Ketogenic-Mimicking Diet as a Therapeutic Modality for Bipolar Disorder: Biomechanistic Rationale and Protocol for a Pilot Clinical Trial

This paper presents the biomechanistic rationale and protocol for a pilot clinical trial of a ketogenic-mimicking diet in bipolar disorder. The diet combines ketone ester supplementation with a low glycemic index dietary intervention, intended to mimic high ketone levels and minimal glucose and insulin spiking. The trial aims to investigate effects on neural network stability, mood, and biomarker outcomes, and the key question is whether benefits can be achieved with a less restrictive diet.