Time-restricted eating as an adjunctive intervention for bipolar disorder

Extensive research indicates that sleep and biological rhythms are often disrupted among those with bipolar disorder (BD) and among their relatives, and that these biological rhythms are tied to severity of illness, to cognitive dysfunction, and to metabolic syndromes. Accordingly, there is a profound need for interventions that can stabilize biological rhythms in BD. Time-restricted eating (TRE) is an intervention shown to improve circadian rhythms in animals and humans, but it has not been tested in BD. We aim to conduct two studies to examine TRE in BD. First, we will conduct a randomized controlled trial (RCT) to examine efficacy as compared to a control intervention of the Mediterranean diet, and to test the hypothesis that the intervention will be particularly powerful early in the course of BD. Second, to understand mechanisms, we will measure how TRE adherence predicts the diurnal amplitude of core circadian clock gene expression and phase and amplitude of melatonin secretion changes after 1 month, and how amplitude of clock gene expression predicts changes in symptoms and QOL. If successful, this work will provide a novel, easily implemented and highly acceptable intervention for BD, and a critically needed test of the circadian rhythm hypothesis of BD.