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Severe mental illness is characterised by a 15-year mortality gap driven by cardiometabolic disease. Antipsychotic treatment leads to increased appetite and rapid weight gain. The 12-week lifestyle pilot intervention improved dietary intake and prevented antipsychotic-induced weight gain. Here we report two-year outcomes. Participants were exposed to an extended program. Weight and waist circumference were measured, and food frequency questionnaire completed. Diet quality was higher, and discretionary food intake was 40% lower, at two-years compared to baseline. Weight and waist-circumference did not increase. This pilot study demonstrated sustained effectiveness of a dietetic intervention in youth with first-episode psychosis with improvements in diet quality and no increase in weight secondary to antipsychotic medication initiation. [ABSTRACT FROM AUTHOR]

Objective: This article aims to draw mental health clinicians' attention to the connections between nutrition and mental health, and the roles that Accredited Practising Dietitians play in improving mental and physical health through dietary change.Methods: Selective narrative review.Results: Unhealthy dietary practices are common in high prevalence and severe mental illness. Epidemiological evidence demonstrates that nutrients and dietary patterns impact on mental health. In addition, poor physical health is well documented in people with mental illness and the greatest contributor to the mortality gap. Dietary intervention studies demonstrate improved mental and physical health outcomes. Accredited Practising Dietitians translate nutrition science into practical advice to improve the nutritional status of patients with mental illness, and prevent and manage comorbidities in a variety of care settings.Conclusions: Medical Nutrition Therapy offers opportunities to improve the physical and mental health of people living with mental illness. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article related to the role of mental health dietitians in prevention of cardiometabolic decline in early psychosis which appeared in a previous issue.

Research on nutraceutical and dietary interventions in psychiatry has grown substantially, but progress is hindered by methodological inconsistencies and limited reporting standards. To address this, the International Society for Nutritional Psychiatry Research presents the first guidelines on clinical trial design, conduct, and reporting for future clinical trials in this area. Recommendations were developed using a Delphi process including eighteen researchers with considerable clinical trial expertise and experience in either methodology, nutraceutical, or dietary interventions in psychiatry. These guidelines provide forty-nine recommendations for clinical trial design and outcomes, five for trial reporting, and seven for future research priorities. The recommendations included in these guidelines are designed to inform both nutraceutical and dietary clinical trial interventions in Nutritional Psychiatry. Common themes include an emphasis on the importance of a multidisciplinary research team and integration of co-design processes into the conduct and design of clinical research, methods to improve transparency and replicability of trial outcomes, and measures to address common biases in nutrition trials. Furthermore, we provide recommendations for future research including examining a greater variety of nutraceutical and dietary interventions, scalable delivery models, effectiveness and implementation studies, and the need to investigate these interventions in the prevention and management of less studied psychiatric conditions (e.g. schizophrenia and bipolar disorder). Recommendations included within these guidelines are intended to improve the rigor and clinical relevance of ongoing and future clinical trials in Nutritional Psychiatry.

People living with mental illness report a broad spectrum of nutrition risks, beyond malnutrition, but appropriate and adequately validated nutrition risk screening tools for mental health settings are lacking. This study aimed to develop a nutrition-risk screening tool, the NutriMental Screener, and to perform preliminary feasibility and validity testing. In an international, stakeholder engaging approach, a multifaceted nutrition-risk screening tool for mental health services was developed by means of workshops with international stakeholders and two online surveys. Feasibility of the NutriMental screener was tested as part of a research study in Switzerland with 196 participants, evenly distributed across the three study groups (sixty-seven outpatients and sixty-five inpatients with psychotic or depressive disorders as well as sixty-four controls without mental illness). The NutriMental screener consists of ten items covering different nutritional issues that indicate the need for referral to a dietitian or clinical nutritionist. Almost all patients (94·7 %) reported at least one nutrition risk by means of the NutriMental screener. Prevalence for nutrition risks via NutriMental screener was higher in patients than in controls. Almost every second patient expressed a desire for nutritional support (44·7 %). After further validity testing is completed, there is the potential for the NutriMental Screener to replace malnutrition screening tools as routine screening in various mental health settings aiming to organise nutritional therapy prescriptions in a more targeted and efficient manner.

Objective: To examine the accuracy and likely clinical usefulness of the Psychosis Metabolic Risk Calculator (PsyMetRiC) in predicting up-to six-year risk of incident metabolic syndrome in an Australian sample of young people with first-episode psychosis., Method: We conducted a retrospective study at a secondary care early psychosis treatment service among people aged 16-35 years, extracting relevant data at the time of antipsychotic commencement and between one-to-six-years later. We assessed algorithm accuracy primarily via discrimination (C-statistic), calibration (calibration plots) and clinical usefulness (decision curve analysis). Model updating and recalibration generated a site-specific (Australian) PsyMetRiC version., Results: We included 116 people with baseline and follow-up data: 73% male, mean age 20.1 years, mean follow-up 2.6 years, metabolic syndrome prevalence 13%. C-statistics for both partial- (C = 0.71, 95% CI 0.64-0.75) and full-models (C = 0.72, 95% CI 0.65-0.77) were acceptable; however, calibration plots demonstrated consistent under-prediction of risk. Recalibration and updating led to slightly improved C-statistics, greatly improved agreement between observed and predicted risk, and a narrow window of likely clinical usefulness improved significantly., Conclusion: An updated and recalibrated PsyMetRiC model, PsyMetRiC-Australia, shows promise. Validation in a large sample is required to confirm its accuracy and clinical usefulness for the Australian population., Competing Interests: DisclosureThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.