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Serial studies from the US and Europe suggest that energy expenditure from physical activity increased between 1981 and 2017, during the onset of the obesity epidemic, while basal metabolic expenditure declined, implicating other factors such as dietary composition that impact metabolic rate [86]

Several case studies have reported the onset of mania and rapid-cycling bipolar disorder following cerebellar lesions caused by either surgery or trauma, which indicates a potential role for the cerebellum in the pathophysiology of bipolar disorder [110,111,112]

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With the increase of FFA oxidation, PPAR is activated, and the expression of BBD and OCTN2 in oxidative tissue is simulated to facilitate disposal (85)