Kerri Waldron
The University of Cincinnati is partnering with UCLA Health on a groundbreaking pilot study to investigate whether a ketogenic diet, when used alongside standard medications, can improve symptoms in adolescents and young adults with bipolar disorder. While research has shown promising results for ketogenic therapy in adults with bipolar disorder, this will be the first study to examine its effects specifically in young people.
This innovative approach could potentially offer new options for managing a condition that often proves challenging to treat effectively with medications alone. The study aims to determine both the feasibility of implementing a ketogenic diet in this population and its potential impact on mood stability.
Study design and implementation
Set to begin in March, the research will enroll approximately 40 participants aged 12-21 who have been diagnosed with bipolar 1, bipolar 2, or unspecified bipolar disorders. These young people will follow a 16-week ketogenic program while continuing to take their prescribed mood stabilizing medications.
To ensure proper implementation of the diet, all participants will work closely with a team of registered dietitians, psychiatrists, and psychologists affiliated with the study. The research team will provide all food to participants at no charge, removing potential barriers to adherence and ensuring consistent implementation of the dietary protocol.
“We are excited to have the opportunity to conduct a pilot study examining the feasibility and mood stabilizing effects of this innovative strategy for adolescents and young adults living with bipolar spectrum disorders,” said Melissa DelBello, MD, site principal investigator, Dr. Stanley and Mickey Kaplan professor and chair of the Department of Psychiatry and Behavioral Neuroscience in UC’s College of Medicine and a UC Health physician.
Comprehensive assessment of outcomes
The study will implement rigorous evaluation methods to track participants’ responses to the intervention. Independent evaluators will conduct monthly psychiatric assessments to measure changes in depression, mania, anxiety, psychosis, psychosocial functioning, and quality of life.
Beyond mental health metrics, the research will also monitor metabolic changes through daily blood fingerprick ketone measurements. This dual focus on both psychiatric and physiological markers will provide a comprehensive picture of how the ketogenic diet influences overall health in young people with bipolar disorder.
These detailed assessments will help researchers determine whether the metabolic changes associated with ketosis correlate with improvements in mood symptoms and overall functioning.
Collaborative research effort
This multi-site study brings together expertise from leading institutions across the country. UCLA Health will serve as the coordinating research site, with additional participating sites including the University of Cincinnati, the University of Pittsburgh Medical Center, and the University of Colorado.
At UC, Luis Rodrigo Patino Duran, MD, will serve as a site co-investigator, working alongside Dr. DelBello to implement the study protocol and monitor participants.
The national principal investigator, David Miklowitz, PhD, distinguished professor of psychiatry in the Division of Child and Adolescent Psychiatry at the UCLA Semel Institute for Neuroscience and Human Behavior, noted that if this pilot study demonstrates feasibility, further research would be needed to compare the ketogenic therapy against other interventions, such as a non-ketogenic Mediterranean diet.
The science behind ketogenic therapy for mental health
The ketogenic diet, which involves consuming high amounts of fats, moderate protein, and very low carbohydrates, forces the body to burn fats rather than carbohydrates for energy. This metabolic state, known as ketosis, produces compounds called ketone bodies that can cross the blood-brain barrier and potentially influence brain function.
Preliminary research has suggested that this metabolic shift may have beneficial effects on brain energy metabolism, inflammation, and neurotransmitter systems—all of which are implicated in bipolar disorder. Adults with bipolar disorder who have followed ketogenic diets in previous studies have reported improvements in mood stability, energy levels, and cognitive function.
The mechanisms behind these potential benefits remain an active area of research, with theories ranging from the diet’s effects on mitochondrial function to its impact on the gut-brain axis and inflammatory pathways.
Addressing the challenges of bipolar treatment in young people
Bipolar disorder in adolescents and young adults presents unique challenges. The condition often manifests differently in younger populations compared to adults, with more frequent mood episodes, mixed states, and rapid cycling between depression and mania. Additionally, the developmental demands of adolescence can complicate treatment adherence and management.
Current pharmacological treatments for bipolar disorder, including mood stabilizers and antipsychotic medications, can carry significant side effects that may be particularly problematic for developing brains and bodies. These can include weight gain, metabolic disturbances, and cognitive effects that interfere with academic performance.
Finding complementary approaches that might enhance treatment efficacy or potentially allow for lower medication doses could significantly improve quality of life for young people with bipolar disorder. The ketogenic diet, if proven effective, could represent such an adjunctive therapy.
Potential implications for future treatment
If the pilot study yields positive results, it could open new avenues for treating bipolar disorder in young people. Dietary interventions like the ketogenic diet might offer several advantages over medication alone, including fewer side effects, greater patient autonomy, and potential improvements in physical health alongside mental health benefits.
The findings could also contribute to the growing field of nutritional psychiatry, which examines how dietary patterns influence mental health conditions. This emerging area recognizes that what we eat affects not just our bodies but also our brains, with potential implications for mood, cognition, and behavior.
However, researchers caution that the ketogenic diet should be viewed as a potential complement to, not a replacement for, evidence-based pharmacological treatments. The study explicitly maintains participants on their prescribed mood stabilizing medications while adding the dietary intervention.
Looking ahead: next steps in research
The pilot study, funded by Baszucki Group, represents an initial step in exploring ketogenic therapy for young people with bipolar disorder. If the approach proves feasible and shows preliminary evidence of benefit, larger randomized controlled trials would be needed to establish efficacy.
Future research might examine questions such as which subgroups of patients benefit most from ketogenic therapy, the optimal duration of the diet, whether the diet could allow for reduced medication dosages, and how the intervention compares to other dietary approaches.
The research team has also emphasized the importance of studying long-term adherence, as the ketogenic diet represents a significant departure from typical eating patterns and may be challenging to maintain over extended periods.
A potential tool in the treatment toolkit
For the millions of young people affected by bipolar disorder worldwide, new treatment approaches are sorely needed. If the ketogenic diet proves effective as an adjunctive therapy, it could become an important additional tool in the treatment toolkit for this challenging condition.
By exploring innovative approaches like nutritional therapy, researchers hope to address the limitations of current treatments and improve outcomes for adolescents and young adults living with bipolar disorder. The University of Cincinnati’s participation in this pioneering study represents an important step toward that goal.
As the study progresses, findings will contribute to our understanding of the complex relationship between metabolism, nutrition, and mental health, potentially benefiting not just those with bipolar disorder but also individuals with other psychiatric conditions.
Source: bing.com
