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Intensive Dietary Intervention Eases Mood Variability in Patients with Bipolar Disorder

Jolynn Tumolo

A diet designed to lower omega-6 fatty acid intake and increase omega-3 fatty acid intake improved mood and pain variability in patients with bipolar disorder, according to study results published in Bipolar Disorders.

“As clinicians, we understand that if we can help our patients better control these symptoms between episodes, it could help reduce the number of times they relapse into acute episodes,” said Erika Saunders, MD, chair of the department of psychiatry and behavioral health at Penn State Health Milton S. Hershey Medical Center. “Our goal with this trial was to see if specific dietary interventions could help patients with mood variability between episodes.”

The study randomized 82 patients with bipolar disorder to 1 of 2 diets: a dietary intervention that altered levels of specific polyunsaturated fatty acids, or a control intervention characterized by typical US levels of polyunsaturated fatty acids. Over 12 weeks, patients consumed the assigned diets while participating in usual bipolar disorder care, including mood-stabilizing medication.

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Researchers hypothesized that altering the types and amounts of dietary fatty acids consumed would allow the body to generate metabolites with specific purposes, such as reducing pain or inflammation. Specifically, the experimental diet reduced omega-6 fatty acid intake by limiting red meat, eggs, and certain oils but increased omega-3 fatty acid intake by adding flax seed and fatty fishes such as tuna and salmon.

Participants, who were blinded to their group assignment, received specific foods and cooking instructions with unlabeled cooking oils, as well as specially prepared snacks and baked goods. They completed twice-daily surveys on their mood, pain, and other symptoms and also had bloodwork taken to measure fatty acid levels and any other dietary effects on the body.

The study found that participants assigned the high omega-3, low omega-6 fatty acid diet showed reduced variability in mood, energy, irritability, and pain compared with those assigned the control diet.

“At this time, we can’t yet recommend this type of diet for patients with bipolar disorders, although we found the diet to be safe,” said Dr Saunders. “This carefully constructed nutrition plan shows promise for regulating mood between manic and depressive episodes, but we’re not sure if this could be widely adopted since it would be challenging for patients to follow this rigorous program.”

References

Saunders EFH, Mukherjee D, Myers T, et al. Adjunctive dietary intervention for bipolar disorder: a randomized, controlled, parallel-group, modified double-blinded trial of a high n-3 plus low n-6 diet. Bipolar Disord. Published online July 4, 2021. doi: 10.1111/bdi.13112

Adjusting fatty acid intake may help with mood variability in bipolar disorders. News release. Penn State. September 23, 2021. Accessed October 15, 2021.

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