A planned UK study will compare a ketogenic diet with NHS EatWell guidance to find out whether either can ease depressive symptoms in people with bipolar disorder. The ENERGISE-BD trial is still underway, and the sources available do not report results showing that one approach works better.
What is the ENERGISE-BD trial?
ENERGISE-BD is a planned randomised controlled trial jointly led by the Universities of Edinburgh and Birmingham. Its full title is “Evaluating Nutritional Ketosis Versus NHS EatWell Guidelines for Bipolar Depression: Single Blind Phase III Randomised Controlled Trial.” The study plans to recruit about 200 people and has £7.9 million in funding from Wellcome, according to the University of Edinburgh announcement of 1 October 2026.
It is designed to test whether a ketogenic diet or NHS EatWell guidance can help with depressive symptoms in people with bipolar disorder. It is a research question, not an established dietary treatment.
What will participants do?
Participants are expected to follow their assigned diet for 12 weeks, with support from dietitians, while continuing their usual medication. The study will compare these two approaches:
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| Trial arm | Dietary approach | Duration and support |
|---|---|---|
| Ketogenic diet | A high-fat, low-carbohydrate diet intended to produce nutritional ketosis | 12 weeks, with dietitian support |
| NHS EatWell guidance | The UK NHS healthy-eating approach | 12 weeks, with dietitian support |
Both groups continue usual medication. The study is not evidence that participants should stop or change prescribed treatment.
What will researchers measure?
The main question is whether either dietary approach affects depressive symptoms. Researchers also plan to examine brain-chemistry measures, how practical the diets are to follow, and their potential cost implications for the NHS. About half of the planned participants are expected to have brain scans, according to the University of Edinburgh.
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The project is also supported by NHS Lothian, Birmingham and Solihull Mental Health NHS Foundation Trust, and the Edinburgh Clinical Trials Unit, which contributes trial-design, delivery, data-systems and statistical expertise. Bipolar Scotland and Bipolar UK are among the patient organisations supporting the project.
When and where is recruitment planned?
The University of Edinburgh said on 1 October 2026 that recruitment would start in central Scotland before expanding to the Birmingham area in early 2027. A Bipolar Edinburgh account said recruitment was expected to begin at the start of October 2026; that expectation does not confirm that enrolment is currently open.
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The University of Edinburgh Research Explorer lists the project as active, with a start date of 1 February 2026 and a planned end date of 31 March 2031. Its record does not establish current enrolment status. For current eligibility criteria and recruitment information, contact the trial team rather than assuming places are available.
What does earlier research show?
The larger trial follows a smaller Edinburgh pilot of a ketogenic diet in bipolar disorder. The pilot was single-group and non-randomised, with an eight-week intervention and assessments before and after the diet. It included mental-health measures, blood pressure, blood tests and brain imaging, according to the Health Research Authority summary.
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Because the pilot did not randomly compare keto with a control diet, it can inform feasibility and early-stage research but cannot establish that keto treats bipolar depression or is better than another diet. The University of Edinburgh says ENERGISE-BD was partly motivated by accounts from people with lived experience who felt their symptoms improved while trying keto. Those accounts explain why researchers are testing the question; they are not clinical evidence that the diet works.
Independent reader supportYour contribution helps us test, update, and keep practical guides available for everyone.What can readers conclude now?
ENERGISE-BD is intended to provide a more robust comparison of ketogenic eating and NHS EatWell guidance, but the sources available do not report its findings. Until results are published, neither dietary approach can be said on this evidence to treat bipolar depression or outperform the other. The planned sample size, funding and brain scans describe the study; none is a measure of treatment effect.
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