https://orcid.org/0000-0003-0075-282X
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ABSTRACT
Introduction: Individuals with bipolar disorder (BD) have higher rates of unhealthy lifestyles and risk for medical comorbidities Research currently suggests that dietary factors may play a role in the development of depression and anxiety. Therefore, nutritional approaches are potential strategies for the treatment of BD. The aim of this review is to summarize the available evidence on nutrition and BD. Materials and Methods: The paper was developed based on PRISMA 2020 guidelines. The search was conducted in Sep-2021 using PubMed and Cochrane Library, augmented by manually checked references lists. The search found 986 studies, of which 47 were included, combined with 13 from reference lists, totaling 60 studies. Results: There were 33 observational trials, of which 15 focused on fatty acids, 9 on micronutrients, 5 on specific foods, 4 on macro and micronutrients. The 27 interventional studies mainly focused on fatty acids, micronutrients and N-acetylcysteine (NAC). Discussion: Dietary intake or supplementation of unsaturated fatty acids, mainly Omega-3 seems to be associated with improved BD symptoms, along with seafood, folic acid and zinc. Studies found variable, mainly non-significant impacts of creatine, carnitine, vitamin D, inositol or NAC supplementation on BD. There are promising results associated with Coenzyme Q10 (Coq10) and probiotics. Taken together, these preliminary findings suggest that dietetic approaches might be included as part of BD treatment. Also considering the high risk of metabolic disorders in individuals with BD, they should be encouraged to choose healthy dietary lifestyles, including daily intake of fruits, vegetables, seafood and whole grains.
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Notes on contributors
Fernanda C. Gabriel
Fernanda C. Gabriel is a Brazilian dietitan, MS in nutrition by the University of Illinois at Chicago and volunteer at Bipolar Disorder Research Program at the Department of Psychiatry, University of São Paulo Medical School.
Manoela Oliveira
Manoela Oliveira is a dietitian, MS in nutrition and PhD candidate at University of Illinois at Chicago.
Bruna De M. Martella
Bruna De M. Martella is a Brazilia psychiatrist, volunteer at the Bipolar Disorder Research Program at the Department of Psychiatry, University of São Paulo Medical School.
Michael Berk
Michael Berk is an NHMRC Senior Principal Research Fellow at Deakin University, where he heads the IMPACT institute. His major interests are in the discovery and implementation of novel therapies.
Elisa Brietzke
Elisa Brietzke is Professor of the Department of Psychiatry, Queen's University where he leads the NeuroMood Lab, a research group focused in the study of neurobiology and innovative treatments of bipolar disorder.
Felice N. Jacka
Felice N. Jacka is Professor of Nutritional Psychiatry, Director of the Food & Mood Centre at Deakin University, and founder and president of the International Society for Nutritional Psychiatry Research (ISNPR). Professor Jacka has pioneered and led a highly innovative and influential program of research that examines how individuals’ diets interact with mental and brain health across the lifecourse. Professor Jacka is an ISI Highly-Cited Researcher (2020 & 2021) and has received a Medal of the Order of Australia for her contributions to Nutritional Psychiatry research.
Beny Lafer
Beny Lafer is Associate Professor and Director of the Bipolar Disorder Research Program at the Department of Psychiatry, University of São Paulo Medical School. His major interests are the study of the neurobiological basis and the development of novel treatments for bipolar disorder.