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Aim: To evaluate the implementation of a mixed virtual and in‐person brief intervention for young people, aged 12–25 years, presenting to a large urban mental health service in crisis with suicidal ideation and/or self‐harm. Methods: A pragmatic, real‐world evaluation was conducted on the Youth Brief Intervention Service between June 2021 (inception) and October 2022. Service users were offered four sessions over an approximate one‐month period. Sessions focused on distress tolerance, safety plans and support systems. Implementation outcomes related to service uptake, retention, fidelity of the model and service user experience. Effectiveness outcomes were measured pre‐post and included mental health‐related hospital service utilization (primary outcome), functioning, mental health status, self‐harm, suicidal ideation and quality of life. Results: Of the 136 young people referred to the Youth Brief Intervention Service, 99 were accepted with 17 disengaging before the first session. Eighty percent of people who commenced, completed the package of care. Young persons' and parent/carers experience of service was high (97% and 88%, respectively). Mental health‐related emergency department presentations and inpatient days decreased from 3 months pre‐intake to 3 months post‐intake (42 vs. 7 presentations, X2 = 25.3, p <.001; 11 vs. 0 inpatient days, X2 = 9.1, p =.01). There were significant improvements in mental health status, days engaging in self‐harm, general health and functioning and quality of life. Conclusions: The Youth Brief Intervention Service is feasible, acceptable, subjectively beneficial and coincided with less mental health‐related emergency department presentations and inpatient days, and improved mental health status and behaviour. [ABSTRACT FROM AUTHOR]

Objectives: In 2013, a cluster‐controlled pilot study found the 12‐week Keeping the Body in Mind (KBIM) lifestyle and life skills intervention was able to prevent weight gain in a small sample of youth experiencing first‐episode psychosis (FEP) with fewer than 4 weeks of antipsychotic exposure. This study aims to evaluate the effectiveness of KBIM as routine care on anthropometry and metabolic biochemistry in a larger sample of youth with FEP across three community mental health services. Method: This retrospective chart audit was conducted on youth with FEP, prescribed a therapeutic dose of antipsychotic medication, and who engaged with KBIM between 2015 and 2019. Primary outcomes were weight and waist circumference. Secondary outcomes were blood pressure, blood glucose, and blood lipids. Outcomes were collected in at baseline and at 12 weeks. Data on program engagement were obtained from the participant's medical file. Results: One‐hundred and eighty‐two people met inclusion criteria, and up to 134 people had baseline and 12‐week data on one or more outcome. Mean number of sessions attended was 11.1 (SD = 7.3). Increases in weight and waist circumference were limited to 1.5 kg (SD = 5.3, t(133) = 3.2, p =.002) and 0.7 cm (SD = 5.8, t(109) = 1.2, p =.23) respectively. Eighty‐one percent of participants did not experience clinically significant weight gain (>7% of baseline weight). There were no significant changes in blood pressure or metabolic biochemistry. Conclusion: The prevention of substantial gains in weight and waist circumference observed in the initial pilot study was maintained with implementation of KBIM as part of routine clinical care for youth with FEP. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to explore food insecurity prevalence and experiences of adults with severe mental illness living in Northern England. Methods: This mixed‐methods cross‐sectional study took place between March and October 2022. Participants were adults with self‐reported severe mental illness living in Northern England. The survey included demographic, health, and financial questions. Food insecurity was measured using the US Department of Agriculture Adult Food Security measure. Quantitative data were analysed using descriptive statistics and binary logistic regression; and qualitative data using content analysis. Results: In total, 135 participants completed the survey, with a mean age of 44.7 years (SD: 14.1, range: 18–75 years). Participants were predominantly male (53.3%), white (88%) and from Yorkshire (50.4%). The food insecurity prevalence was 50.4% (n = 68). There was statistical significance in food insecurity status by region (p = 0.001); impacts of severe mental illness on activities of daily living (p = 0.02); and the Covid pandemic on food access (p < 0.001). The North West had the highest prevalence of food insecurity (73.3%); followed by the Humber and North East regions (66.7%); and Yorkshire (33.8%). In multivariable binary logistic regression, severe mental illness' impact on daily living was the only predictive variable for food insecurity (odds ratio = 4.618, 95% confidence interval: 1.071–19.924, p = 0.04). Conclusion: The prevalence of food insecurity in this study is higher than is reported in similar studies (41%). Mental health practitioners should routinely assess and monitor food insecurity in people living with severe mental illness. Further research should focus on food insecurity interventions in this population. [ABSTRACT FROM AUTHOR]

Our aim was to conduct an umbrella review of evidence from meta-analyses of observational studies investigating the link between sugar-sweetened beverage consumption and human health outcomes. Using predefined evidence classification criteria, we evaluated evidence from 47 meta-analyses encompassing 22,055,269 individuals. Overall, 79% of these analyses indicated direct associations between greater sugar-sweetened beverage consumption and higher risks of adverse health outcomes. Convincing evidence (class I) supported direct associations between sugar-sweetened beverage consumption and risks of depression, cardiovascular disease, nephrolithiasis, type 2 diabetes mellitus, and higher uric acid concentrations. Highly suggestive evidence (class II) supported associations with risks of nonalcoholic fatty liver disease and dental caries. Out of the remaining 40 meta-analyses, 29 were graded as suggestive or weak in the strength of evidence (classes III and IV), and 11 showed no evidence (class V). These findings inform and provide support for population-based and public health strategies aimed at reducing sugary drink consumption for improved health. [ABSTRACT FROM AUTHOR]

People with severe mental illness (SMI), including schizophrenia and related psychoses and bipolar disorder, are at greater risk for obesity compared with people without mental illness. An altered resting metabolic rate (RMR) may be a key driving factor; however, published studies have not been systematically reviewed. This systematic review and meta-analysis aimed to determine whether the RMR of people with SMI assessed by indirect calorimetry differs from (i) controls, (ii) predictive equations and (iii) after administration of antipsychotic medications. Five databases were searched from database inception to March 2022. Thirteen studies providing nineteen relevant datasets were included. Study quality was mixed (62 % considered low quality). In the primary analysis, RMR in people with SMI did not differ from matched controls (n 2, standardised mean difference (SMD) = 0·58, 95 % CI −1·01, 2·16, P = 0·48, I 2 = 92 %). Most predictive equations overestimated RMR. The Mifflin–St. Jeor equation appeared to be most accurate (n 5, SMD = −0·29, 95 % CI −0·73, 0·14, P = 0·19, I 2 = 85 %). There were no significant changes in RMR after antipsychotic administration (n 4, SMD = 0·17, 95 % CI −0·21, 0·55, P = 0·38, I 2 = 0 %). There is little evidence to suggest there is a difference in RMR between people with SMI and people without when matched for age, sex, BMI and body mass, or that commencement of antipsychotic medication alters RMR. [ABSTRACT FROM AUTHOR]

People with severe mental illness (SMI), such as major depression, bipolar disorder, and schizophrenia, experience numerous risk factors that may predispose them to food insecurity; however, the prevalence of food insecurity and its effects on health are under-researched in this population group. This systematic review and meta-analysis aimed to describe the prevalence and correlates of food insecurity in people with SMI. A comprehensive electronic search was conducted up to March 2021. Random effects meta-analysis was employed to determine the prevalence of food insecurity in SMI, and odds ratio (OR) of food insecurity in people with SMI compared to non-psychiatric controls/general population. Twenty-nine unique datasets (31 publications) were included. Prevalence estimate of food insecurity in people with SMI was 40% (95% CI 29–52%, I2 = 99.7%, N = 27). People with SMI were 2.71 (95% CI 1.72–3.25) times more likely to report food insecurity than the comparator group (Z = 11.09, p < 0.001, I2 = 95%, N = 23). The odds of food insecurity in SMI were higher in high/high-middle income countries compared to low/low-middle income countries, likely due to the high food insecurity rates in the general population of lower income countries. There was no difference in food insecurity rates by diagnosis. Food insecurity should be a consideration for health professionals working with community-dwelling people with SMI. [ABSTRACT FROM AUTHOR]

Aim: Determine the discretionary energy intake of Indigenous Australian adolescents and its relationship with sex, body image, health, and geographical remoteness. Methods: Cross‐sectional data from the 2012 to 2013 National Aboriginal and Torres Strait Islander Nutrition and Physical Activity Survey (n = 264, 15–17 years). Dietary data were collected using an Automated Multiple‐Pass Method, anthropometric data by trained interviewers; self‐perceived measures of body weight, level of satisfaction with current weight, and self‐assessed health were self‐reported. General linear models were used to investigate predictors. Results: Discretionary energy intake contributed 35.4% and 54.2% of total energy intake for males and females, respectively, primarily from the sub‐groups: soft drinks; pastries; potatoes; sugar, honey and syrups; cordials; and potato snacks. Discretionary energy intake was associated with higher energy intake (p < 0.001) and self‐perceived body weight (p = 0.022), while sex had significant interactions with self‐assessed health (psex = 0.005), satisfaction with current weight (psex < 0.001), and geographical remoteness (psex = 0.007). Contribution of discretionary energy intake to total energy intake was greatest for males with an increased risk of metabolic complications (50% vs. 37%; p > 0.05), those who perceived themselves to be overweight (56% vs. 27%; p < 0.001), and those who were dissatisfied with their weight (56% vs. 19%; p < 0.001), compared to females. No differences were found by dieting status, risk of metabolic complications, and under‐reporting of energy intake. Conclusions: Discretionary energy intake was excessive among Indigenous Australian adolescents and had relationships with self‐perceived health, weight satisfaction, and geographical remoteness, which was moderated by sex. To successfully reduce discretionary food intake among Indigenous Australian adolescents, further research is required to develop sex specific and culturally appropriate strategies. [ABSTRACT FROM AUTHOR]

The microbiome has been implicated in the development of metabolic conditions which occur at high rates in people with schizophrenia and related psychoses. This exploratory proof-of-concept study aimed to: (i) characterize the gut microbiota in antipsychotic naïve or quasi-naïve people with first-episode psychosis, and people with established schizophrenia receiving clozapine therapy; (ii) test for microbiome changes following a lifestyle intervention which included diet and exercise education and physical activity. Participants were recruited from the Eastern Suburbs Mental Health Service, Sydney, Australia. Anthropometric, lifestyle and gut microbiota data were collected at baseline and following a 12-week lifestyle intervention. Stool samples underwent 16S rRNA sequencing to analyse microbiota diversity and composition. Seventeen people with established schizophrenia and five people with first-episode psychosis were recruited and matched with 22 age-sex, BMI and ethnicity matched controls from a concurrent study for baseline comparisons. There was no difference in α-diversity between groups at baseline, but microbial composition differed by 21 taxa between the established schizophrenia group and controls. In people with established illness pre-post comparison of α-diversity showed significant increases after the 12-week lifestyle intervention. This pilot study adds to the current literature that detail compositional differences in the gut microbiota of people with schizophrenia compared to those without mental illness and suggests that lifestyle interventions may increase gut microbial diversity in patients with established illness. These results show that microbiome studies are feasible in patients with established schizophrenia and larger studies are warranted to validate microbial signatures and understand the relevance of lifestyle change in the development of metabolic conditions in this population. [ABSTRACT FROM AUTHOR]

Dietary guidelines for many Western countries base their edible oil and fat recommendations solely on saturated fatty acid content. This study aims to demonstrate which nutritional and bioactive components make up commonly consumed edible oils and fats; and explore the health effects and strength of evidence for key nutritional and bioactive components of edible oils. An umbrella review was conducted in several stages. Food composition databases of Australia and the United States of America, and studies were examined to profile nutrient and bioactive content of edible oils and fats. PUBMED and Cochrane databases were searched for umbrella reviews, systematic literature reviews of randomized controlled trials or cohort studies, individual randomized controlled trials, and individual cohort studies to examine the effect of the nutrient or bioactive on high-burden chronic diseases (cardiovascular disease, type 2 diabetes mellitus, obesity, cancer, mental illness, cognitive impairment). Substantial systematic literature review evidence was identified for fatty acid categories, tocopherols, biophenols, and phytosterols. Insufficient evidence was identified for squalene. The evidence supports high mono- and polyunsaturated fatty acid compositions, total biophenol content, phytosterols, and possibly high α-tocopherol content as having beneficial effects on high-burden health comes. Future dietary guidelines should use a more sophisticated approach to judge edible oils beyond saturated fatty acid content. [ABSTRACT FROM AUTHOR]

Aim: The present study aimed to measure the prevalence and severity of food insecurity in people with a severe mental illness, defined as schizophrenia and related psychoses, and bipolar disorder; and explore relationships between food insecurity status, and sociodemographic and clinical characteristics. Methods: This cross‐sectional study recruited community‐dwelling people with severe mental illness receiving clozapine and/or a long‐acting injectable antipsychotic medication within three mental health services in Sydney, Australia. Participants completed the 18‐item Household Food Insecurity Access Scale. Sociodemographic and medical information was obtained from participants' medical records. Independent samples t‐test and chi‐square analyses were used to test for between group differences based on food insecurity status. Binary logistic regression analyses adjusting for age and gender were used to determine the odds ratio. Results: One‐hundred and eighty‐eight people completed the assessment: 63% were male, mean age was 49.2 ± 12.4 years, and the majority (85%) had a diagnosis of schizophrenia. Food insecurity was detected in 31% of participants. Of those who were food insecure, 12% were classified as severe, 13% as moderate and 7% as mild. Tobacco smoking was higher in food insecure people compared to food secure people (odds ratio = 3.1, 95% CI 1.3 to 7.1, p = 0.01). Food insecurity status was not associated with demographic, diagnostic or other clinical data. Conclusions: Food insecurity is highly prevalent among community‐dwelling people with severe mental illness receiving clozapine and/or long‐acting injectable antipsychotic medication. Food security screening should be considered as routine care for this population group. [ABSTRACT FROM AUTHOR]

The scandal of premature mortality in people with serious mental illness is well established. Despite an increase in studies evaluating the efficacy of lifestyle interventions, translating this evidence into routine clinical care and policies is challenging, in part due to limited effectiveness or implementation research. We highlight the challenge of implementation that is increasingly recognized in clinical practice, advocate for adopting implementation science to study the implementation and systematic update of effective interventions in practice and policy, and provide directions for future research. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to comprehensively assess dietary intake, nutrition knowledge and food addiction in young people with mental illness. Methods: This was a three‐arm cross‐sectional study of 16–25‐year‐olds attending community mental health services who met criteria for: (i) first‐episode psychosis (FEP), (ii) ultra‐high risk for psychosis (UHR) or (iii) depression/anxiety. Participants self‐completed three validated questionnaires: (i) Australian Eating Survey, (ii) General Nutrition Knowledge Questionnaire—Revised and (iii) Yale Food Addiction Score Questionnaire. Results: Thirty participants (mean age 19.7 ± 2.5 years) completed the study (10 per study arm); 43% of the energy intake was obtained from energy‐dense, non‐nutritious foods, higher than the recommended upper limit (<15%) and the levels reported in the general population (35%). Mean diet quality score was 33.5 ± 11.8 of 73. Mean food addiction symptom score was 3.3 ± 3.7. Prevalence of food addiction was 37%. Nutrition knowledge was lower in the FEP and UHR participants than the depression/anxiety group (48.2 ± 13.8 and 49.5 ± 8.2 of 88 respectively); however, this difference was not statistically significant. Conclusions: Unhealthy dietary intake was observed in the early stages of mental illness, likely seeding future poor physical health. Further research is needed on the role of food addiction in this population, including effective intervention techniques. [ABSTRACT FROM AUTHOR]