Diet quality and associations with lactate and metabolic syndrome in bipolar disorder

Kassandra A. Zachos, Ophelia Godin, Jaehyoung Choi, Jae H. Jung, Bruno Aouizerate, Valérie Aubin, Frank Bellivier, Raoul Belzeaux-R, Philippe Courtet, Caroline Dubertret, Bruno Etain, Emmanuel Haffen, Antoine Lefrere A, Pierre-Michel Llorca, Emilie Olié, Mircea Polosan, Ludovic Samalin, Raymund Schwan, Paul Roux,
Journal of Affective Disorders. 2024-11-01; 364: 167-177
DOI: 10.1016/j.jad.2024.05.167

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1. J Affect Disord. 2024 Aug 6;364:167-177. doi: 10.1016/j.jad.2024.05.167.
Online ahead of print.

Diet quality and associations with lactate and metabolic syndrome in bipolar
disorder.

Zachos KA(1), Godin O(2), Choi J(3), Jung JH(4), Aouizerate B(5), Aubin V(6),
Bellivier F(7), Belzeaux-R R(8), Courtet P(9), Dubertret C(10), Etain B(7),
Haffen E(11), Lefrere A A(12), Llorca PM(13), Olié E(9), Polosan M(14), Samalin
L(13), Schwan R(15), Roux P(16); FondaMental Academic Centers of Expertise in
Bipolar Disorders (FACE-BD) Collaborators; Barau C(34), Richard JR(35), Tamouza
R(2), Leboyer M(2), Andreazza AC(36).

Collaborators: Etain B(17), Olié E(18), Leboyer M(19), Haffen E(19), Llorca
PM(19), Barteau V(20), Bensalem S(20), Godin O(20), Laouamri H(20), Souryis
K(20), Hotier S(21), Pelletier A(21), Hergeta F(21), Petrucci J(21), Willaume
L(21), Bellivier F(22), Hennion V(22), Marlinge E(22), Meheust J(22), Richard
A(22), Carminati M(22), Francisque H(22), Dubertret C(23), Mazer N(24),
Portalier C(25), Scognamiglio C(25), Bing A(25), Laurent P(24), Gard S(26),
M’Bailara K(26), Elkael C(26), Hoorelbeke F(26), Minois I(26), Sportich J(26),
Da Ros N(26), Boukhobza L(27), Courtet P(27), Denat S(27), Deffinis B(27),
Ducasse D(27), Gachet M(27), Lengvenyté A(27), Molière F(27), Nass L(27),
Tarquini G(27), Lefrere A(28), Moreau E(28), Pastol J(28), Groppi F(28),
Polomeni H(28), Bauberg J(28), Lescalier L(28), Muraccioli I(28), Suray A(28),
Cohen R(29), Kahn JP(29), Milazzo M(29), Wajsbrot-Elgrabli O(29), Bougerol
T(30), Pouchon A(30), Bertrand A(30), Fredembach B(30), Suisse A(30), Denoual
Q(30), Polosan M(30), Galliot AM(31), Brehon L(31), Bonny G(31), Durand L(31),
Feuga V(31), Kayser N(31), Roux P(31), Aubin V(32), Cussac I(32), Dupont MA(32),
Loftus J(32), Medecin I(32), Samalin L(33), Llorca PM(33), Mennetrier M(33),
Bonnet T(33), Lacelle D(33), Vayssié M(33), Beal C(33), Blanc O(33).

Author information:
(1)Department of Pharmacology and Toxicology, Temerty Faculty of Medicine,
University of Toronto, Toronto, ON, Canada; Mitochondrial Innovation Initiative,
MITO2i, Toronto, ON, Canada; FACE-BD Clinical Sites and Principal Collaborators
in France, France.
(2)INSERM U955 IMRB, Translational Neuropsychiatry laboratory, AP-HP, Hôpital
Henri Mondor, DMU IMPACT, Fédération Hospitalo-Universitaire de Médecine de
Précision en Psychiatrie (FHU ADAPT), Paris Est Créteil University (UPEC); ECNP
Immuno-NeuroPsychiatry Network, France; Fondation FondaMental, Créteil, France.
(3)Department of Pharmacology and Toxicology, Temerty Faculty of Medicine,
University of Toronto, Toronto, ON, Canada; Mitochondrial Innovation Initiative,
MITO2i, Toronto, ON, Canada.
(4)Department of Pharmacology and Toxicology, Temerty Faculty of Medicine,
University of Toronto, Toronto, ON, Canada.
(5)Fondation FondaMental, Créteil, France; Centre Hospitalier Charles Perrens,
Pôle de Psychiatrie Générale et Universitaire, Laboratoire NutriNeuro (UMR INRAE
1286), Université de Bordeaux, Bordeaux, France.
(6)Fondation FondaMental, Créteil, France; Pôle de Psychiatrie, Centre
Hospitalier Princesse Grace, Monaco.
(7)Fondation FondaMental, Créteil, France; Université Paris Cité, INSERM
UMR-S1144, Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris,
France; AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, DMU Neurosciences,
Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologique,
Paris, France.
(8)Fondation FondaMental, Créteil, France; Univ. Montpellier & Department of
Psychiatry, CHU de Montpellier, France.
(9)Fondation FondaMental, Créteil, France; IGF, Univ. Montpellier, CNRS, INSERM,
Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier,
France.
(10)Fondation FondaMental, Créteil, France; AP-HP, Groupe
Hospitalo-Universitaire AP-HP Nord, DMU ESPRIT, Service de Psychiatrie et
Addictologie, Hôpital Louis Mourier, Colombes, France; Université de Paris,
Inserm UMR1266, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.
(11)Fondation FondaMental, Créteil, France; Université de Franche-Comté, UR 481
LINC, Service de Psychiatrie de l’Adulte, CIC-1431 INSERM, CHU de Besançon,
F-2500, France.
(12)Fondation FondaMental, Créteil, France; Pôle de Psychiatrie, Assistance
Publique Hôpitaux de Marseille, Marseille, France; INT-UMR7289, CNRS
Aix-Marseille Université, Marseille, France.
(13)Fondation FondaMental, Créteil, France; Department of Psychiatry, CHU
Clermont-Ferrand, University of Clermont Auvergne, CNRS, Clermont Auvergne INP,
Institut Pascal (UMR 6602), Clermont-Ferrand, France.
(14)Fondation FondaMental, Créteil, France; Univ. Grenoble Alpes, Inserm, U1216,
CHU Grenoble Alpes, Grenoble Institut Neurosciences, Grenoble, France.
(15)Université de Lorraine, Centre Psychothérapique de Nancy, Inserm U1254,
Nancy, France.
(16)Fondation FondaMental, Créteil, France; Centre Hospitalier de Versailles,
Service Universitaire de Psychiatrie d’Adulte et d’Addictologie, Le Chesnay,
France; Université Paris-Saclay & Université de Versailles
Saint-Quentin-En-Yvelines, INSERM UMR1018 Centre de recherche en Épidémiologie
et Santé des Populations, Equipe DevPsy-DisAP, Paris, France.
(17)FACE-BD Clinical Coordinating Center (Fondation FondaMental), France; AP-HP,
GH Saint-Louis-Lariboisière-Fernand Widal, Pôle Neurosciences, Paris, France.
(18)FACE-BD Clinical Coordinating Center (Fondation FondaMental), France;
Département d’Urgence et Post Urgence Psychiatrique, CHRU Montpellier,
Montpellier, France.
(19)FACE-BD Clinical Coordinating Center (Fondation FondaMental), France.
(20)FACE-BD Data Coordinating Center (Fondation FondaMental), France.
(21)AP-HP, DHU PePSY, Pôle de Psychiatrie et d’Addictologie des Hôpitaux
Universitaires H Mondor, Créteil, France.
(22)AP-HP, GH Saint-Louis-Lariboisière-Fernand Widal, Pôle Neurosciences, Paris,
France.
(23)APHP, Groupe Hospitalo-universitaire AP-HP Nord, DMU ESPRIT, Service de
Psychiatrie et Addictologie, Hôpital Louis Mourier, Colombes, France; Centre
Hospitalier Princesse Grace, Monaco.
(24)APHP, Groupe Hospitalo-universitaire AP-HP Nord, DMU ESPRIT, Service de
Psychiatrie et Addictologie, Hôpital Louis Mourier, Colombes, France; AHPH,
Departement de Psychiatrie, Hopital Louis Mourier, Colombes, France.
(25)APHP, Groupe Hospitalo-universitaire AP-HP Nord, DMU ESPRIT, Service de
Psychiatrie et Addictologie, Hôpital Louis Mourier, Colombes, France.
(26)Hôpital C. Perrens, Centre Expert Trouble Bipolaire, Pôle de Psychiatrie
Générale et Universitaire.
(27)Département d’Urgence et Post Urgence Psychiatrique, CHRU Montpellier,
Montpellier, France.
(28)Pôle de Psychiatrie, addictologie et pédopsychiatrie, Hôpital Sainte
Marguerite, Marseille, France.
(29)Service de Psychiatrie et Psychologie Clinique, CHU de Nancy, Hôpitaux de
Brabois, Vandoeuvre Les Nancy, France.
(30)Service Universitaire de Psychiatrie, CHU de Grenoble et des Alpes,
Grenoble.
(31)Centre Hospitalier de Versailles, Service Universitaire de Psychiatrie
d’adultes et d’addictologie, Le Chesnay, France.
(32)Centre Hospitalier Princesse Grace, Monaco.
(33)Service de Psychiatrie d’adultes B, Centre Expert Trouble Bipolaire, CHU de
Clermont-Ferrand, Clermont-Ferrand, France.
(34)Plateforme de Ressources Biologiques, HU Henri Mondor, Créteil, France.
(35)INSERM U955 IMRB, Translational Neuropsychiatry laboratory, AP-HP, Hôpital
Henri Mondor, DMU IMPACT, Fédération Hospitalo-Universitaire de Médecine de
Précision en Psychiatrie (FHU ADAPT), Paris Est Créteil University (UPEC); ECNP
Immuno-NeuroPsychiatry Network, France.
(36)Department of Pharmacology and Toxicology, Temerty Faculty of Medicine,
University of Toronto, Toronto, ON, Canada; Mitochondrial Innovation Initiative,
MITO2i, Toronto, ON, Canada; Department of Psychiatry, University of Toronto,
Toronto, ON, Canada. Electronic address: .

BACKGROUND: Nutrition is largely affected in bipolar disorder (BD), however,
there is a lack of understanding on the relationship between dietary categories,
BD, and the prevalence of metabolic syndrome. The objective of this study is to
examine dietary trends in BD and it is hypothesized that diets with increased
consumption of seafood and high-fiber carbohydrates will be correlated to
improved patient outcomes, and a lower frequency of metabolic syndrome.
METHODS: This retrospective cohort study includes two French cohorts. The
primary cohort, FACE-BD, includes 268 stable BD patients. The second cohort,
I-GIVE, includes healthy controls, both stable and acute BD and schizophrenia
patients. Four dietary categories were assessed: meat, seafood, low-fiber and
high-fiber carbohydrates. Dietary data from two food frequency questionnaires
were normalized using min-max scaling and assessed using various statistical
analyses.
RESULTS: In our primary cohort, the increased high-fiber carbohydrate
consumption was correlated to lower prevalence of metabolic syndrome and
improved mood. Low-fiber carbohydrate consumption is associated with higher BMI,
while higher seafood consumption was correlated to improved mood and delayed age
of onset. Results were not replicated in our secondary cohort.
LIMITATIONS: Our populations were small and two different dietary questionnaires
were used; thus, results were used to examine similarities in trends.
CONCLUSIONS: Overall, various dietary trends were associated with metabolic
syndrome, BMI, lactate, mood and age of onset. Improving our understanding of
nutrition in BD can provide mechanistic insight, clinically relevant nutritional
guidelines for precision medicine and ultimately improve the quality of lives
for those with BD.