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Diet and Its Role in Preventing and Managing Health Disparities in People Living with Mental Illness

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: closed (30 September 2023) | Viewed by 23530

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Special Issue Editors

Dr. Annabel Müller-Stierlin

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Guest Editor

Department of Psychiatry and Psychotherapy II, Ulm University, 89070 Ulm, Germany
Interests: mental health; healthcare services research; community-based care; integrated care; nutrition

Dr. Scott B. Teasdale

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Guest Editor

School of Psychiatry, UNSW Sydney, Kensington 2033, Australia
Interests: mental health; cardiometabolic health; nutrition

Special Issue Information

Dear Colleagues,

Mental illness is rapidly becoming one of the largest global burdens. Current treatments do not always exert an optimal response, and adjunctive approaches, such as diet, are being explored to assist in the prevention and treatment of mental illness.

Furthermore, people living with mental illness have an unacceptably reduced life expectancy compared to the general population, mainly due to comorbid physical health conditions. Abdominal obesity, hypertriglyceridemia, metabolic syndrome, low high-density lipoprotein, diabetes, and hypertension occur at considerably higher rates than in their peers without mental illness. Low diet quality and disordered eating behaviors are contributing factors. In recent years, various pathomechanisms have been identified that explain how mental illness and somatic comorbidity can mutually exacerbate each other. Among other things, these include metabolic abnormalities, inflammatory responses, immunological processes, and altered gut microbiota.

Given the growing interest in nutritional psychiatry research, we invite authors to submit original articles, methods papers, or reviews that further our understanding of the role of dietary behavior and dietary interventions for mental health, as well as for the physical health of people with mental illness.

Potential topics include, but are not limited to:

Diet-related issues in people living with mental illness;
Impact of mental health state on dietary behavior;
Mechanisms by which diet influences mental health;
Innovations/interventions to address dietary behavior of people living with mental illness;
Methods to improve nutritional psychiatry research.

Dr. Annabel Müller-Stierlin
Dr. Scott B. Teasdale
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

dietary behavior
disordered eating
mental illness
mental health
nutritional psychiatry

Published Papers (7 papers)

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Research

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12 pages, 382 KiB

Open AccessArticle

The Association between Vegan, Vegetarian, and Omnivore Diet Quality and Depressive Symptoms in Adults: A Cross-Sectional Study

by Hayley Walsh, Megan Lee and Talitha Best

Int. J. Environ. Res. Public Health 2023, 20(4), 3258; https://doi.org/10.3390/ijerph20043258 - 13 Feb 2023

Cited by 4 | Viewed by 4419

Abstract

Dietary patterns and depressive symptoms are associated in cross-sectional and prospective-designed research. However, limited research has considered depression risk related to meat-based and plant-based dietary patterns. This study explores the association between diet quality and depressive symptoms across omnivore, vegan, and vegetarian dietary patterns. A cross-sectional online survey utilised the Dietary Screening Tool (DST) and the Centre for Epidemiological Studies of Depression Scale (CESD-20) to measure diet quality and depressive symptoms, respectively. A total of 496 participants identified as either omnivores (n = 129), vegetarians (n = 151), or vegans (n = 216). ANOVA with Bonferroni post hoc corrections indicates that dietary quality was significantly different between groups F(2, 493) = 23.61, p < 0.001 for omnivores and vegetarians and omnivores and vegans. Diet quality was highest in the vegan sample, followed by vegetarian and omnivore patterns. The results show a significant, moderately negative relationship between higher diet quality and lower depressive symptoms (r = −0.385, p < 0.001) across groups. Hierarchical regression showed that diet quality accounted for 13% of the variability in depressive symptoms for the omnivore sample, 6% for vegetarians, and 8% for vegans. This study suggests that diet quality in a meat-based or plant-based diet could be a modifiable lifestyle factor with the potential to reduce the risk of depressive symptoms. The study indicates a greater protective role of a high-quality plant-based diet and lower depressive symptoms. Further intervention research is needed to understand the bi-directional relationship between diet quality and depressive symptoms across dietary patterns. Full article

(This article belongs to the Special Issue Diet and Its Role in Preventing and Managing Health Disparities in People Living with Mental Illness)

12 pages, 471 KiB

Open AccessArticle

“Maybe it’s Not Just the Food?” A Food and Mood Focus Group Study

by Megan F. Lee, Douglas Angus, Hayley Walsh and Sally Sargeant

Int. J. Environ. Res. Public Health 2023, 20(3), 2011; https://doi.org/10.3390/ijerph20032011 - 21 Jan 2023

Cited by 5 | Viewed by 3912

Abstract

Epidemiological and intervention studies in nutritional psychiatry suggest that the risk of mood disorders is associated with what we eat. However, few studies use a person-centred approach to explore the food and mood relationship. In this qualitative study of 50 Australian participants, we explored individuals’ experiences with food and mood as revealed during focus group discussions. Using a thematic template analysis, we identified three themes in the food and mood relationship: (i) social context: familial and cultural influences of food and mood, (ii) social economics: time, finance, and food security, and (iii) food nostalgia: unlocking memories that impact mood. Participants suggested that nutrients, food components or food patterns may not be the only way that food impacts mood. Rather, they described the social context of who, with, and where food is eaten, and that time, finances, and access to healthy fresh foods and bittersweet memories of foods shared with loved ones all impacted their mood. Findings suggest that quantitative studies examining the links between diet and mood should look beyond nutritional factors and give increased attention to the cultural, social, economic, and identity aspects of diet. Full article

(This article belongs to the Special Issue Diet and Its Role in Preventing and Managing Health Disparities in People Living with Mental Illness)

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13 pages, 347 KiB

Open AccessArticle

“It’s about What You’ve Assigned to the Salad”: Focus Group Discussions on the Relationship between Food and Mood

by Megan F. Lee, Joanne F. Bradbury, Jacqui Yoxall and Sally Sargeant

Int. J. Environ. Res. Public Health 2023, 20(2), 1476; https://doi.org/10.3390/ijerph20021476 - 13 Jan 2023

Cited by 8 | Viewed by 2872

Abstract

Current observational and interventional studies in nutritional psychiatry suggest that healthy dietary patterns rich in fresh whole foods could protect against depressive symptoms, and that unhealthy dietary patterns high in ultra-processed and refined foods could contribute to depressive symptoms. However, no studies have explored detailed subjective accounts behind the food and mood relationship. This study aimed to uncover unknown factors in the human experience with food and mood. Using a phenomenological framework, this focus group study applied thematic template analysis to accounts of over 50 Australians aged between 18 and 72. Three themes were identified from the transcript of the focus groups: (i) reactive and proactive relationships with food, (ii) acknowledgement of individual diversity relating to eating and mental health, and (iii) improving mood by removing food restriction and eating intuitively. The data highlights the complexity of the relationship between food and mood that extends beyond biological mechanisms which could be used to extend current epidemiological and intervention studies in the field of dietary patterns and depression. Full article

(This article belongs to the Special Issue Diet and Its Role in Preventing and Managing Health Disparities in People Living with Mental Illness)

15 pages, 1001 KiB

Open AccessArticle

Exploration of Perceived Determinants of Disordered Eating Behaviors in People with Mental Illness—A Qualitative Study

by Annabel S. Mueller-Stierlin, Anna Peisser, Sebastian Cornet, Selina Jaeckle, Jutta Lehle, Sabrina Moerkl and Scott B. Teasdale

Int. J. Environ. Res. Public Health 2023, 20(1), 442; https://doi.org/10.3390/ijerph20010442 - 27 Dec 2022

Cited by 5 | Viewed by 2157

Abstract

Disordered eating behaviors are common in people with a serious mental illness (SMI) such as schizophrenia, bipolar disorder and major depressive disorder. This study employed qualitative exploration to understand the perceived determinants of eating behaviors, in particular those connected to disordered eating patterns, in people with SMI. In total, 28 semi-structured interviews were conducted in a consecutive sample of people with SMI under treatment in local mental health services in Australia (n = 12), Germany (n = 8) and Austria (n = 8) (mean age: 43.3 years, proportion of female participants: 61%, proportion of participants with ICD-10 F2 diagnosis: 57%, proportion of participants with ICD-10 F3 diagnosis: 64%). A thematic analysis approach, the framework method, was applied using MAXQDA 2020. Three main themes of determinants were derived: (i) impacts to daily functioning, (ii) disrupted physical hunger cues and (iii) emotional hunger. For impacts to daily functioning, the following themes emerged: lack of daily structure, time and drive, and difficulty planning ahead. For physical hunger, themes emerged for disrupted hunger and satiety cues, and mindless eating. All motives listed in the Palatable Eating Motives Scale (PEMS), i.e., coping, reward, social and conformity, have been reported by participants to be drivers for their emotional eating behavior. Subsequent reported behaviors were eating too much or too little, binge eating, night eating and food cravings. We conclude that interprofessional approaches should target daily functioning, disrupted physical hunger cues and emotional eating to reduce disordered eating behaviors in people with SMI. Full article

(This article belongs to the Special Issue Diet and Its Role in Preventing and Managing Health Disparities in People Living with Mental Illness)

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13 pages, 699 KiB

Open AccessArticle

Assessment of Nutritional Status and Risk of Malnutrition Using Adapted Standard Tools in Patients with Mental Illness and in Need of Intensive Psychiatric Treatment

by Ladina Risch, Florian Hotzy, Stefan Vetter, Sascha Hiller, Kathrin Wallimann, Erich Seifritz and Sonja Mötteli

Int. J. Environ. Res. Public Health 2023, 20(1), 109; https://doi.org/10.3390/ijerph20010109 - 22 Dec 2022

Cited by 3 | Viewed by 2644

Abstract

People with severe mental illness (SMI) are often in poor physical health, resulting in higher mortality and reduced life expectancy compared to the general population. Although eating habits are one of the main predictors of physical health, few studies assess the nutritional status and eating behavior of people with SMI. The aim of this study was to examine the nutritional status and risk of malnutrition in people with SMI who were in need of intensive psychiatric treatment. The cross-sectional study included 65 inpatients and 67 outpatients with psychotic or depressive disorders from the Psychiatric Hospital of the University of Zurich. Patients’ assessments at admission included anthropometric measurements, such as weight and height, and interview data including severity of symptoms and functioning (SCL-K-9, PHQ-D, CGI, m-GAF), personal and medical data, nutrition risk screening tools (adapted NRS, MNA-SF), and laboratory values. The results showed that 32% of the inpatients and 34% of the outpatients were at risk of malnutrition, which was associated with higher levels of psychiatric symptoms and lower levels of functioning. Regardless, the body mass index (BMI) was overweight in both groups (mean BMI_inpatients = 25.3, mean BMI_outpatients = 27.9). These results indicate that a substantial proportion of psychiatric patients seems to be at risk of malnutrition, despite most being overweight, and hence they might benefit from nutritional support during their psychiatric treatment. Moreover, nutritional risk screening tools specifically developed for the mental healthcare setting are needed. Full article

(This article belongs to the Special Issue Diet and Its Role in Preventing and Managing Health Disparities in People Living with Mental Illness)

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11 pages, 751 KiB

Open AccessArticle

Folate Status as a Nutritional Indicator among People with Substance Use Disorder; A Prospective Cohort Study in Norway

by Mitra Bemanian, Jørn Henrik Vold, Ranadip Chowdhury, Christer Frode Aas, Rolf Gjestad, Kjell Arne Johansson and Lars Thore Fadnes

Int. J. Environ. Res. Public Health 2022, 19(9), 5754; https://doi.org/10.3390/ijerph19095754 - 09 May 2022

Cited by 3 | Viewed by 2279

Abstract

Substance use disorder (SUD) is associated with poor nutrition. Vitamin B9, or folate, is an important micronutrient for health. The aim of this prospective longitudinal cohort study was to assess serum folate levels among people with SUD and to investigate the impact of factors related to substance use severity on folate status. Participants were recruited from outpatient clinics for opioid agonist therapy (OAT) and municipal health-care clinics for SUD in Western Norway. They were assessed annually, including blood sampling for determination of micronutrient status. Overall, 663 participants with a total of 2236 serum folate measurements were included. A linear mixed model was applied, and measures are presented as β-coefficients with 95% confidence interval (CI). Forty-eight percent (CI: 44–51) of the population had low serum folate levels (s-folate < 10 nmol/L), and 23% (CI: 20–26) were deficient (s-folate < 6.8 nmol/L) at baseline. Sixty percent (CI: 53–65) sustained their poor folate status in at least one subsequent assessment. Except for weekly use of cannabis (mean difference in serum folate [nmol/L]: −1.8, CI: −3.3, −0.25) and alcohol (1.9, CI: 0.15, 3.6), weekly use of no other substance class was associated with baseline differences in serum folate when compared to less frequent or no use. Injecting substances was associated with a reduction in serum folate over time (−1.2, CI: −2.3, −0.14), as was higher dosages of OAT medication (−1.1, CI: −2.2, −0.024). Our findings emphasize the need of addressing nutrition among people with severe SUD. Full article

(This article belongs to the Special Issue Diet and Its Role in Preventing and Managing Health Disparities in People Living with Mental Illness)

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Other

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22 pages, 1208 KiB

Open AccessSystematic Review

Emotional Eating Interventions for Adults Living with Overweight or Obesity: A Systematic Review and Meta-Analysis

by Jo Smith, Xiao Qi Ang, Emma L. Giles and Gemma Traviss-Turner

Int. J. Environ. Res. Public Health 2023, 20(3), 2722; https://doi.org/10.3390/ijerph20032722 - 03 Feb 2023

Cited by 6 | Viewed by 4341

Abstract

Background: Emotional eating (EE) may be defined as a tendency to eat in response to negative emotions and energy-dense and palatable foods, and is common amongst adults with overweight or obesity. There is limited evidence regarding the effectiveness of interventions that address EE. Objectives: To synthesize evidence on the effectiveness of EE interventions for weight loss and EE in adults living with overweight or obesity. Methods: This is a systematic review and meta-analysis. Adhering to the PRISMA guidance, a comprehensive electronic search was completed up to February 2022. Random effects meta-analysis was carried out to determine the percentage change in weight and EE scores. Results: Thirty-four studies were included. The combined effect size for percentage weight change was −1.08% (95% CI: −1.66 to −0.49, I² = 64.65%, n = 37), once adjusted for publication bias. Similarly, the combined effect size for percentage change in EE was −2.37%, (95% CI: −3.76 to −0.99, I² = 87.77%, n = 46). Cognitive Behavioural Therapy showed the most promise for reducing weight and improving EE. Conclusions: Interventions to address EE showed promise in reducing EE and promoted a small amount of weight loss in adults living with overweight or obesity. Full article

(This article belongs to the Special Issue Diet and Its Role in Preventing and Managing Health Disparities in People Living with Mental Illness)

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