A meta‐review of “lifestyle psychiatry”: the role of exercise,smoking, diet and sleep in the prevention and treatment of mental disorders

There is increasing academic and clinical interest in how “lifestyle factors” traditionally associated with physical health may also relate to mental health and psychological well‐being. In response, international and national health bodies are producing guidelines to address health behaviors in the prevention and treatment of mental illness. However, the current evidence for the causal role of lifestyle factors in the onset and prognosis of mental disorders is unclear. We performed a systematic meta‐review of the top‐tier evidence examining how physical activity, sleep, dietary patterns and tobacco smoking impact on the risk and treatment outcomes across a range of mental disorders. Results from 29 meta‐analyses of prospective/cohort studies, 12 Mendelian randomization studies, two meta‐reviews, and two meta‐analyses of randomized controlled trials were synthesized to generate overviews of the evidence for targeting each of the specific lifestyle factors in the prevention and treatment of depression, anxiety and stress‐related disorders, schizophrenia, bipolar disorder, and attention‐deficit/hyperactivity disorder. Standout findings include: a) convergent evidence indicating the use of physical activity in primary prevention and clinical treatment across a spectrum of mental disorders; b) emerging evidence implicating tobacco smoking as a causal factor in onset of both common and severe mental illness; c) the need to clearly establish causal relations between dietary patterns and risk of mental illness, and how diet should be best addressed within mental health care; and d) poor sleep as a risk factor for mental illness, although with further research required to understand the complex, bidirectional relations and the benefits of non‐pharmacological sleep‐focused interventions. The potentially shared neurobiological pathways between multiple lifestyle factors and mental health are discussed, along with directions for future research, and recommendations for the implementation of these findings at public health and clinical service levels.     

Nutritional psychiatry research: an emerging discipline and its intersection with global urbanization,environmental challenges and the evolutionary mismatch

In 21st-century public health, rapid urbanization and mental health disorders are a growing global concern. The relationship between diet, brain function and the risk of mental disorders has been the subject of intense research in recent years. In this review, we examine some of the potential socioeconomic and environmental challenges detracting from the traditional dietary patterns that might otherwise support positive mental health. In the context of urban expansion, climate change, cultural and technological changes and the global industrialization and ultraprocessing of food, findings related to nutrition and mental health are connected to some of the most pressing issues of our time. The research is also of relevance to matters of biophysiological anthropology. We explore some aspects of a potential evolutionary mismatch between our ancestral past (Paleolithic, Neolithic) and the contemporary nutritional environment. Changes related to dietary acid load, advanced glycation end products and microbiota (via dietary choices and cooking practices) may be of relevance to depression, anxiety and other mental disorders. In particular, the results of emerging studies demonstrate the importance of prenatal and early childhood dietary practices within the developmental origins of health and disease concept. There is still much work to be done before these population studies and their mirrored advances in bench research can provide translation to clinical medicine and public health policy. However, the clear message is that in the midst of a looming global epidemic, we ignore nutrition at our peril.     

Training for the Treatment-room Sister in General Practice

A discussion group course for treatment-room nurses was organized in the spring of 1971 by the Thames Valley Faculty of the Royal College of General Practitioners. Twenty-eight nurses took part. Some were from local authorities but most were privately employed. Questionnaires were completed by participants. The course has had several consequences, and it is felt that some form of specific training for this branch of nursing should be established.     

How the Enga Cope with Frost in the 21st Century: Food Insecurity,Migration, and Development in the Papua New Guinea Highlands

Human Ecology - We use a mixed methods approach to examine high-altitude subsistence horticulturalists’ responses to food insecurity caused by El Niño related droughts and frosts in the...     

In the Time of Frost: El Niño and the Political Ecology of Vulnerability in Papua New Guinea

ABSTRACT

Climatic anomalies associated with El Niño bring prolonged droughts and night-time frosts that devastate subsistence gardens in the Papua New Guinea highlands. As a customary process of adaptation to the subsequent food insecurity caused by crop-destroying frosts, people migrate to lower altitude areas where kin and friends provide sustenance and social support. However, with increasing economic development and the demise of collective kin endeavours in the region, long-distance migration networks no longer appear to offer people respite from food insecurity. In this paper, I examine the changes in social responses to El Niño-caused food shortages at varying scales – from subsistence farmers to international aid agencies – over the past several El Niño events. The paper explores the production of vulnerability when customary social-ecological systems of adaptation intersect with regional and national politics, development efforts, and humanitarian aid agencies.