty acids
6. Increase bioavailability of iron, zinc, and other minerals

Also read: AI Cannot Replace Doctors, It Can Only Complement, Says Dr Santosh Sivaranjani

What Are Fermented Foods?

Fermented foods are defined as foods or beverages produced through controlled microbial growth and the conversion of food through enzymatic action. These foods are transformed by microbes intentionally, unlike spoiled foods that are altered unintentionally by microbes.

A lot of fermented foods are produced across the globe, including dairy, vegetables, grains, and legumes. Some of the popular ones that are consumed are sourdough bread, kimchi, curd, miso, etc.

When we eat fermented foods, the bacteria survive the digestion and make their way to the small and large intestines, where they secrete beneficial compounds, inhibit intestinal pathogens, and influence the composition of the gut microbiome.

Not all fermented foods contain live microorganisms. Major examples of this are chocolate and coffee.

1. Chocolate is made by fermenting cacao beans with natural yeasts and bacteria, which are killed off when the beans are heated and roasted.
2. Coffee is considered a fermented food because beans typically undergo a fermentation process. The microbes are destroyed when coffee beans are roasted.

The flavor profiles of both chocolate and coffee are influenced by fermentation, leading to the creation of that unique and rich flavour loved by everyone.

“A big part of the reason that chocolate or coffee tastes different is because of the way that it’s fermented in that region and the microbes that are present in that region,” said Chris Damman, a microbiome and nutrition expert and gastroenterologist at the digestive health center at the University of Washington Medical Center.

How To Eat Fermented Foods

Ideally, one or two servings of fermented food should be eaten daily, and new varieties should be tried to gain the full benefits of consuming different types of polyphenols, probiotics, and their by-products.

Fermented foods like kimchi, pickles, and sauerkraut can be relatively high in sodium, so avoid them when on low-sodium diets or with hypertension. Eating too many fermented foods can create problems for those who have a compromised immune system.

For those who are well, look for ways to incorporate fermented foods in your favorite dishes. Here's how:

• While having a burger or stir fry, add a topping of kimchi;
• While eating salad, top it up with sauerkraut sauce;
• If granola or cereal is being eaten, replace milk with kefir.
• Craving a snack? Have a bowl of plain Greek yogurt topped off with fruits instead of junk items.

How to Add Fermented Foods To Your Daily Meals

1. Add kimchi to everyday meals. Kimchi can be used as a side dish in sandwiches, wraps, burgers, rice bowls, or even on a toast for that spicy probiotic boost.
2. Swap regular yogurt with Greek yogurt. There is a wide variety of yogurt available that can be enjoyed by garnishing with fruits and granola.
3. Instead of sugary soft drinks, drink Kombucha- a fermented tea that offers a tangy flavor and refreshing feel.
4. Incorporate fermented soy products like Tempeh and Miso in stir fries, soups, salads, and gain bowls.

Bonus tip: Start with small portions and gradually increase the intake to allow your digestive system to adapt.

In a bid to strengthen food hygiene and safety standards, the Food Safety and Standards Authority of India (FSSAI) has directed Food Business Operators (FBOs) across the country to ensure that only food-grade, corrosion-resistant knives, blades, and cutting equipment are used in food handling and processing operations.

The directive, issued under Schedule 4 of the Food Safety and Standards (Licensing and Registration of Food Businesses) Regulations, 2011, also requires FBOs to maintain all cutting equipment in a sound and hygienic condition. In addition, the food regulator has asked State Food Safety Commissioners and Regional Directors to maintain strict vigilance and ensure compliance during inspections.

FSSAI Flags Use of Unsafe Cutting Equipment

"Schedule 4 of the aforesaid Regulations requires that equipment, utensils and food-contact surfaces used in food handling, preparation, processing, packaging and storage shall be made of food-grade, non-toxic, corrosion-resistant materials and shall be maintained in a hygienic condition so as to prevent contamination of food," FSSAI said in its advisory.

The regulations further require that such equipment and utensils be adequately cleaned and disinfected at appropriate intervals to prevent food contamination.

According to FSSAI, it has come to the regulator's notice that certain food businesses are using rusted, corroded, chipped, painted, damaged, or otherwise unsuitable knives, blades, and cutting equipment during food handling, preparation, processing, cutting, slicing, and packaging operations.

The food regulator noted that the use of rusted, corroded, chipped, painted, damaged, inadequately cleaned, or non-food-grade cutting tools can result in physical, chemical, and microbiological contamination of food.

Also read: FSSAI Introduces Stricter Quality Checks For Besan, Seafood, And Edible Oils: What You Should Know

What Did The FSSAI Advisory Recommend?

FSSAI has directed all Food Business Operators to ensure strict compliance with the following measures:

• Only food-grade, corrosion-resistant knives, blades, and cutting equipment should be used in food handling and processing operations.
• Knives, blades, and cutting equipment must be maintained in a sound and hygienic condition and be free from rust, corrosion, chipping, paint, cracks, breakage, or any other defect that may contaminate food.
• Rusted, corroded, chipped, damaged, or otherwise unsuitable cutting equipment must be immediately removed from use and replaced.
• Adequate cleaning, sanitization, and sterilization procedures, wherever applicable, must be followed at prescribed intervals.

FSSAI warned that any non-compliance observed will attract action under the Food Safety and Standards Act, 2006, and regulations made thereunder.

Unsafe Food A Major Public Health Concern

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Unsafe food continues to pose a significant global health challenge. According to a recent World Health Organization (WHO) report, unsafe food causes approximately 866 million illnesses and 1.5 million deaths worldwide every year.

Children under five years of age bear a disproportionate burden, accounting for 29 per cent of the health impact linked to unsafe food. In 2021 alone, unsafe food was associated with an estimated 143,000 deaths among children in this age group.

The WHO also warned that exposure to chemical hazards in food, including methylmercury and lead, can damage the developing brain and result in lifelong neurological and developmental problems in children.

Eggs are a great source of protein. At the same time, they are one of the most common foods that cause allergies in children.

A new study conducted in Australia showed that introducing eggs to children before the age of one may reduce the risk of allergy by 17 per cent. The findings were published in the journal JAMA Pediatrics.

Jennifer Koplin, Associate Professor at the Child Health Research Centre at The University of Queensland, said: “Australia has one of the highest rates of food allergy in the world, with one in 10 infants allergic to one or more foods".

To curb the allergy rates, the Australian infant feeding guidelines, issued by the Australasian Society of Clinical Immunology and Allergy in 2016, revolutionized allergy prevention by advising parents to introduce well-cooked egg and smooth peanut butter soon after starting solid foods, generally around six months of age.

The research, led by a team from UQ and the Murdoch Children's Research Institute, examined 7,200 children in two Australian population-based studies to assess whether egg allergy rates had declined since the introduction of the guidelines. The risk of allergy decreased by 17 per cent among babies who started eating eggs early.

“Most parents followed the guidelines, and these results provide reassurance that this advice will help reduce the chance of their child developing an egg allergy,” Dr Koplin said.

Also read: I Ate Eggs And Toast For Breakfast Every Day—Here’s How My Body Reacted

Lesser Allergy In Infants With Eczema

According to Associate Professor Rachel Peters of the Murdoch Children's Research Institute, the reduction in egg allergy was more pronounced in babies with eczema, a known risk factor for food allergies. Among these children, egg allergy rates were reduced from 35 per cent to 22 per cent.

“The introduction of the 2016 guidelines was a major change from most advice given in the 1990s and early 2000s, which recommended parents delay giving eggs and other allergenic foods until 1–3 years of age if there was a strong family history of allergy,” Dr Peters said.

Allergenic Foods Before Age One

Other common allergy-causing foods, such as cow's milk, fish, sesame, wheat, and tree nuts, are also recommended to be included in a child's diet before one year of age. Dr Koplin, however, urged for more research into food allergies.

Read More: Eating Almonds Daily Can Prevent Cognitive Decline In Prediabetic Adults

Common Symptoms of Egg Allergy

According to the Mayo Clinic, egg allergy symptoms usually start a few minutes to a few hours after eating eggs or foods containing eggs. While egg allergies can occur as early as infancy, most children outgrow their egg allergy by age 16.

Egg allergy symptoms can include:

• Skin swelling or itchy bumps called hives — the most common egg allergy reaction.
• Stuffy or runny nose and sneezing, also known as allergic rhinitis.
• Digestive symptoms such as cramps, upset stomach and vomiting.
• Asthma symptoms such as coughing, wheezing, chest tightness or shortness of breath.