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Abstract Background Compared with the general population, individuals with severe mental illness (SMI) have increased prevalence rates of obesity and greater risk for cardiovascular disease. This study aimed to investigate the effects of a long term nutritional intervention on body weight, body fat and cardiovascular risk factors in a large number of patients with SMI. Methods Nine hundred and eighty-nine patients with a mean ± S.D age of 40 ± 11.7 yrs participated in a 9 mo nutritional intervention which provided personalised dietetic treatment and lifestyle counselling every two weeks. Patients had an average body mass index (BMI) of 34.3 ± 7.1 kg.m-2 and body weight (BW) of 94.9 ± 21.7 kg. Fasted blood samples were collected for the measurement of glucose, total cholesterol, triglycerides and HDL- cholesterol. All measurements were undertaken at baseline and at 3 mo, 6 mo and 9 mo of the nutritional intervention. Results Four hundred and twenty-three patients of 989 total patients' cases (42.8%) dropped out within the first 3 months. Two hundred eighty-five completed 6 months of the program and 145 completed the entire 9 month nutritional intervention. There were progressive statistically significant reductions in mean weight, fat mass, waist and BMI throughout the duration of monitoring (p < 0.001). The mean final weight loss was 9.7 kg and BMI decreased to 30.7 kg.m-2 (p < 0.001). The mean final fat mass loss was 8.0 kg and the mean final waist circumference reduction was 10.3 cm (p < 0.001) compared to baseline. Significant and continual reductions were observed in fasting plasma glucose, total cholesterol and triglycerides concentrations throughout the study (p < 0.001). Conclusion The nutritional intervention produced significant reductions in body weight, body fat and improved the cardiometabolic profile in patients with SMI. These findings indicate the importance of weight-reducing nutritional intervention in decreasing the cardiovascular risk in patients with SMI.

Background: Stress has been shown to be associated with poor nutrition among young women. However, studies around the topic have major limitations in their methodologies and the role of confounding factors within this association remains unclear in the literature. Objective: To investigate the associations between stress and dietary quality/patterns in a culturally diverse population of childbearing-aged women. Methods: A secondary analysis of data from two studies conducted in UK and Lebanon was performed using Structural Equation Modelling (SEM) to explore the role of country context, socio-economic status, and physical variables. Participants were healthy women of childbearing age (n = 493). Variables measured were dietary intake, stress, physical activity, sociodemographic variables, and Body Mass Index. These were included in the SEM analysis to examine the mediating effect of stress. Results: The results showed that, among all variables, only country had a significant effect on dietary quality and patterns through the mediatory effect of stress. Participants from Lebanon were found to have higher stress levels compared to participants from the UK, and this contributed to a lower adherence to a Mediterranean diet. Conclusions: This study shows that for women of childbearing age, having a good diet quality/pattern is dependent on stress levels and country context. [ABSTRACT FROM AUTHOR]

There is now evidence to suggest that there may be an interaction between B vitamins and n -3 PUFA, with suggestions that increasing intake of both nutrients simultaneously may benefit cognition in older adults. The aim of this systematic review was to investigate whether supplementation with a combination of n -3 PUFA and B vitamins can prevent cognitive decline in older adults. Randomised controlled trials conducted in older adults that measured cognitive function were retrieved. The included trials provided a combination of n -3 PUFA and B vitamins alone, or in combination with other nutrients. Trials that provided n -3 PUFA alone and also measured B vitamin status or provided B vitamin supplementation alone and measured n -3 PUFA status were also included. The databases searched were The Cochrane Library, EMBASE, CINAHL, Scopus and MEDLINE. A total of 14 papers were included in the analysis (n 4913; age: 60–70 years; follow-up 24 weeks to 4 years). The meta-analysis results found a significant benefit of nutrient formulas, which included both n -3 PUFA and B vitamins alongside other nutrients, v. placebo on global cognition assessed using composite scores from a neuropsychological test battery (G = 0·23, P = 0·002), global cognition using single measures of cognition (G = 0·28, P = 0·004) and episodic memory (G = 0·32, P = 0·001). The results indicate that providing a combination of n -3 PUFA and B vitamins as part of a multi-nutrient formula benefits cognition in older adults v. a placebo, and the potential for an interaction between these key nutrients should be considered in future experimental work. [ABSTRACT FROM AUTHOR]

The global pandemic of overweight and obesity is linked to non-communicable disease (NCD) risk, incidence, and outcomes(1). Moderate weight-loss (5-10%) has considerable benefits, yet high quality diets can offer protective nutritional factors for NCD while encouraging nutritious, sustainable, and empowering dietary/lifestyle change. Evidence supports Mediterranean-style diet (MD) efficacy, yet adherence and adoption are becoming low even in countries of the Mediterranean basin(2). Obesogenic environments, ultra-processed foods, and social factors are implicated in low adoption. An adapted MD could improve adherence and adoption for UK populations(3). This systematic review aims to investigate substitutions and adaptations to MD. The following databases were searched for articles published between inception and December 2023: the Cochrane Library, EMBASE, CINAHL, Scopus, and MEDLINE. Risk of bias was assessed using the Revised Cochrane v2 tool for randomized trials. Articles were included if they met the following criteria: (1) study type was experimental or quasi-experimental; (2) mean participant age between 18 and 65 years (3) healthy or pre-clinical population (4) modification, adaptation, or tailoring of MD to specific populations. The databases identified 4,478 results. Forward citation searching returned two eligible results. A total of seventeen articles were included in the analysis. Fourteen were RCTs, one each of crossover and uncontrolled trials, and one protocol. Six studies were reported as part of the PREDIMED multicentre trials, while the protocol represented the RESMENA-S trials (hypocalorific, low glycaemic index diets). Ten were independent. PREDIMED studies supplemented MD with either extra virgin olive oil or nuts, with control group following a low-fat American Heart Association diet. Remaining interventions demonstrated heterogenicity of MD design; a ketogenic MD with phytoextract supplementation; three studies required aerobic exercise (i) daily (walk ≥30 minutes), (ii) weekly (150 minutes), or (iii)trainer-led resistance programme, with MD [ (i) MD with EVOO and pistachios, (ii) low-carbohydrate MD with walnuts (iii) hypocalorific macronutrientpercentage-adjusted MD]. A further three studies (two hypocalorific and one ketogenic) required no change to habitual physical activity levels. Five studies (PREDIMED) recorded leisure-time physical activity. Three studies [ (i) PREDIMED (ii) personalised hypocalorific MD (iii) isocaloric MD] had no activity information. Only one study [personalised low-calorie MD] applied a psychological behaviour change model. No studies specifically reported hydration levels or conviviality intervention; uncertain whether this information was included in professional-led education. The present systematic review finds paucity of evidence in RCTs of MD customisation for specific countries in healthy or pre-clinical individuals. Interventions have largely focused on augmenting MD with extra consumption of specific foods. Other components of the MD and lifestyle such as conviviality, hydration, adequate rest, seasonal and traditional ingredients, and lack of sedentarism were not reported. [ABSTRACT FROM AUTHOR]

Chronic low-grade inflammation has been associated with poor mood states and reduced mental well-being, increasing the chances of comorbidities such as diabetes and mental illness (1). Inflammation and stress share a bi-directional relationship (2), impacting an individual's mood and mental well-being. Whole food interventions such as the Mediterranean diet (MD) possess antiinflammatory properties and might offer protection for perceived stress and mood disorders (3). This systematic review investigated the effects of whole food interventions on stress, mood, and mental well-being. The following databases were searched for studies published until the end of March 2024: MEDLINE, CINAHL, Prospero, Web of Science, Cochrane Library (n = 6). Inclusion criteria were: (1) RCT; (2) mean participant age between 18 and 65 years; (3) measured one (or more) relevant outcomes e.g. stress, mood, or mental wellbeing; (4) whole food intervention. The Cochrane Risk of Bias v2 will be used to assess randomised controlled trials (RCT) (4). The review identified 3,854 results in accordance with the PRISMA guidelines with fifteen meeting inclusion criteria. Backward citation searching yielded 8 studies. A total of twenty-three studies were included in this review. Seventeen applied whole food dietary intervention (WFDI) while six investigated supplementing the habitual i.e. adding nuts to diet (STH). Seventeen studies used WFDI: MD (n = 7), Nordic diet (n = 1), Ketogenic diet (n = 1), time-restricted eating (n = 1), a priori diets (n = 7). The remaining six STH studies supplemented with: nuts (n = 3), basil (n = 1), cacao (n = 1) and corn leaf (n = 1). Five studies reported positive changes in mood states i.e. vigor (p <.05). Two of these investigated the effects of a 10-day MD intervention compared to habitual diet, finding significant improvement in mood states (n = 4). Three studies measured mental well-being as an outcome with WFDI, MD (n = 1) and a priori diets (n = 2) reporting significance (p <.05) but demonstrating heterogenicity in measurement methods. Two studies were conducted with the outcome of stress with a WFDI, Mediterranean diet (n = 1) and a priori (n = 1). The findings reported to have a positive effect on reducing stress, when compared to baseline (p <.035). Four studies examined the effects of STH on mood states reporting positive significant change respectively: nut (n = 2), basil (n = 1), cacao (n = 1). This systematic review is the first to examine the interaction of whole food intervention with stress, mood, and/or mental well-being. Our findings offer an insight to the interplay of different whole food interventions, whether entire diet or supplementation on the outlined outcomes in this review. The findings demonstrate heterogenicity of measurements which could be a factor in not establishing significance in some studies (n = 9). Other considerations of this review are the confounding variables that can influence stress, mood, and mental well-being such as physical activity, hydration, sleep quality. [ABSTRACT FROM AUTHOR]

Background: Maintaining a physically active lifestyle across the life course can add to an individual's health and well‐being. Many people are insufficiently active to achieve these gains with a trend towards further decreases in activity as people age. Community‐based group exercise programmes have been shown to be one means of increasing sustained activity levels for older people. Aim: To understand how and why older people sustain participation to community‐based group exercise programmes from a humanising perspective. Methods: A multiple‐case study approach was employed to study three exercise programmes in the South‐West of England. Data were collected through participant observation, focus groups and documentation. Data were analysed with deductive thematic analysis and mapped against the humanisation framework. Results: Findings suggest that the humanising nature of these particular exercise programmes supported sustained participation. In these programmes, agency was evidenced in the way participants self‐selected their level of exertion with exercises. There was freedom to be their unique selves and exercise within the limits of their insider challenges of an ageing body. Through this non‐judgemental exercise environment, there was an embodied understanding of who they were as people. The exercise programme became part of their personal journey. This journey helped inform their future by enabling them to keep active and maintain independence, allowing them to continue engaging in the world. There was a sense of togetherness and belonging which led to feelings of homeliness as they found a sense of place within the group. The friendships they formed helped them make sense and add meaning to their experiences and personal health challenges. Conclusions: When planning exercise environments to support the long‐term adoption of a sustained behaviour change, in the form of physical activity for older people, it is helpful to consider dimensions that make an individual feel human. [ABSTRACT FROM AUTHOR]