What is a Good Bipolar Diet?

Bret: 
What should you eat if you have bipolar disorder? If you believe a recent article from leading online health site, Healthline, it’s as simple as eating whole grains, fish, turkey beans, nuts, and chocolate. But the only problem is that despite them listing references in the article, there’s really no supportive evidence that any of these foods are helpful for bipolar disorder.

Yet, this is the type of advice we find all over the internet about a brain healthy diet and how to eat if you have bipolar disorder. So, let’s get into the details and see if there’s maybe a better way to eat to help with your mental and overall health.

Welcome to The Metabolic Mind Podcast. I’m your host, Dr. Bret Scher. Metabolic Mind is a non-profit initiative of Baszucki Group where we’re providing information about the intersection of metabolic health and mental health and metabolic therapies, such as nutritional ketosis as therapies for mental illness.

Thank you for joining us. Although our podcast is for informational purposes only and we aren’t giving medical advice, we hope you will learn from our content and it will help facilitate discussions with your healthcare providers to see if you could benefit from exploring the connection between metabolic and mental health.

At Metabolic Mind, we strongly believe how you eat and choose to live your life has dramatic and meaningful impacts on your mental health. So, on the one hand, I wan to applaud Healthline and other sites that explore the concept of food for brain health. But at the same time, I’m a little dismayed by the often misleading and unsubstantiated advice.

It’s no surprise that many who choose to follow this advice end up feeling lost and feeling that nutrition has no impact on their mental health when they try it and it doesn’t work, right? So, let’s explore why this is unsubstantiated advice and what may work better. So, here’s the overarching conclusion when it comes to food and mental health that individual foods may have somewhat of an impact.

Sure but what we really need to emphasize is the diet as a whole, or the dietary matrix, is much more important. And what’s also clear is that some dietary interventions have more profound effects on our brain function and chemistry than others. For instance, ketogenic therapy is probably the most prominent dietary-based treatment that can change the physiology and the metabolic state of our brains altering neurotransmitters, reducing brain inflammation, and bypassing the need for insulin in a metabolically unhealthy, or insulin-resistant, brain.

Eating more whole grains or dark chocolate won’t come near to this effect. And that doesn’t mean everybody needs to eat a keto diet, but it’s helpful to understand the different magnitude of impact that we can expect. So, let’s get into these Healthline recommendations, and I’m going to save my favorite example for later.

But their first recommendation is eating more whole grains. And this is a common misconception in nutrition in medicine, that whole grains are by default healthy for our bodies and our brains. And studies have shown that eating whole grains instead of refined grains is beneficial for both systemic and brain health.

But there really should be no surprise given the potential negative health effects of refined grains. But that’s a far cry from saying that whole grains are by themselves inherently healthy and good for mental health and bipolar disorder. And here’s the thing, they reference a study, but the study they cite to back their claim, is a very low-quality nutritional observational study.

And we’ve often pointed out the weaknesses of these studies and emphasize that they don’t indicate cause and effect by any means, and they rarely have significant enough findings to be meaningful for an individual. And so, here’s a perfect example. The study found that those who ate more whole grains had lower symptom scores of depression, but they also found that those who didn’t drink alcohol had higher symptom scores.

So, why aren’t we concluding that alcohol prevents depression? Because the data quality’s poor, and that doesn’t fit with our inherent nutritional biases. But I hope you can see the problem here. We can’t just believe some of the results and think they’re true and discount others.

So instead, we have to realize that all the results are low-quality and really have to be suspect and until replicated in higher quality findings. And so there’s really no clear evidence that eating whole grains is beneficial for bipolar disorder or for brain health in general, especially if somebody has metabolic dysfunction.

All right, but next on the list are Omega-3s, which likely have the strongest evidence of the group and as it came from a randomized controlled trial. But we still have to question whether the beneficial effects are from the Omega-3 themselves. Can we just pop pills for Omega-3s, or is it the effect of the fish or the foods that contain the Omega-3s?

But as I mentioned, this group likely has the strongest support. So, thumbs up to that. But the next three on the Healthline list are turkey, beans, and nuts. And their evidence from turkey comes from a study reporting that serotonin can be helpful. Nothing to do with turkey, but since turkey might be able to increase serotonin, it must be good.

Sorry, but science doesn’t work that way. Like how much does it increase? Does that have the same effects? There’s no cited data to even suggest anything about turkey being beneficial. And the same is true for nuts and beans. The evidence they cite for nuts and beans are that we’re deficient in magnesium, and there’s a small signal that magnesium may help mental health.

So, therefore, nuts and beans, which have some magnesium, must be good. But again, that’s not how this works, and it’s incredibly misleading to suggest that there’s evidence supporting people with bipolar disorder will benefit from eating beans and nuts. Now, sure, they can be part of a healthy diet. But to say that there’s specific evidence that they’re beneficial for bipolar disorder, it is just simply wrong.

But here’s my favorite. I said I was going to save it for later. My favorite is dark chocolate. Now, who wouldn’t want chocolate to be good for us, right? Like I’m rooting for this one. But the study they cited was a four-week trial in healthy, middle age adults with no mental health disorders, and it demonstrated reduced mental and physical fatigue.

Now, that’s a pretty big leap to take this study, and say that dark chocolate is inherently good for people with bipolar disorder now. And look, I don’t mean to single out or berate Healthline. Their article just happened to be the one that found its way into my inbox. But I wanted to use it as the prime example of how we should be exceedingly careful about how, you know, about diet blogs and articles that say one food is healthy for a certain health condition, especially mental health.

And again, I think that’s something that sets ketogenic interventions apart from the idea that certain foods are good or bad. As I mentioned, ketogenic therapy changes the physiology and chemistry of our brains, and simply eating more beans isn’t going to do that. Thanks for listening to the Metabolic Mind Podcast.

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