Needham Nicole, Campbell Iain H, Grossi Helen, Kamenska Ivana, Rigby Benjamin P, Simpson Sharon A, McIntosh Emma, Bahuguna Pankaj, Meadowcroft Ben, Creasy Frances, Mitchell-Grigorjeva Maja, Norrie John, Thompson Gerard, Gibbs Melissa C, McLellan Ailsa, Fisher Cheryl, Moses Tessa, Burgess Karl, Brown Rachel, Thrippleton Michael J, Campbell Harry, Smith Daniel J
Centre for Clinical Brain Sciences, University of Edinburgh, UK.
Department of Nutrition and Dietetics, Royal Hospital for Children and Young People, NHS Lothian, UK.
BJPsych Open. 2023 Oct 10;9(6):e176. doi: 10.1192/bjo.2023.568.
Recent evidence from case reports suggests that a ketogenic diet may be effective for bipolar disorder. However, no clinical trials have been conducted to date.
To assess the recruitment and feasibility of a ketogenic diet intervention in bipolar disorder.
Euthymic individuals with bipolar disorder were recruited to a 6-8 week trial of a modified ketogenic diet, and a range of clinical, economic and functional outcome measures were assessed. Study registration number: ISRCTN61613198.
Of 27 recruited participants, 26 commenced and 20 completed the modified ketogenic diet for 6-8 weeks. The outcomes data-set was 95% complete for daily ketone measures, 95% complete for daily glucose measures and 95% complete for daily ecological momentary assessment of symptoms during the intervention period. Mean daily blood ketone readings were 1.3 mmol/L (s.d. = 0.77, median = 1.1) during the intervention period, and 91% of all readings indicated ketosis, suggesting a high degree of adherence to the diet. Over 91% of daily blood glucose readings were within normal range, with 9% indicating mild hypoglycaemia. Eleven minor adverse events were recorded, including fatigue, constipation, drowsiness and hunger. One serious adverse event was reported (euglycemic ketoacidosis in a participant taking SGLT2-inhibitor medication).
The recruitment and retention of euthymic individuals with bipolar disorder to a 6-8 week ketogenic diet intervention was feasible, with high completion rates for outcome measures. The majority of participants reached and maintained ketosis, and adverse events were generally mild and modifiable. A future randomised controlled trial is now warranted.
病例报告的最新证据表明，生酮饮食可能对双相情感障碍有效。然而，迄今为止尚未进行临床试验。
评估生酮饮食干预双相情感障碍的招募情况和可行性。
招募处于双相情感障碍缓解期的个体参加一项为期6 - 8周的改良生酮饮食试验，并评估一系列临床、经济和功能结局指标。研究注册号：ISRCTN61613198。
在27名招募的参与者中，26人开始并20人完成了为期6 - 8周的改良生酮饮食。干预期间，每日酮测量的结局数据集完成率为95%，每日血糖测量的完成率为95%，每日症状的生态瞬时评估的完成率为95%。干预期间平均每日血酮读数为1.3 mmol/L（标准差 = 0.77，中位数 = 1.1），所有读数中有91%表明处于酮症状态，这表明对饮食的依从性很高。超过91%的每日血糖读数在正常范围内，9%表明有轻度低血糖。记录了11起轻微不良事件，包括疲劳、便秘、嗜睡和饥饿。报告了1起严重不良事件（一名服用SGLT2抑制剂药物的参与者发生正常血糖性酮症酸中毒）。
招募处于双相情感障碍缓解期的个体参加为期6 - 8周的生酮饮食干预是可行的，结局指标的完成率很高。大多数参与者达到并维持了酮症状态，不良事件一般较轻且可调整。现在有必要进行未来的随机对照试验。
