Food and mood: how do diet and nutrition affect mental wellbeing?

Experiences of Nurses Regarding Self-Care: A Qualitative Systematic Review and Meta-Synthesis

Nurses are susceptible to burnout, making it crucial for them to engage in self-care. This review consolidated the experiences of nurses regarding self-care. Seven electronic databases were searched from inception till October 2024: PubMed, Embase, CINAHL, PsycINFO, Web of Science, Scopus, and ProQuest Dissertations and Theses Global. The enhancing transparency in reporting the synthesis of qualitative research statements and Sandelowski and Barroso's guidelines guided this review. Quality appraisal of included studies was conducted using the Critical Appraisal Skills Program tool. Data were thematically synthesized. Confidence in review findings was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation-Confidence in the Evidence from Reviews of Qualitative research approach. Three main themes were identified from the 24 included studies: (1) Being a nurse: An occupational hazard towards self-care, (2) Catalyst towards self-care, and (3) Call to action. Nurses' poor engagement in self-care practices were due to work-related challenges (e.g., working hours), poor self-care awareness, and negative influence from their colleagues and leaders. Conversely, nurses were motivated to engage in self-care when they received encouragement from their peers and leaders.

Causal relationship between B vitamins and neuropsychiatric disorders: A systematic review and meta-analysis

Recently, there has been an increasing interest in how diet and nutrition influence both physical and mental health. Numerous studies have highlighted the potential role of B vitamins in neuropsychiatric disorders (NPDs), yet the exact causal relationship between these nutrients and NPDs remains unclear. In our Mendelian randomization (MR) meta-analysis, we examined the links between B vitamins (VB6, VB12, and folate) and NPDs, utilizing data from previous MR studies, the UK Biobank, and FinnGen databases. Our MR analysis revealed a complex, multifaceted association: VB6 appears to protect against Alzheimer's disease (AD) but may increase the risk for conditions such as major depressive disorder and post-traumatic stress disorder. VB12 seems protective against autism spectrum disorder (ASD) but may heighten the risk for bipolar disorder (BD). Folate has shown protective effects against AD and intellectual disability (ID). The meta-analysis suggests that B vitamins may protect against certain disorders like AD and Parkinson's disease, but they might also be risk factors for anxiety and other psychiatric conditions. Further subgroup analysis indicates that VB6 protects against epilepsy and schizophrenia but increases the risk of mania; VB12 protects against ID and ASD but raises the risk of schizophrenia and BD; folate protects against schizophrenia, AD, and ID. These findings reveal the intricate influence of B vitamins on mental health, emphasizing that different B vitamins have distinct impacts on various NPDs. This complexity underscores the importance of personalized supplementation in developing future therapeutic approaches for NPDs.

MUSAE: Fusion of art and technology to address challenges in food and health

There is an urgent need to transform our current food system to improve population health/wellbeing and planetary health. A number of challenges exist in order to achieve this. Artists, with their innate ability to use imagination to envision future needs and solve problems, represent a key group in this transformation. The project MUSAE brings together artists with experts from different disciplines to define an innovative model to integrate artistic collaboration in the (European) Digital innovation hubs (E-DIHs). They will employ the Design Futures Art-Driven (DFA) methods to enable artists and a range of companies involved in food production and distribution to develop innovative products and services that address key issues in the food system. MUSAE will run two residencies involving 23 artists and 11 SMEs working with three main technologies-Artificial Intelligence, Wearables and Robotics-to envision the future scenarios for societal needs and technology applications, as well as develop future-driven prototypes, thus opening new markets and innovations in the area of food.

Food insecurity and youth suicidal behaviours: Evidence from the Canadian Health Survey of Children and Youth

OBJECTIVE

Youth suicide, a major cause of death, is linked to poverty and other adverse experiences. Evidence of its association with food insecurity is unclear due to inadequate controls for household income in previous research. This cross-sectional study used independent reports of household income, food insecurity, and suicidal behaviours to examine these associations in a population-based sample.

METHODS

The 2019 Canadian Health Survey on Children and Youth surveyed 6735 youth (15-17 years), gathering data on sadness/hopelessness, suicidal ideation, and suicide attempts. Adults provided information on household food insecurity using a multi-item scale and about diagnosed mood disorders in youth. Household income data were provided by government tax records. We used Poisson regressions to estimate the relative risk (RR) of each suicidal behaviour attributed to household food insecurity, adjusting for household income and other covariates.

RESULTS

Approximately one in five (19.8%) youth experienced marginal (5.2%), moderate (7.9%), or severe (3.3%) food insecurity. Moderate or severe food insecurity was associated with increased risks of sadness/hopelessness, mood disorder, suicide ideation, and suicide attempts (RRs 1.30-2.17) after controlling for household income differences and other covariates. Generally, more severe food insecurity was positively associated with suicide behaviours.

CONCLUSION

Household food insecurity is associated with youth suicidal behaviours, independently of household income. Its underlying pathway to youth mental health includes social and psychological factors that require targeted policy intervention.

L-Arginine and Nitric Oxide in Vascular Regulation-Experimental Findings in the Context of Blood Donation

This narrative review provides an analysis of the role of nitric oxide (NO) and its precursors, particularly L-arginine, in vascular regulation and health, with an emphasis on findings from our experimental research in animal models. NO serves as a critical mediator of vascular function, contributing to vasodilation, the regulation of blood flow, and the prevention of thrombosis. As a primary precursor of NO, L-arginine is essential for maintaining endothelial integrity, modulating mitochondrial function, and reducing oxidative damage. This review synthesises the data and contextualises these findings within the physiological challenges faced by blood donors, such as repeated blood donation and associated oxidative stress. It examines the effects of L-arginine supplementation on mitochondrial respiration, lipid peroxidation, and microsomal oxidation in different conditions, including differences in age, gender, and dietary interventions. The mechanisms by which L-arginine enhances NO production, improves vascular elasticity, and alleviates endothelial dysfunction caused by reduced NO bioavailability are also investigated. By integrating experimental findings with insights from the existing literature, this review provides a perspective on the potential of L-arginine supplementation to address the specific physiological needs of blood donors. It highlights the importance of personalised nutritional approaches in enhancing donor recovery and vascular resilience. In addition, this review assesses the wider implications of L-arginine supplementation in mitigating oxidative stress and preserving vascular function. The interplay between NO bioavailability, dietary factors, and physiological adaptation in blood donors is highlighted, along with the identification of current knowledge gaps and recommendations for future research. By presenting both original experimental evidence and a critical synthesis of the literature, this article highlights the therapeutic potential of NO precursors, particularly L-arginine, in promoting vascular health in the context of blood donation.

Takeaway food consumption and depressive symptoms in Chinese university students: mediating effects of physical activity

Background

The consumption of takeaways is becoming increasingly prevalent. Despite this, the relationship between takeaway food consumption and depressive symptoms in Chinese populations has not been clarified. Furthermore, the factors that mediate the association between takeaway frequency and depressive symptoms are unknown.

Methods

Questionnaires were employed to collect data from 6,417 new students at Chongqing Medical University in the autumn of 2023, including sociodemographic information, takeaway frequency, physical activity levels (measured by the International Physical Activity Questionnaire Short Form), and depressive symptoms (measured by the Patient Health Questionnaire-9). Multiple linear regression and mediation analysis were performed. Multiple imputations were used to fill in missing data through sensitivity analyses.

Results

Among 6417 participants, 2,606 (40.6%) students ordered takeaway at least once a week, with 235 (3.7%) of them ordering takeaway food every day. Takeaway frequency was significantly associated with depressive symptoms (β=0.034, P=0.006), and physical activity partially mediated this relationship (95% bootstrap confidence interval=0.0024, 0.0371).

Conclusions

The study highlights the negative relationship between takeaway frequency and emotional well-being, emphasizing the need to focus on the emotional health of frequent takeaway food consumers. Moreover, our study suggests that increased physical activity may alleviate takeaway-induced mood-related outcomes.

Understanding the bidirectional association between obesity and risk of psychological distress and depression in young adults in the US: available evidence, knowledge gaps, and future directions

While the physical health effects of obesity are well-characterized, an emerging branch of research has shown that obesity additionally plays a critical role in one's mental health. Young adults, in a pivotal transition phase in their lives, may be particularly prone to the concurrent effects of obesity and adverse mental health outcomes. The purpose of this review is to comprehensively examine existing data regarding the connection between obesity and two widely validated measures of mental health: psychological distress and depression. The connection between mental health outcomes and obesity is mediated by a complex interplay between biological and sociocultural factors, which is explored in this review with particular focus on younger adults aged 20-39. Further, the impact of several demographic factors including race/ethnicity, gender, and immigration status are examined closely. To our knowledge, this review is one of the first efforts to integrate existing knowledge between obesity and mental health, with particular regard for young adults and the impact of other key sociodemographic characteristics. This review has important implications at the interface of two of the most pressing public health crises in the United States.

From air to mind: unraveling the impact of indoor pollutants on psychiatric disorders

Epidemiological evidence from the past 20 years indicates that environmental chemicals brought into the air by the vaporization of volatile organic compounds and other anthropogenic pollutants might be involved, at least in part, in the development or progression of psychiatric disorders. This evidence comes primarily from occupational work studies in humans, with indoor occupations being the most important sources of airborne pollutants affecting neural circuits implicated in mood disorders (e.g., major depressive disorder and bipolar disorder). The current mini review brings together recent findings of indoor airborne pollution from different fields of research, including genetics, neuropathology, and neuroimaging, for gauging underlying physiological mechanisms leading to emotional disturbances that impact nearly all aspects of human behavior. A better understanding of how indoor airborne pollutants affect brain neurons to augment clinical symptoms associated with psychiatric disorders will undoubtedly be useful in the subsequent treatment of patients with major depressive and/or bipolar disorders. This article is part of the themed issue, "Understanding the Link Between Environmental Pollutants, Brain & Behavior."

Evaluating the Significance of Obesity or Excessive Weight in Various Mental Health Disorders: A Systematic Review

Obesity is a major global public health challenge affecting all countries and communities. The link between obesity and various types of physical morbidities has been widely acknowledged in different studies. Despite the immense impact of obesity on mental health, its full effect on the areas has not been as explored as the impact on physical health has been. Following an extensive review of various recent studies, the objective of this study is to evaluate the correlations and effects of obesity on mental health disorders, in addition to reflecting on the significance of assessing the correlation. The other objective of this study is to evaluate obesity prevalence in mentally ill individuals. We believe that the realization of these objectives will address the existing literature gaps within the population of mentally ill persons in addition to aiding with the necessary preventive knowledge that will enable the provision of optimum mental and physical health. Therefore, this study entailed the performance of a systematic review of several online databases, including Scopus, Web of Sciences, PubMed, Google Scholar, and MEDLINE. This systematic review also utilized an increasingly robust methodology based on the Cochrane guidelines and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Thus, the inclusion criteria stipulated that only studies published between 2010 and 2024 and published in the English language were to be included in this systematic review. The quality of the included studies was assessed using an appraisal tool for cross-sectional studies. As a result, 12 studies met the inclusion criteria for this systematic review and were reviewed. The findings indicate that the prevalence rate of obesity in individuals with mental health disorders surpasses the prevalence of the condition within the general population, suggesting that mentally ill persons are at a higher risk of developing obesity, even as one of the major side effects of psychiatric treatment is excessive weight gain. Individuals with personality disorders, including borderline personality disorder, avoidant personality disorder, dependent personality disorder, and antisocial personality disorder, among others, presented the highest prevalence rate of obesity compared to those with psychosis. Prospective studies should focus on evaluating the various mitigating factors that underlie the weight gain and obesity development that occur across mental health disorders.

Annual Research Review: Micronutrients and their role in the treatment of paediatric mental illness

The aim of this narrative review is to summarize evidence relating the importance of nutrient intake from diet and supplementation for paediatric mental health. We begin by reviewing several mechanisms by which nutrients maximize brain health, including enabling metabolic reactions to occur, supporting mitochondrial function, reducing inflammation and assisting with detoxification. Circumstances that may contribute to an individual requiring additional nutrients beyond what are available in the diet, such as consumption of nutritionally depleted food, individual differences in biological need, long-term medication use and gut-brain health needs are then reviewed. These factors underpin the importance of tackling deficiencies relative to individual metabolic requirements with a broad spectrum of micronutrients, as opposed to a single nutrient approach, to address personal metabolic needs and/or environmentally induced nutrient depletions. The evidence for treating psychological symptoms with supplementary micronutrients is presented, summarizing research using broad-spectrum micronutrients in the treatment of mental health issues including aggression, autism spectrum disorder, attention-deficit/hyperactivity disorder and emotional dysregulation, often with medium between-group effect sizes compared with placebo, with clinically meaningful changes. The breadth and consistency of the findings highlight the importance of receiving a complete foundation of nutrients to optimize brain health; however, the small number of studies identifies the importance of future work to replicate these preliminary findings. Documented safety in 8-week randomized controlled trials with open-label extensions up to 16 weeks and longer-term follow-up for 1.5-5 years in smaller samples provide reassurance that this treatment approach does not result in serious adverse events. We provide recommendations for future research including consistency in micronutrient interventions, scalable delivery models, effectiveness and implementation studies and the need to investigate these interventions in the prevention and management of less-studied childhood psychiatric conditions.

KETO-MOOD: Ketogenic Diet for Microbiome Optimization and Overcoming Depression - A Protocol for a Randomized Controlled Trial

INTRODUCTION

Major depressive disorder (MDD) significantly impacts millions worldwide, with limited success in achieving remission for many patients, leading to high disease burden and increased suicide risk. Psychotherapy and antidepressants, although effective, do not provide relief for all, prompting the search for alternative treatments. Ketogenic diets have demonstrated positive effects on brain health. Our study aims to investigate the efficacy of the ketogenic diet in alleviating MDD symptoms, filling a critical gap in psychiatric treatment options and offering a novel dietary approach with potential to mitigate disease burden and enhance mental well-being.

METHODS

This phase 2 randomized controlled trial will evaluate the efficacy of a 10-week program of dietitian counseling and ketogenic meal provision versus an intervention with similar dietetic contact promoting a healthy, insulin-lowering, non-ketogenic diet. The primary outcome is the change in the Patient Health Questionnaire nine-item depression score. Secondary outcomes include cognitive and affective mindfulness, self-efficacy, sleep, cognitive function, work and social adjustment, and various immunological, metabolic, and microbiome markers at weeks 6 and 10.

CONCLUSION

This study addresses a critical gap in depression treatment by exploring the ketogenic diet's potential as a metabolic mood enhancing intervention. Given the global impact of depression and limitations of current therapies, this research is valuable for exploring previously underappreciated neuroprotective and metabolic mechanisms and clinical benefits.

Prospective study of food intake changes in adolescent elite athletes

Background

Inadequate energy intake among athletes can lead to low energy availability (LEA) which in turn can result in negative effects on athletic performance and physical and psychological health. This syndrome is known as relative energy deficiency in sports (REDs).

Objective

To map perceived changes in overall food intake among adolescent athletes during the previous year, as well as weekly changes during a 3-month period and to examine how these changes are associated with mental health, physical load and sex.

Methods

A total of 168 high school athletes from eight different sports participated. A baseline questionnaire examined changes in training habits and food intake in the past year, mental health (short version of the Warwick-Edinburgh Mental Well-being Scale (SWEMWBS)), injury history and previous periods of poor psychological health. Weekly digital questionnaires for 3 months tracked weekly physical and mental load and changes in food intake. Comparative and correlation analyses were performed with p<0.05 considered significant.

Results

A decreased food intake during the previous year was reported more often among athletes experiencing periods of poor mental health than those without such periods (10% vs 2%; p=0.034). Athletes who decreased their food intake reported lower mental well-being than athletes who increased their food intake (mean difference in SWEMWBS=4.69±1.57; p=0.021). Over a 3-month period, most athletes did not change their food intake, yet fluctuations in physical load were reported.

Conclusion

This study showed that athletes experiencing lower mental health or period(s) of poor mental health reported decreased food intake more often than those with better mental health or those without period(s) of poor mental health. In addition, the mismatch found between perceived weekly changes in overall food intake and changes in physical load during the same time period could potentially result in an increased risk for LEA.

The Role of Dietary Antioxidants, Food Supplements and Functional Foods for Energy Enhancement in Healthcare Professionals

Healthcare professionals frequently experience significant work overload, which often leads to substantial physical and psychological stress. This stress is closely linked to increased oxidative stress and a corresponding decline in energy levels. This scoping review investigates the potential impact of dietary antioxidants and food supplements in conjunction with diet in controlling these negative effects. Through an analysis of the biochemical pathways involved in oxidative stress and energy metabolism, the paper emphasizes the effectiveness of targeted dietary interventions. Key dietary antioxidants, such as vitamins C and E, polyphenols, and carotenoids, are evaluated for their ability to counteract oxidative stress and enhance energy levels. Additionally, the review assesses various food supplements, including omega-3 fatty acids, coenzyme Q10, and ginseng, and their mechanisms of action in energy enhancement. Practical guidelines for incorporating energy-boost dietary strategies into the routine of healthcare professionals are provided, emphasizing the importance of dietary modifications in reducing oxidative stress and improving overall well-being and performance in high-stress healthcare environments. The review concludes by suggesting directions for future research to validate these findings and to explore new dietary interventions that may further support healthcare professionals under work overload.

A Lack of Food for Thought: Midlife Food Insecurity and Its Association With Subsequent Cognitive Ability of Older Americans

OBJECTIVES

The 50-59 age group in the United States experience higher levels of food insecurity (FI) compared to older adults. While previous research has identified an association between FI and cognition outcomes in older populations, limited research has examined midlife as a specific FI exposure window and the association of this hardship with long-run cognition outcomes.

METHODS

Utilizing 14 waves of Health and Retirement Study (HRS) data (1995-2020), I applied mixed-effects models to assess the relationship between midlife FI exposure and later-life cognitive function, controlling for childhood disadvantages and other health-related and sociodemographic characteristics.

RESULTS

Findings indicate that both cumulative FI duration and ever experiencing FI during ages 50-59 are significantly associated with subsequent cognitive decline. Specifically, ever experiencing FI during midlife was linked to a decrease in cognitive function by 0.07 standard units (95% confidence interval [CI], -0.13 to -0.003; p < .05). In addition, each additional year of FI exposure during midlife was associated with a reduction in cognitive function by 0.01 standard units (95% CI: -0.03 to -0.003; p < .05). These associations remained robust even after accounting for a range of potential confounders and covariates.

DISCUSSION

The findings support the cumulative inequality model, suggesting that midlife FI is a significant predictor of lower cognitive function in later life. Both the timing and extent of FI during midlife are crucial factors in shaping cognitive health outcomes. Policy interventions targeting FI in the 50-59 age group could play a pivotal role in promoting healthy aging and mitigating cognitive decline in older adulthood.

Californian Public University Students' Attitudes, Beliefs, and Barriers to Plant-Based Nutrition

Adopting a plant-based diet (PBD) has environmental sustainability benefits and has been shown to improve overall health and quality of life, yet for most people a diet shift towards a plant-based one remains a challenge, due to personal and environmental obstacles. Important independent decisions on self-care and nutritional habits occur in the first year of enrollment for college students. This cross-sectional quantitative study aims to examine the association between health beliefs, motivators, barriers, self-efficacy, and mental health status and following a more PBD in college students. A total of 449 Californian public university and junior college students completed an online survey. A stepwise multiple regression model was used to predict the level of intention to follow a PBD. Self-efficacy (β = 0.28, P < .001), motivators (β = 0.33, P < .001), and barriers (β = -0.19, P < .001) significantly predicted and accounted for 35% of the variance in intention to follow a PBD. The results reveal that greater self-efficacy, higher motivation, and fewer barriers predicted higher intention to follow a PBD. Beliefs did not add significantly to following a PBD.

The Impact of Physical Activity and Lifestyle on Mental Health: A Network Analysis

AIM

This study aimed to investigate the association between physical activity (PA), lifestyle, and symptoms of depression, anxiety, and stress.

METHODS

A cross-sectional study was carried out using an online questionnaire. PA (International Physical Activity Questionnaire), lifestyle (Short Multidimensional Inventory Lifestyle Evaluation), and mental health (Depression, Anxiety, and Stress Scale-21) were assessed. Mean scores were compared between groups of physically active and inactive participants, controlling for gender, education, and income. Furthermore, associations were made between the variables, and individual network analyses were carried out for each mental health domain. The sample consisted of 353 individuals (age = 33.8 [12.2], 59.2% women).

RESULTS

In network analyses, PA was indirectly related to depression and stress through the relationship with other lifestyle domains such as diet and nutrition or through stress management and social support. The same path was observed for anxiety; however, a direct partial correlation was also observed between PA and anxiety, suggesting that PA seems to intervene more directly in this aspect of mental health.

CONCLUSION

It is concluded that PA is indirectly (via stress management, diet and nutrition, and social support) associated with depression and stress and has direct and indirect associations (via stress management and social support) with anxiety.

The Effect of Lifestyle Interventions on Anxiety, Depression and Stress: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

BACKGROUND/OBJECTIVES

Depression, anxiety, and stress are common mental health issues that affect individuals worldwide. This systematic review and meta-analysis examined the effectiveness of various lifestyle interventions including physical activity, dietary changes, and sleep hygiene in reducing the symptoms of depression, anxiety, and stress. Using stress as an outcome and conducting detailed subgroup analyses, this study provides novel insights into the differential effects of lifestyle interventions across diverse populations.

METHODS

Five databases were systematically searched: PubMed, Web of Science, Scopus, Cochrane Library, and Google Scholar, for gray literature searches. Keywords were used to search each database. The search period was from the conception of the databases until August 2023 and was conducted in English. For each analysis, Hedges' g was reported with a 95% confidence interval (CI) based on the random-effects method. Subgroups were analyzed and heterogeneity and publication bias were examined.

RESULTS

Ninety-six randomized clinical trial studies were included in this meta-analysis. Lifestyle interventions reduced depression (Hedges g -0.21, 95% confidence interval -0.26, -0.15; p < 0.001; I2 = 56.57), anxiety (Hedges g -0.24, 95% confidence interval -0.32, -0.15; p < 0.001; I2 = 59.25), and stress (-0.34, -0.11; p < 0.001; I2 = 61.40).

CONCLUSIONS

Lifestyle interventions offer a more accessible and cost-effective alternative to traditional treatments and provide targeted benefits for different psychological symptoms.

Ultra-Processed Food Consumption and Its Association with Risk of Obesity, Sedentary Behaviors, and Well-Being in Adolescents

BACKGROUND/OBJECTIVES

The literature on consumption of ultra-processed food (UPF) using the NOVA classification is still limited. Therefore, the aim of the present study was twofold: (i) to compare the UPF consumption, sedentary behaviors, and well-being perception between boys and girls; and (ii) to investigate the association between the UPF consumption and risk of overweight, sedentary behaviors, and well-being in adolescents.

METHODS

The present cross-sectional study comprised a sample of 245 adolescents (131 boys) aged 12-17 years-old (M = 14.20; SD = 1.09). Height and weight were assessed, and subsequently, the BMI was computed; furthermore, total body fat percentage was measured with bioelectrical impedance. Daily consumption of UPF was assessed by the NOVA screener and time spent sedentary was assessed by the Midlands Behavior Health 2024 questionnaire. The Mental Health Continuum-Short Form (MHC-SF) was used to measure adolescents' psychosocial well-being. Pearson's correlations and logistic regression analysis were used, controlling for biological, behavioral, and socio-economic confounders.

RESULTS

No sex differences were observed for the different UPF NOVA subscales. Boys reported higher computer use levels than girls on the weekend (p = 0.025), and they spent more time playing electronic games during the week (p = 0.005) and on the weekend than their female counterparts (p < 0.001). Moreover, boys reported higher scores in all well-being dimensions (p < 0.001) than girls.

CONCLUSIONS

The findings revealed, after controlling for sex, sedentary time, and active behaviors, adolescents who consumed UPF on the previous day tended to be associated with a higher risk of being overweight, but also marginally without statistical significance (OR = 0.91, 95% CI: 0.83-1.01, p = 0.06). Of relevance, the present study revealed that both boys and girls of mothers with high educational levels were less likely to be classified as overweight or obese youth.

Socio-demographic determinants of dietary choices and their impact on health in Spanish adults

Background

Although Spain has traditionally followed the Mediterranean diet, in recent years, changes have become noticeable in the food preferences of the population. These changes include adopting new diets and dietary trends, such as plant-based diets, intermittent fasting and raw food diets. These choices are influenced by cultural, social and socio-demographic factors, and their impact on health should be studied in detail.

Aim

The objectives of this research are: (1) to study the prevalence of different dietary patterns among the Spanish population, (2) to explore the dependence of dietary choice on socio-demographic factors, (3) to investigate the relationship between the social habits and lifestyle choices of the population and how it affects health.

Methods

A descriptive cross-sectional study was carried out on the Spanish population. Using a questionnaire constructed and validated by the research team, socio-demographic data were collected and different nutritional, social and lifestyle habits of the targeted population were explored.

Results

A valid sample of 22,181 people was collected among which 17,573 (79.2%) people claimed to follow a Mediterranean dietary pattern, 1,425 (6.4%) people followed a plant-based diet, 365 (1.6%) people are vegans, 1,018 people (4.6%) practiced intermittent fasting, 252 (1.1%) people followed a raw food diet and 1,548 people (7%) claimed to follow other types of diets. The data show that younger people (18-25 years old) tend to adopt more often a plant-based diet than older people and that women tend to follow this type of diet more often than men. On the other hand, men seem to practice intermittent fasting more frequently. A higher tendency to practice a raw food diet was found among people living in villages than those living in cities. Moreover, some trends were found in different regions of Spain, with greater adherence to a plant-based diet in Catalonia, while intermittent fasting is more common in the Region of Murcia. Finally, the results indicate that individuals who pay attention to their diet and experiment with various dietary patterns are generally more health-conscious. This is reflected in their adoption of healthier behaviors, such as exercising more and reducing their intake of alcohol and sugary drinks.

Health Benefits Beyond the Scale: The Role of Diet and Nutrition During Weight Loss Programmes

INTRODUCTION

Obesity management strategies such as caloric restriction, very-low-calorie diets (VLCDs), and meal replacements can lead to moderate short-term weight loss. However, many patients face significant challenges in maintaining these results. Personalized interventions, including behavioral counseling and physical activity, have been shown to improve long-term adherence and success. Current clinical guidelines emphasize the pivotal role of dietitians in enhancing patient outcomes through nutritional therapy. When combined with pharmacotherapy and bariatric surgery, the focus shifts from mere weight loss to broader health improvements.

METHODS

This review explores the evolving role of dietitians in obesity management, advocating for a shift from a weight-centric approach to a more holistic model that prioritizes overall health gains. Key areas of interest include dietetic interventions' impact on metabolic health, cardiovascular function, gut microbiome balance, inflammation, and psychological well-being.

RESULTS

Dietetic interventions have been shown to provide significant health improvements beyond weight loss. These include enhanced metabolic and cardiovascular health, better gut microbiome balance, reduced inflammation, improved sleep quality, mental well-being, and overall quality of life. By focusing on non-scale victories such as improved insulin sensitivity, lipid profiles, and mental health, dietitians play a crucial role in driving long-term success in obesity management. These outcomes highlight the need to shift the focus from short-term weight loss to a more comprehensive view of health gains.

CONCLUSIONS

The role of dietitians in obesity management is expanding to encompass a more comprehensive and individualized approach. Moving beyond a focus on weight reduction, this paradigm promotes long-term, patient-centered strategies that address the multifactorial nature of obesity. By combining dietary changes with regular physical activity and behavioral support, dietitians can contribute to sustained health improvements, treating obesity as a chronic, complex disease.

Were there any missing mediators between visual impairment and anxiety symptoms? Results from Chinese Longitudinal Healthy Longevity Survey

Introduction

Visual impairment, encompassing low visual acuity and visual field loss, significantly impacts the older adult population worldwide, leading to increased disability and mortality risks. Recent studies suggest a strong association between visual impairment and anxiety, particularly among older adults. This study aims to explore the relationship between visual impairment and anxiety symptoms in older adult individuals in China, and to investigate potential mediating factors.

Methods

Data for this study were derived from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS), including 11,702 participants aged 65 and older. Visual impairment was assessed through self-reported visual function, while anxiety symptoms were measured using the 7-item Generalized Anxiety Disorder scale (GAD-7). Additional assessments included sleep quality and duration, exercise status, and dietary diversity. Logistic regression models and mediation analysis were employed to explore associations and mediating effects.

Results

The findings indicate that visual impairment is significantly associated with increased anxiety symptoms among the older adult (OR = 1.51, 95% CI: 1.32-1.72, p < 0.001). Mediation analysis revealed that sleep quality, dietary diversity score (DDS), and plant-based DDS significantly mediated the relationship between visual impairment and anxiety. In contrast, sleep duration, exercise, and animal-based DDS did not show significant mediating effects.

Conclusion

Visual impairment is a crucial predictor of anxiety symptoms in the older adult. Improving sleep quality and promoting a diverse plant-based diet may mitigate anxiety symptoms in this population. Interventions targeting these areas could enhance the mental health and quality of life of older adult individuals with visual impairment.

The effect of diet quality and body mass index on depression in older adults: a growth curve analysis

BACKGROUND

Nutrition not only plays an important role in one's physical health, but also mental health. The causal association between nutrition and mental health remains unclear. While a healthy dietary pattern may protect one against mental illness, it is also possible that poor mental health could lead to unhealthy eating habits or choices. Furthermore, emerging studies suggest that a higher body mass index (BMI) is associated with a lower risk of depressive symptoms in older adults, contrasting the effect observed in other populations. With an ageing population, this study aimed to investigate the long-term impact of a healthy dietary pattern, BMI, and other covariates on depressive symptoms in older adults.

METHODS

We conducted a cohort study between 2014 and 2017, with each follow-up assessment being one year apart. A total of 2081 participants above 65 years old (M = 79.65, SD = 7.94) completed the baseline assessment in 2014, which included basic demographics, self-reported eating habits, depressive symptoms, and the measurement of height and weight. Distance to supermarkets and fast food was calculated based on participants' residential addresses. Two growth models were performed to assess the trajectory of change in depressive symptoms over time.

RESULTS

Older adults experienced a significant decrease in depressive symptoms over time (intercept = 2.68, p < .001; slope = -0.25, p < .001). At baseline, a higher diet quality (B = -0.95, p < .001), higher BMI (B = -0.09, p < .001), younger age (B = 0.40, p = .001), being a male (B = 0.76, p < .001), and having fewer chronic diseases (B = 0.39, p < .001) were associated with lower levels of depressive symptoms. Over time, a higher diet quality (B = 0.14, p = .05), higher BMI (B = 0.02, p = .04), and fewer chronic diseases (B = -0.08, p < .001) predicted lower levels of depressive symptoms over time.

CONCLUSIONS

A higher diet quality and higher BMI may serve as protective factors for depressive symptoms in older adults. Potential implications are being discussed.

Nutritional Modulation of the Gut-Brain Axis: A Comprehensive Review of Dietary Interventions in Depression and Anxiety Management

Mental health is an increasing topic of focus since more than 500 million people in the world suffer from depression and anxiety. In this multifactorial disorder, parameters such as inflammation, the state of the microbiota and, therefore, the patient's nutrition are receiving more attention. In addition, food products are the source of many essential ingredients involved in the regulation of mental processes, including amino acids, neurotransmitters, vitamins, and others. For this reason, this narrative review was carried out with the aim of analyzing the role of nutrition in depression and anxiety disorders. To reach the review aim, a critical review was conducted utilizing both primary sources, such as scientific publications and secondary sources, such as bibliographic indexes, web pages, and databases. The search was conducted in PsychINFO, MedLine (Pubmed), Cochrane (Wiley), Embase, and CinAhl. The results show a direct relationship between what we eat and the state of our nervous system. The gut-brain axis is a complex system in which the intestinal microbiota communicates directly with our nervous system and provides it with neurotransmitters for its proper functioning. An imbalance in our microbiota due to poor nutrition will cause an inflammatory response that, if sustained over time and together with other factors, can lead to disorders such as anxiety and depression. Changes in the functions of the microbiota-gut-brain axis have been linked to several mental disorders. It is believed that the modulation of the microbiome composition may be an effective strategy for a new treatment of these disorders. Modifications in nutritional behaviors and the use of ergogenic components are presented as important non-pharmacological interventions in anxiety and depression prevention and treatment. It is desirable that the choice of nutritional and probiotic treatment in individual patients be based on the results of appropriate biochemical and microbiological tests.

A Theory of Food Exploration with Gender Differences: Childhood Eating Habits and Implicit Food Attitudes

BACKGROUND/OBJECTIVES

The growing interest in nutritional psychology has sparked explorations into how eating habits impact one's emotional, cognitive, and physical health. The Theory of Food (ToF) posits that childhood eating patterns shape food choices in adulthood, influenced by cognitive and associative representations formed early in life. This study explores the relationship between specific childhood eating habits-fruit and snack consumption-and implicit attitudes toward these food groups in adulthood. It also investigates whether this relationship differs by gender.

METHODS

One hundred and nineteen participants completed a recall questionnaire about their childhood eating habits and an Implicit Association Test (IAT) to assess implicit attitudes toward food groups. The primary hypotheses were that greater fruit consumption in childhood would lead to more positive attitudes toward fruits, and higher snack consumption would result in more favourable attitudes toward snacks.

RESULTS

The results did not support the initial hypotheses, indicating no direct relationship between the consumption of fruits or snacks in childhood and implicit attitudes in adulthood. However, further analyses revealed a significant difference in implicit attitudes toward fruits below versus high childhood fruit consumption participation, particularly among women.

CONCLUSIONS

These findings highlight the complexity of the relationship between childhood eating habits and implicit food attitudes. While no direct associations were found for the overall sample, the significant differences in attitudes based on childhood fruit consumption in women suggest gender-specific patterns. These results emphasize the need for further research to unravel the intricate connections between early eating behaviours and later food attitudes.

Dietary Habits, Physical Activity and Body Mass Index in Transgender and Gender Diverse Adults in Italy: A Voluntary Sampling Observational Study

Transgender and gender-diverse (TGD) individuals continue to experience harassment and discrimination across various aspects of life, significantly impacting their physical and mental health. The scarcity of data on their general health, particularly regarding dietary habits, remains a challenge in developing effective healthcare strategies for this population. To address this gap, we analyzed selected dietary habits, physical activity (PA), and body mass index (BMI) among Italian TGD adults compared to the Italian general population (IGP). An online anonymous survey was conducted via the Computer Assisted Web Interviewing technique from June 2020 to June 2021. Participants were enrolled through clinical centers and TGD organizations. Data from 959 TGD adults were analyzed using chi-squared tests and logistic regression models. Key findings indicated that approximately 70% of TGD individuals consumed fewer servings of fruit and vegetables (FV) than recommended (five or more servings per day). Although red meat consumption was lower overall, a greater percentage of TGD individuals reported consuming more than three servings per week. Additionally, 58% of TGD participants indicated that they did not engage in any PA, compared to 36% of the IGP. Notably, significant differences in BMI were identified, with higher rates of overweight and obesity among TGD individuals assigned female at birth. These results underscore the urgent need for tailored nutritional guidelines and inclusive public health strategies to meet the specific health needs of the Italian TGD population. Expanding access to targeted interventions could contribute to improving overall well-being in this marginalized group.

Implementation of health-promoting retail initiatives in the Healthier Choices in Supermarkets Study-qualitative perspectives from a feasibility study

BACKGROUND

Improving food environments like supermarkets has the potential to affect customers' health positively. Scholars suggest researchers and retailers collaborate closely on implementing and testing such health-promoting interventions, but knowledge of the implementation of such interventions is limited. We explore the implementation of four health-promoting food retail initiatives selected and developed by a partnership between a research institution, a large retail group, and a non-governmental organisation.

METHODS

The four initiatives included downsizing of bags for pick'n' mix sweets and soda bottles at the check-out registers, shelf tags promoting healthier breakfast cereal options, and replacing a complimentary bun with a banana offered to children. The initiatives were implemented for 6 weeks (or longer if the store manager allowed it) in one store in Copenhagen, Denmark. Data were collected through observations, informal interviews with customers, and semi-structured interviews with retailers. We conducted a thematic analysis of transcripts and field notes inspired by process evaluation concepts and included quantitative summaries of selected data.

RESULTS

Two out of four initiatives were not implemented as intended. The implementation was delayed due to delivery issues, which also resulted in soda bottles not being downsized as intended. The maintenance of the shelf tags decreased over time. Retailers expressed different levels of acceptability towards the initiatives, with a preference for the complimentary banana for children. This was also the only initiative noticed by customers with both positive and negative responses. Barriers and facilitators of implementation fell into three themes: Health is not the number one priority, general capacity of retailers, and influence of customers and other stakeholders on store operation.

CONCLUSIONS

The retailers' interests, priorities, and general capacity influenced the initiative implementation. Retailers' acceptability of the initiatives was mixed despite their involvement in the pre-intervention phase. Our study also suggests that customer responses towards health-promoting initiatives, as well as cooperation with suppliers and manufacturers in the development phase, may be determining to successful implementation. Future studies should explore strategies to facilitate implementation, which can be applied prior to and during the intervention.

Dietary Patterns and Geriatric Syndromes in Adults: Analysis of the 2018-19 National Health and Nutrition Survey

BACKGROUND

The study of dietary patterns in older adults (OA) and their association with geriatric syndromes (GS) is scarce in Latin America.

OBJECTIVE

To describe the association of dietary patterns with GS in the Mexican older adult population, using data from the 2018-19 National Health and Nutrition Survey.

METHODS

Dietary data were collected from 3,511 adults (≥60 years of age, both sexes) using a semi-quantitative food frequency questionnaire. Dietary patterns were derived by principal component analysis based on the consumption of 162 foods from 24 food groups. The GS studied were: frailty, depressive symptoms (DS), low appendicular skeletal muscle mass (ASMM); additionally, we studied inflammation (serum CRP>5 mg/L). Logistic regression models were used.

RESULTS

Four major dietary patterns were identified: a) "Western", b) "Prudent", c) "Soups", and d) "Traditional". The middle and higher tertiles of the "Prudent" pattern were associated with lower odds of DS (OR 0.71, p = 0.04; and OR 0.61, p = 0.008), respectively. The second tertile of the "Soups" pattern was associated with lower odds of low ASMM (OR 0.68, p = 0031) and inflammation (OR 0.58, p = 0.022). The highest tertile of the "Traditional" pattern was associated with low ASMM (OR 1.55, p = 0.008) and lower odds of inflammation (OR 0.69, p = 0.044). No association was found between the "Western" dietary pattern and GS.

CONCLUSIONS

Three of four major dietary patterns were associated with GS in older Mexican adults. Further studies are needed to address strategies to improve diet quality in this age group and its association with health and functional outcomes.

Engaging with 'less affluent' communities for food system transformation: a community food researcher model (FoodSEqual project)

The UK food system is distorted by inequalities in access, failing the people most in need, yet it should provide access to safe, nutritious affordable food for all citizens. Dietary patterns are associated with socio-demographic characteristics, with high levels of diet-related disease mortality attributed to poor dietary habits. Disadvantaged UK communities face urgent public health challenges, yet are often treated as powerless recipients of dietary and health initiatives. The need for food system transformation has been illustrated within recent UK government policy drivers and research funding. The Food Systems Equality project is a research consortium that aims to 'co-produce healthy and sustainable food systems for disadvantaged communities'. The project focusses on innovating food products, supply chains and policies, placing communities at the centre of the change. Tackling the above issues requires new ways of working. Creative approaches in food research are known to empower a wider range of individuals to share their 'lived food experience' narratives, building relationships and corroborating co-production philosophies, thus promoting social justice, and challenging more traditional positivist/reductionist 'biomedical' approaches for nutrition and food studies. This review paper critiques the use of community-centric approaches for food system transformation, focusing on one, a community food researcher model() as an exemplar, to highlight their utility in advocating with rather than for less affluent communities. The potential for creative methods to lead to more equitable and lasting solutions for food system transformation is appraised, consolidating the need for community-driven systemic change to foster more progressive and inclusive approaches to strengthen social capital. The paper closes with practice insights and critical considerations offering recommendations for readers, researchers, and practitioners, enabling them to better understand and apply similar approaches.

The Moderating Role of Dietary Quality and Dietary Fibre Intake on the Mood Effects of Positive Expressive Writing: A Pilot Study

BACKGROUND

Positive expressive writing is associated with enhanced psychological wellbeing. Several individual differences are known to moderate the enhancement effects of positive expressive writing, but no studies to date have investigated the optimal dietary conditions under which expressive writing effects occur. In this pilot study, we sought to investigate whether diet quality and dietary fibre intake moderate the effects of positive writing on mood.

METHODS

The participants (12 males, 25 females, Mage = 33.0, SDage = 13.1) completed self-reported measures of dietary quality, dietary fibre intake, and positive and negative affect. They were then randomly allocated to complete either a positive expressive writing or neutral writing activity for 10 min. Positive and negative affect were measured again immediately after each activity.

RESULTS

Those participants who reported better diet quality and greater dietary fibre intake exhibited a significantly greater increase in positive affect following positive expressive writing relative to neutral writing. No significant effects were observed for negative affect.

CONCLUSIONS

For the first time, we report that the effects of positive expressive writing on positive mood are enhanced under optimal dietary conditions. Further replication studies are needed to determine whether dietary factors can influence the conditions under which positive expressive writing benefits occur. We speculate that dietary influences on the gut-brain axis are a potential mechanism.

Fruit for thought

OBJECTIVE

This commentary discusses the New Zealand Labour Party's announcement to remove tax on fresh and frozen fruits and vegetables. It aims to explore its potential impact on the psychological well-being of New Zealanders in the context of the growing global burden of mental illnesses in the current food environment.

CONCLUSIONS

The proposed tax exemption on fruits and vegetables demonstrates the government's commitment to improving the food environment. While the precise mental health effects of this potential tax change remain unstudied, existing evidence suggests a positive impact on New Zealanders' well-being, marking a pivotal step in addressing broader health issues and fostering a healthier, more equitable food landscape.

The association between junk foods consumption and attention deficit hyperactivity disorder in children and adolescents: a systematic review and meta-analysis of observational studies

The adverse effects of junk foods on the risk of attention deficit hyperactivity disorder (ADHD) symptoms were reported in several studies. In this meta-analysis, the association between junk food consumption and the risk of ADHD was investigated in children and adolescents. A comprehensive systematic search was conducted to find all relevant literature via four databases, including PubMed, Web of Science, Scopus, and Google scholar, up to September 2022. Two independent authors screened all documents based on inclusion criteria. The overall effect sizes and related 95% confidence interval (CI) were pooled with the random effect approach. Subgroup analysis was done to measure potential sources of heterogeneity between studies. The quality of the included studies was evaluated with The Newcastle-Ottawa scale (NOS). Nine observational studies with 58,296 children /adolescents were eligible to be include in the meta-analysis. According to the random effect model, there was a positive relation between the consumption of junk foods and ADHD symptoms (odds ratio (OR): 1.24, 95%CI 1.15-1.34, P < 0.001, I2: 37.4%, P = 0.085). A similar significant positive association was shown in the subgroups analysis by different junk foods (sweetened beverages/soft drinks, sweets/candies, and other types of junk foods). This meta-analysis finding demonstrated that consuming junk foods, especially sweetened beverages/soft drinks, and sweets/candies is associated with ADHD symptoms.

A systematic review of the effect of dietary and nutritional interventions on the behaviours and mental health of prisoners

Prisoners experience a higher burden of poor health, aggressive behaviours and worsening mental health than the general population. This systematic review aimed to identify research that used nutrition-based interventions in prisons, focusing on outcomes of mental health and behaviours. The systematic review was registered with Prospective Register of Systematic Reviews on 26 January 2022: CRD42022293370. Inclusion criteria comprised of current prisoners with no limit on time, location, age, sex or ethnicity. Only quantitative research in the English language was included. PubMed/Medline, Web of Science, EMBASE, PsycINFO and CINAHL were searched, retrieving 933 results, with 11 included for qualitative synthesis. Studies were checked for quality using the revised tool to assess risk of bias in randomised trials or risk of bias in non-randomised studies of interventions tool. Of the included studies, seven used nutritional supplements, three included diet changes, and one used education. Of the seven supplement-based studies, six included rule violations as an outcome, and only three demonstrated significant improvements. One study included mental health as an outcome; however, results did not reach significance. Of the three diet change studies, two investigated cognitive function as an outcome, with both reaching significance. Anxiety was included in one diet change study, which found a significant improvement through consuming oily fish. One study using diet education did not find a significant improvement in overall mental resilience. Overall, results are mixed, with the included studies presenting several limitations and heterogeneity. Future research should aim to consider increased homogeneity in research design, allowing for a higher quality of evidence to assess the role nutrition can play in improving the health of prisoners.

Adherence to the EAT-Lancet diet and incident depression and anxiety

High-quality diets have been increasingly acknowledged as a promising candidate to counter the growing prevalence of mental health disorders. This study aims to investigate the prospective associations of adhering to the EAT-Lancet reference diet with incident depression, anxiety and their co-occurrence in 180,446 UK Biobank participants. Degrees of adherence to the EAT-Lancet diet were translated into three different diet scores. Over 11.62 years of follow-up, participants in the highest adherence group of the Knuppel EAT-Lancet index showed lower risks of depression (hazard ratio: 0.806, 95% CI: 0.730-0.890), anxiety (0.818, 0.751-0.892) and their co-occurrence (0.756, 0.624-0.914), compared to the lowest adherence group. The corresponding hazard ratios (95% CIs) were 0.711 (0.627-0.806), 0.765 (0.687-0.852) and 0.659 (0.516-0.841) for the Stubbendorff EAT-Lancet index, and 0.844 (0.768-0.928), 0.825 (0.759-0.896) and 0.818 (0.682-0.981) for the Kesse-Guyot EAT-Lancet diet index. Our findings suggest that higher adherence to the EAT-Lancet diet is associated with lower risks of incident depression, anxiety and their co-occurrence.

The Relationship between Diet, Depression, and Alzheimer's Disease: A Narrative Review

PURPOSE OF REVIEW

This narrative review evaluates the role of diet in the relationship between depression and Alzheimer's disease (AD).

RECENT FINDINGS

AD and depression are often comorbid, and depression appears to independently increase the future risk of AD. Evidence suggests diet influences the risk of both conditions directly and indirectly. Diet impacts neurochemical and biological processes that may affect the development and progression of depression and cognitive dysfunction. The dietary components offering the greatest protection against depression and AD are yet to be determined. Current evidence highlights the importance of polyphenolic compounds, folate, B vitamins, and polyunsaturated fatty acids, along with adherence to dietary patterns like the Mediterranean diet, which includes multiple beneficial dietary factors.

SUMMARY

The investigation of dietary factors in the prevention of depression and AD is a comparatively young field of research. Comprehensive highly characterised longitudinal datasets and advanced analytical approaches are required to further examine the complex relationship between diet, depression, and AD. There is a critical need for more research in this area to develop effective preventive strategies aimed at maintaining mental and physical health with advancing age.

Food addiction and the physical and mental health status of adults with overweight and obesity

Background

Overweight and obesity now affect more than a third of the world's population. They are strongly associated with somatic diseases, in particular increasing the risk of many metabolic and cardiovascular diseases, but also with mental disorders. In particular, there is a strong association between obesity and depression. As a result, more attention is paid to the neurobiological, behavioural, and psychological mechanisms involved in eating. One of these is food addiction (FA). Research comparing lifestyle elements, physical and mental health problems of excess body weight and individuals with FA is limited and has focused on younger people, mainly students. There is also a lack of studies that relate actual metabolic parameters to FA. To better understand the problem of FA also in older adults, it is important to understand the specific relationships between these variables.

Methods

A cross-sectional survey was conducted with 172 adults with overweight and obesity (82% female) aged 23-85 years. The mean age of all subjects was M = 59.97 years (SD = 11.93), the mean BMI was M = 32.05 kg/m2 (SD = 4.84), and the mean body fat was M = 39.12% (SD = 6.48). The following questionnaires were used: Food Frequency Questionnaire-6 (FFQ-6), Global Physical Activity Questionnaire (GPAQ), Three Factor Eating Questionnaire-R18 (TFEQ-R18), Yale Food Addiction Scale 2. 0 (YFAS 2.0), Zung Self-Rating Depression Scale (SDS). Body composition, anthropometry, fasting glucose, lipid profile, and blood pressure were measured.

Results

A total of 22.7% of participants with overweight and obesity had symptoms of depression according to the SDS, and 18.6% met the criteria for FA according to YFAS 2.0. FA was statistically significantly more common among people up to 50 years. BMI, body fat mass, diastolic blood pressure and sedentary behaviour were statistically significantly higher in people with FA symptoms. Those who were sedentary for 301-450 min per day were significantly more likely to have depressive symptoms, and those who were sedentary for more than 450 min per day were significantly more likely to have FA symptoms.

Conclusions

Our findings complement the current literature on FA, particularly in older adults and metabolic parameters, and suggest further research directions. Although our cross-sectional study design does not allow causal interpretations, increasing physical activity appears to be particularly important in the management of people with overweight or obesity and FA. This may be even more important than for people with depression alone, but future research is needed to explore these relationships further.

What Are the Roots of the Nation's Poor Health and Widening Health Inequalities? Rethinking Economic Growth for a Fairer and Healthier Future

Health inequalities are differences in health between groups in society. Despite them being preventable they persist on a grand scale. At the beginning of 2024, the Institute of Health Equity revealed in their report titled: Health Inequalities, Lives Cut Short, that health inequalities caused 1 million early deaths in England over the past decade. While the number of studies on the prevalence of health inequalities in the UK has burgeoned, limited emphasis has been given to exploring the factors contributing to these (widening) health inequalities. In this commentary article I will describe how the Government's relentless pursuit of economic growth and their failure to implement the necessary regulatory policies to mitigate against the insecurity and health effects neoliberal free market capitalism (referred to as capitalism herein) causes in pursuit of innovation, productivity and growth (economic dynamism) is one key driver underpinning this social injustice. I contend that if the priority really is to tackle health inequalities and ensure health for all then there is an imperative need to move beyond regulation alone to mitigate the worst effects of capitalist production; the goal of the economy has to change to fully restore the balance between economic growth and public health.

Understanding the experiences of ketogenic metabolic therapy for people living with varying levels of depressive symptoms: a thematic analysis

Background

Evidence suggests that a ketogenic diet (KD) may help to alleviate psychiatric symptoms, including depression and anxiety. Positive changes have been reported such as improvements in cognition, concentration, and sleep, a reduction in hunger, and an increase in well-being, energy, confidence, and resilience. This research aims to understand the impact of a non-calorie-restricted KD on depression and aspects of psychological well-being in those with varying degrees of depressive symptoms. Though there are a few studies directly exploring the experiences of those following a KD, this will be the first study to explore the narrative from a mental health and psychological well-being viewpoint.

Method

A sample of nine participants who had followed a non-calorie restricted KD intervention of 50 g of carbohydrates or less per day for at least 12 weeks were recruited. Participants were split into 'healthy adults' group who had no to low depressive symptoms and 'depressive symptoms' group who had mild to moderate depressive symptoms. A reflexive thematic analysis was considered suitable for this study.

Findings

Five core themes and 24 subthemes were created. These were, (1) Poor health prior to program; (2) Hunger and cravings-the food and mood connection; (3) Psychological well-being improvements; (4) It becomes a lifestyle; and (5) Implementation difficulties. Participants experienced mental health improvements such as increased self-esteem, confidence, motivation, and achievement. Some experienced more control in life and a greater sense of reward. Those with depressive symptoms who initially reported low self-worth and hopelessness later reported increased self-esteem and renewed meaning and purpose in life. The findings from this study reflect the previous reports that the diet implementation can be difficult initially, but soon becomes easy to follow and turns into a lifestyle.

Conclusion

In the literature, there are very few qualitative studies that explore the accounts and lived experiences of those following a KD. From the participants' accounts in this study, it appears that the benefits and positive outcomes of this diet outweigh any negative side-effects experienced. This is encouraging for those who are looking for adjunctive therapies to address and improve their depressive symptoms and overall mental health.

Evaluation of the Consumption of Junk Food Products and Lifestyle among Teenagers and Young Population from Romania

BACKGROUND

The long-term consumption of junk food products can lead to nutritional and metabolic imbalances, especially when it is associated with a lack of physical activity and the consumption of alcohol or other high-calorie products.

METHODS

The evaluation of junk food consumption among teenagers and young people in Romania was carried out with the help of a cross-sectional study based on a questionnaire.

RESULTS

A total number of 1017 respondents participated in this study, comprising 470 males and 547 females aged between 16 and 25 years. Although the majority of young people fell into the normal-weight category (607 of them, p < 0.0001), some aspects can be noted that in the long term can produce a series of nutritional imbalances: an increased tendency toward sedentarism, with 553 (p = 0.613) of the respondents declaring that they performed sports rarely or not at all, and a tendency toward relatively high consumption of foods high in calories (fast food products and especially fried potatoes, hamburgers, shawarma, pastries, and snacks, along with sweetened drinks and even alcoholic beverages). The respondents participating in this study even indicated a perceived addiction to the consumption of certain products: coffee (50.48%), fried potatoes (38.9%), hamburgers (37.05%), shawarma (31.65%), and snacks (30.08%). Many of these products are rich in calories, saturated fat, and even trans fat.

CONCLUSIONS

This study highlights a series of aspects that can have long-term negative effects related to the excess weight associated with other imbalances: consumption preferences among young people for hypercaloric fast food products, sweetened drinks associated with reduced physical activity, and even the development of some forms of food addictions for a series of hypercaloric foods.

Impact of vegetarianism on cognition and neuropsychological status among urban community-dwelling adults in Telangana, South India: a cross-sectional study

PURPOSE

The potential benefits of vegetarian diets in reducing cognitive impairment have garnered attention due to existing mixed results; hence, our study aims to examine the impact of vegetarianism on cognitive function and neuropsychological status among urban community-dwelling adults from Telangana.

METHODS

The dietary patterns were self-reported and dietary data collected using a Food Frequency Questionnaire while cognitive function was assessed using Mini-Mental State Examination (MMSE) and depression, anxiety, and stress (DASS-21) questionnaire for psychological measures. Adults (N = 304) aged 40 years and above, who followed either a vegetarian or non-vegetarian diet for at least 6 months prior to data collection, scored MMSE ≥ 19 indicating mild cognitive impairment, and were recruited using convenience sampling.

RESULTS

Among the participants, vegetarians (n = 155) exhibited significantly better mood states compared to non-vegetarians (n = 149), as indicated by lower scores on the DASS subscales for depression (10.0 ± 0.06 vs. 17.0 ± 0.07, p =  < 0.001), anxiety (4.0 ± 0.05 vs. 6.0 ± 0.07, p = 0.005), and stress (8.0 ± 0.02 vs. 10.0 ± 0.05, p = 0.007). Vegetarians also demonstrated superior cognitive functioning compared to non-vegetarians, as indicated by higher MMSE scores (26.0 ± 0.04 vs. 24.0 ± 0.03, p =  < 0.001). MMSE scores were inversely correlated with depression, anxiety, and stress for vegetarians (ρ = - 0.371, p = 0.000; ρ = - 0.027, p = 0.734; and ρ = - 0.105, p = 0.914), respectively. Similar to the vegetarians group, MMSE scores were negatively correlated with depression (ρ = - 0.059), but the correlation is not significant.

CONCLUSION

Vegetarianism exerted a positive influence on the cognitive and neuropsychological status of the investigated population. Nevertheless, additional research is required to comprehend the underlying mechanisms that elucidate the long-term effects of vegetarianism and plant-based nutritional interventions on brain health.

The role of health demands, health resources, and adaptability in psychological strain and life satisfaction

The present study harnessed job demands-resources theory to identify key predictors of psychological strain (feeling overwhelmed by one's problems) and life satisfaction among a sample of 1060 adults randomly selected from the Australian electoral roll. The investigation sought to ascertain: (a) the relative contribution of health demands (e.g., inadequate health treatment) and health resources (e.g., access to helpful health-related information) in predicting psychological strain and life satisfaction, (b) the extent to which a recently proposed personal resource-adaptability-explained variance in wellbeing beyond individuals' health demands and resources, and (c) the role of psychological strain in predicting life satisfaction in the context of these demands and resources. Applying structural equation modelling we found that contextual health demands predicted greater psychological strain, individual health resources and adaptability both predicted lower psychological strain and greater life satisfaction, and psychological strain predicted lower life satisfaction. Notably, the adverse effects of health demands reduced significantly when health resources and adaptability were entered into the modelling. Taken together, the findings offer support for a health demands-resources framework that may be applied to better support individuals to respond to the stressors in their lives and in turn boost their sense of subjective wellbeing.

Effects of Modified Ramadan Fasting on Mental Well-Being and Biomarkers in Healthy Adult Muslims - A Randomised Controlled Trial

BACKGROUND

Ramadan fasting has seen increased attention in research, often with inconsistent findings. This study aims to investigate whether dietary and lifestyle modifications during Ramadan can improve well-being and health in healthy adult Muslims.

METHOD

A randomised controlled trial with two parallel groups was conducted in an outpatient clinic of a university hospital in Essen, Germany, in 2016. Healthy adult Muslims (n = 114) aged 18-60 years were randomised to a modified fasting group; i.e., they received educational material prompting dietary and lifestyle modifications pre-Ramadan, and a control group who undertook Ramadan fasting as usual. Primary outcome was quality of life (WHO-5 Well-Being Index). Secondary outcomes included sleep quality, spirituality, and mindfulness (all self-report), body weight, body mass index, body fat, waist circumference, hip circumference, blood pressure, and heart rate, as well as blood serum biomarkers. Safety was examined via adverse events.

RESULTS

The modified fasting group reported significantly higher quality of life (WHO-5) compared to the control after Ramadan (MD 5.9; 95% CI, 0.02-11.8; p < 0.05). Group differences in favour of the modified fasting were also found for satisfaction with health (MD 5.9, 95% CI 0.19-11.67), ease of life (MD 4.1, 95% CI 0.38-7.80) and mindfulness (MD 7.6, 95% CI 2.68-12.52), reductions in weight (MD, - 0.9 kg; 95% CI - 1.39 to - 0.42), BMI (MD - 0.3 kg/m2, 95% CI - 0.50 to - 0.15), hip circumference (MD - 0.3 kg/m2, 95% CI - 0.50 to - 0.15), and diastolic blood pressure (MD - 2.8 mmHg, 95% CI - 5.15 to - 0.43). About 60% of participants reported adverse events, mostly headaches/migraines, dizziness/fatigue, common cold, and gastrointestinal symptoms, with no group differences. One serious non-related adverse event each occurred in both groups.

CONCLUSION

Pre-Ramadan dietary and lifestyle advice can lead to short-term improvements in mental and physical well-being of adult Muslims observing Ramadan. As such, this study demonstrates the potential benefits of culturally appropriate health interventions in a religious context.

TRIAL REGISTRATION

ClinicalTrials.gov (Identifier NCT02775175).

Potential strategies for supporting mental health and mitigating the risk of burnout among healthcare professionals: insights from the COVID-19 pandemic

Healthcare professionals (HCPs) experienced prolonged stressful conditions during the coronavirus disease 2019 pandemic, and the global situation (particularly in the United Kingdom) meant that they continue to sustain mental stress related to the subsequent cost-of-living and healthcare budgeting crises. The psychological toll on HCPs may lead to increased staff attrition, adversely impacting the quality of patient care and work security. To help mitigate this psychological impact, the current evidence is strongly supportive of healthcare providers consistently adopting programmes fostering improvement in coping and resilience, facilitating healthy lifestyle, and allocating some resources for therapeutic strategies (e.g. cognitive behavioural therapy-based strategies and other strategies specified to trauma-related issues) which can be delivered by trained professionals. We stress that some approaches are not a one-size-fits-all strategy, and we also highlight the need to encourage treatment-seeking among those who need it. These strategies are highly relevant to healthcare employers and policymakers to support all HCPs in settings marked by prolonged periods of stress. The investment in these strategies are expected not only to reduce staff attrition in the long-term, but are likely to add to the cost-effectiveness of overall healthcare budgetary allocation.

Dietary Phenolic Compounds-Wellbeing and Perspective Applications

Contemporary living is continuously leading to poor everyday choices resulting in the manifestation of various diseases. The benefits of plant-based nutrition are undeniable and research on the topic is rising. Modern man is now aware of the possibilities that plant nutrition can provide and is seeking ways to benefit from it. Dietary phenolic compounds are among the easily accessible beneficial substances that can exhibit antioxidant, anti-inflammatory, antitumor, antibacterial, antiviral, antifungal, antiparasitic, analgesic, anti-diabetic, anti-atherogenic, antiproliferative, as well as cardio-and neuroprotective activities. Several industries are exploring ways to incorporate biologically active substances in their produce. This review is concentrated on presenting current information about the dietary phenolic compounds and their contribution to maintaining good health. Additionally, this content will demonstrate the importance and prosperity of natural compounds for various fields, i.e., food industry, cosmetology, and biotechnology, among others.

A pro-inflammatory diet is associated with long-term depression and anxiety levels but not fatigue in people with multiple sclerosis

BACKGROUND

Multiple sclerosis is characterised by acute and chronic inflammation in the CNS. Diet may influence inflammation, and therefore MS outcomes.

OBJECTIVE

To determine whether the Dietary Inflammatory Index (DII®)) is associated with depression, anxiety, and fatigue in a prospective cohort of people with MS.

METHODS

People with a first clinical diagnosis of demyelination were followed over 10 years (n=223). DII and energy-adjusted DII (E-DIITM) scores were calculated from the dietary intake in the preceding 12 months measured by food frequency questionnaire. Depression and anxiety were assessed by the Hospital Anxiety and Depression Scale (HADS-A and HADS-D, respectively), and fatigue by the Fatigue Severity Scale.

RESULTS

A higher E-DII score was associated with higher levels of depression and anxiety five years later (e.g., highest vs lowest E-DII quartile, HADS-D score: β=2.23, 95%CI=0.98,3.48, p<0.001; HADS-A score: β=1.90, 95%CI=0.59,3.21, p<0.001). A cumulative E-DII score was associated with depression (p<0.01) and anxiety (p=0.05) at the 10-year review. No associations were seen for fatigue.

CONCLUSION

Our findings suggest that, in people with MS, a more pro-inflammatory diet may long-term adverse impact on depression and anxiety, but not fatigue.

Attitude towards healthy nutrition and mental toughness: a study of taekwondo athletes

Healthy nutrition is widely considered the cornerstone of optimal athletic performance, both physically and mentally. This study investigates the critical role of healthy nutrition in shaping the physical and mental performance of athletes, with a specific focus on taekwondo. This research aims to explore the potential relationship between taekwondo athletes' attitudes towards healthy nutrition and their mental toughness. The research group comprised 276 active and licensed taekwondo athletes who voluntarily participated in the study (Age M = 17.18 ± SD = 7.13, N = 125 women, N = 151 men). Ethical approval for the research was obtained prior to the commencement of the study. Data collection instruments included the Healthy Nutrition Attitude Scale, Mental Toughness Scale, and a personal information form. Confirmatory factor analysis was conducted to confirm the validity and reliability of the scales. Descriptive statistics, correlation analysis, and regression analysis were performed to explore the relationship between the variables within the research model. The correlation analysis identified two significant, positive, and moderate correlations: (1) between knowledge about nutrition and mental toughness (r = 0.626) and (2) between positive nutrition and mental toughness (r = 0.672). The regression analysis revealed that both knowledge about nutrition (β = 0.360) and positive nutrition (β = 0.461) significantly contribute to mental toughness. The findings suggest that as athletes' knowledge of nutrition expands and their attitudes towards healthy eating become more positive, their mental toughness also appears to improve. These results are both important and original, adding significant new insights to the existing research landscape.

Mind over Microbes: Investigating the Interplay between Lifestyle Factors, Gut Microbiota, and Brain Health

BACKGROUND

The gut microbiota (GM) of the human body comprises several species of microorganisms. This microorganism plays a significant role in the physiological and pathophysiological processes of various human diseases.

METHODS

The literature review includes studies that describe causative factors that influence GM. The GM is sensitive to various factors like circadian rhythms, environmental agents, physical activity, nutrition, and hygiene that together impact the functioning and composition of the gut microbiome. This affects the health of the host, including the psycho-neural aspects, due to the interconnectivity between the brain and the gut. Hence, this paper examines the relationship of GM with neurodegenerative disorders in the context of these aforesaid factors.

CONCLUSION

Future studies that identify the regulatory pathways associated with gut microbes can provide a causal link between brain degeneration and the gut at a molecular level. Together, this review could be helpful in designing preventive and treatment strategies aimed at GM, so that neurodegenerative diseases can be treated.

Development and Validation of a Food Frequency Questionnaire for Evaluating the Nutritional Status of Patients with Serious Mental Illnesses (DIETQ-SMI) in Bahrain

General food frequency questionnaires (FFQs) have not been tailored for or validated in individuals with psychiatric disorders. Given the unique eating behaviors of patients with serious mental illnesses (SMIs), custom-made tools are needed. Therefore, we developed and validated an FFQ customized to individuals with SMIs. A total of 150 adults with SMIs (schizophrenia, bipolar disorder, or major depression) were recruited from Bahrain. The participants completed the 50-item Dietary Intake Evaluation Questionnaire for Serious Mental Illness (DIETQ-SMI) FFQ and a 3-day food record (FR). The validity of the FFQ was assessed by comparing nutrient intake to FR intake using correlation and reliability statistics. The DIETQ-SMI demonstrated a good ranking validity compared to the FR based on correlation coefficients (rho 0.33 to 0.92) for energy and macro- and micronutrients. The FFQ had high internal consistency (McDonald's omega = 0.84; Cronbach's alpha = 0.91) and test-retest reliability (ICC > 0.90). The FFQ tended to estimate higher absolute intakes than the FR but adequately ranked the intakes. The FFQ value was correlated with the FR for all the items (p < 0.001). The DIETQ-SMI is a valid and reliable FFQ for ranking dietary intake in individuals with an SMI. It can help assess nutritional status and, subsequently, guide interventions in high-risk psychiatric populations.

Quantifying the relationship between gardening and health and well-being in the UK: a survey during the covid-19 pandemic

BACKGROUND

Rates of non-communicable diseases, including cardiovascular disease and type 2 diabetes, and mental health problems, such as anxiety and depression, are high and rising in the urbanising world. Gardening could improve both mental and physical health and help prevent a range of conditions by increasing fruit and vegetable (F&V) consumption, promoting physical activity, and reducing stress. However, good quality quantitative research in the area is scarce, and our understanding of the role of allotments and home gardens, and the effects of the level of engagement in gardening and involvement with food production has thus far been limited.

METHODS

We quantitatively assess the relationship between home and allotment gardening and various indicators and predictors of health and well-being using an online survey of gardeners (n = 203) and non-gardeners (n = 71) in the UK. The survey was composed of multiple validated questionnaires (including the Short Form Food Frequency Questionnaire (SFFFQ), the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS), the Physical Health Questionnaire (PHQ) and the Self-Rated Health question (SRH)) and self-defined questions relating to participants' involvement with gardening and food production, and relevant demographic and lifestyle factors. Data were analysed using a series of hierarchical logistic and multiple linear regression models adjusting for socio-demographic variables.

RESULTS

After adjusting for relevant socio-demographic factors, gardening related variables were associated with better self-rated health, higher mental well-being, increased F&V consumption. Higher F&V intake was in turn also associated with better self-rated health and decreased odds of obesity. Thus, gardening had a positive association with four different aspects of health and well-being, directly or indirectly via increased F&V consumption.

CONCLUSIONS

Our results suggest that gardening in UK allotments and domestic gardens may promote different aspects of health and well-being via multiple mechanisms. Improving access to growing space and promoting regular gardening could provide a range of benefits to public health. More research on how socio-economic factors influence the health and well-being benefits of gardening will help policymakers devise strategies to maximise these benefits.

Self-Perceived Nutritional Competency of Primary Healthcare Physicians in Qassim, Saudi Arabia

INTRODUCTION

Overnutrition plays a vital role in the development of a spectrum of non-communicable diseases. Diet-related disorders have a huge impact on personal health as well as the country's economy for the management of such disorders. The study aims to assess the primary healthcare physicians' nutrition competency, which will be beneficial for evaluating the current situation and future strategies, training, nutrition care, and disease prevention.

METHODOLOGY

Among 147 primary healthcare physicians by simple random sampling from four cities and two rural areas of Qassim, Saudi Arabia, from December 2022 to December 2023 using a validated (NUTCOMP) tool. Data were entered, cleaned, and analyzed with SPSS software version 21.0 (IBM Corp., Armonk, NY). Informed consent was obtained from all study participants. Chi-square and ANOVA tests were applied to draw the significant differences.

RESULTS

A total of 147 participants enrolled in this study, and the mean age and standard deviation (SD) of the study population were 34.38 ± 6.57. More than half of the physicians (n = 76, 51.7%) continued education on nutrition. Significant mean differences were observed between some and focused nutrition content received physicians versus no nutrition content received physicians concerning nutrition skill, communication, and nutrition attitude consecutively (P < 0.0001, P < 0.0001, and P < 0.0001). The mean nutrition knowledge, skill, communication, attitude score, and SD of PHCC physicians were 26.91 ± 5.42 (maximum 35), 31.19 ± 6.18 (maximum 40), 36.73 ± 7.48 (maximum 45), and 34.74 ± 6.23 (maximum 40), respectively.

CONCLUSIONS

Our study results show primary healthcare physicians perceive themselves to have good nutritional competency.