Health Behaviors, Knowledge, Life Satisfaction, and Wellbeing in People with Mental Illness across Four Countries and Comparisons with Normative Sample

Background: People with chronic mental illness have poorer physical health and higher mortality than the general population. We investigated lifestyle factors in people with mental illness across four countries and compared with a normative sample. Design and methods: Data were collected from N=672 people (Germany, n=375; Palestine, n=192; London, n=63; Australia, n=42) with substance abuse disorder (n=224), schizophrenia (n=158), mood disorders (n=227) and somatoform disorders (n=63). The General Health Behaviour Questionnaire measured behaviours and knowledge related to nutrition, physical activity, alcohol, smoking, sleep, life satisfaction and wellbeing. The normative sample were derived from a German population (N=1,019). Data were analysed using ANOVAs and t-tests. Results: The Palestine sample did not differ from the Western samples on reported life satisfaction and wellbeing. However they reported unhealthier diets, less physical activity, and lower knowledge about the impact of diet, physical activity, smoking and sleep on health than the Western samples. Comparing the Western and normative samples, people with mental illness reported lower intake of healthy foods/drinks, higher intake of unhealthy foods, higher exercise, higher alcohol consumption, smoked less cigarettes, had less sleep and reported more sleep problems. Their knowledge was lower for nutrition, physical activity, and smoking. All participants reported lower life satisfaction and wellbeing than the normative sample (P values <0.001). Conclusions: Education on health-related lifestyle factors present important targets for primary care, quality of

Describing socioeconomic gradients in children\u27s diets - does the socioeconomic indicators used matter?

Background:&nbsp;Children of low socioeconomic position (SEP) generally have poorer diets than children of high SEP.&nbsp;However there is no consensus on which SEP variable is most indicative of SEP differences in children&rsquo;s diets. This&nbsp;study investigated associations between diet and various SEP indicators among children aged 9&ndash;13 years.Method: Families (n = 625) were recruited from 27 Adelaide primary schools in 2010. Children completed&nbsp;semi-quantitative food frequency questionnaires providing intake scores for fruit, vegetables, non-core foods,&nbsp;sweetened drinks, and healthy and unhealthy eating behaviours. Parents reported demographic information by&nbsp;telephone interview. Differences in dietary intake scores were compared across parental education, income, occupation,&nbsp;employment status and home postcode.Results: Across most SEP indicators, lower SEP was associated with poorer dietary outcomes, including higher intake&nbsp;of non-core foods and sweetened drinks, and more unhealthy behaviours; and lower intake of fruit and vegetables,&nbsp;and fewer healthy behaviours. The number and type of significant SEP-diet associations differed across SEP indicators&nbsp;and dietary outcomes. Mother&rsquo;s education appeared most frequently as a predictor of children&rsquo;s dietary intake, and&nbsp;postcode was the least frequent predictor of children&rsquo;s dietary intake.Conclusion: Socioeconomic gradients in children&rsquo;s dietary intake varied according to the SEP indicator used,&nbsp;suggesting indicator-specific pathways of influence on children&rsquo;s dietary intake. Researchers should consider multiple&nbsp;indicators when defining SEP in relation to children&rsquo;s eating.</div

People with schizophrenia and depression have a low omega-3 index

Cardiovascular disease (CVD) is higher in people with mental illness and is associated with a 30 year higher mortality rate in this population. Erythrocyte docosahexaenoic acid (DHA) plus eicosapentaenoic acid (EPA) (omega-3 index)≤4% is a marker for increased mortality risk from CVD while \u3e8% is protective. Omega-3 polyunsaturated fatty acids are also important for brain function and may ameliorate symptoms of mental illness. We investigated the erythrocyte omega-3 index in people with mental illness. One hundred and thirty adults aged 18-65 years (32.6% male) with schizophrenia (n=14) and depression (n=116) provided blood samples and completed physiological assessments and questionnaires. Both populations had risk factors for metabolic syndrome and CVD. The average omega-3 index was 3.95% (SD=1.06), compared to an estimated 5% in the Australian population. These data indicate an unfavourable omega-3 profile in people with mental illness that could contribute to higher CVD risk

Healthy dietary indices and risk of depressive outcomes : a systematic review and meta-analysis of observational studies

With depression being the psychiatric disorder incurring the largest societal costs in developed countries, there is a need to gather evidence on the role of nutrition in depression, to help develop recommendations and guide future psychiatric health care. The aim of this systematic review was to synthesize the link between diet quality, measured using a range of predefined indices, and depressive outcomes. Medline, Embase and PsychInfo were searched up to 31st May 2018 for studies that examined adherence to a healthy diet in relation to depressive symptoms or clinical depression. Where possible, estimates were pooled using random effect meta-analysis with stratification by observational study design and dietary score. A total of 20 longitudinal and 21 cross-sectional studies were included. These studies utilized an array of dietary measures, including: different measures of adherence to the Mediterranean diet, the Healthy Eating Index (HEI) and Alternative HEI (AHEI), the Dietary Approaches to Stop Hypertension, and the Dietary Inflammatory Index. The most compelling evidence was found for the Mediterranean diet and incident depression, with a combined relative risk estimate of highest vs. lowest adherence category from four longitudinal studies of 0.67 (95% CI 0.55-0.82). A lower Dietary Inflammatory Index was also associated with lower depression incidence in four longitudinal studies (relative risk 0.76; 95% CI: 0.63-0.92). There were fewer longitudinal studies using other indices, but they and cross-sectional evidence also suggest an inverse association between healthy diet and depression (e.g., relative risk 0.65; 95% CI 0.50-0.84 for HEI/AHEI). To conclude, adhering to a healthy diet, in particular a traditional Mediterranean diet, or avoiding a pro-inflammatory diet appears to confer some protection against depression in observational studies. This provides a reasonable evidence base to assess the role of dietary interventions to prevent depression.Peer reviewe

Why Australian dietary recommendations on fat need to change

A recent editorial in the journal Open Heart suggests many of us have it all wrong when it comes to the balance of fats we eat. The authors urge a return to equal amounts of specific types of fats known as omega-6 and omega-3 polyunsaturated fatty acids in order to help combat global obesity. The paper reflects a recent wave of evidence supporting a revision of guidelines around dietary fat, including in Australia

Omega-3 and Omega-6 Polyunsaturated Fatty Acid Levels and Correlations with Symptoms in Children with Attention Deficit Hyperactivity Disorder, Autistic Spectrum Disorder and Typically Developing Controls.

BACKGROUND:There is evidence that children with Attention Deficit Hyperactivity Disorder (ADHD) and Autistic Spectrum Disorder (ASD) have lower omega-3 polyunsaturated fatty acid (n-3 PUFA) levels compared with controls and conflicting evidence regarding omega-6 (n-6) PUFA levels. OBJECTIVES:This study investigated whether erythrocyte n-3 PUFAs eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) were lower and n-6 PUFA arachidonic acid (AA) higher in children with ADHD, ASD and controls, and whether lower n-3 and higher n-6 PUFAs correlated with poorer scores on the Australian Twin Behaviour Rating Scale (ATBRS; ADHD symptoms) and Test of Variable Attention (TOVA) in children with ADHD, and Childhood Autism Rating Scale (CARS) in children with ASD. METHODS:Assessments and blood samples of 565 children aged 3-17 years with ADHD (n = 401), ASD (n = 85) or controls (n = 79) were analysed. One-way ANOVAs with Tukey's post-hoc analysis investigated differences in PUFA levels between groups and Pearson's correlations investigated correlations between PUFA levels and ATBRS, TOVA and CARS scores. RESULTS:Children with ADHD and ASD had lower DHA, EPA and AA, higher AA/EPA ratio and lower n-3/n-6 than controls (P<0.001 except AA between ADHD and controls: P = 0.047). Children with ASD had lower DHA, EPA and AA than children with ADHD (P<0.001 for all comparisons). ATBRS scores correlated negatively with EPA (r = -.294, P<0.001), DHA (r = -.424, P<0.001), n-3/n-6 (r = -.477, P<0.001) and positively with AA/EPA (r = .222, P <.01). TOVA scores correlated positively with DHA (r = .610, P<0.001), EPA (r = .418, P<0.001) AA (r = .199, P<0.001), and n-3/n-6 (r = .509, P<0.001) and negatively with AA/EPA (r = -.243, P<0.001). CARS scores correlated significantly with DHA (r = .328, P = 0.002), EPA (r = -.225, P = 0.038) and AA (r = .251, P = 0.021). CONCLUSIONS:Children with ADHD and ASD had low levels of EPA, DHA and AA and high ratio of n-6/n-3 PUFAs and these correlated significantly with symptoms. Future research should further investigate abnormal fatty acid metabolism in these disorders

Fish oil and impulsive aggressive behaviour

Letter to the Editor

A comparison of parental views of their pre-school children\u27s healthy versus unhealthy diets. A qualitative study

Abstract not availableJacqueline Peters, Natalie Parletta, John Lynch, Karen Campbel

Adult attention deficit disorder and aggressive behaviour: an exploration of relationships between Brown Attention-Deficit Disorder Scales and the Aggression Questionnaire

Aggressive and violent behaviour is often associated with a diagnosis of attention-deficit hyperactivity disorder (ADHD). This article investigates the relationship between adult attention deficit disorder (ADD) and aggressive cognitions. The Aggression Questionnaire and the Brown Attention-Deficit Disorder Scales were administered to two samples: a low-risk sample comprising university students (n = 60), and a high-risk sample of prison inmates (n = 117). The prevalence of probable ADD was found to be higher in the prison sample (33%), compared with the university sample (20%). There were moderate correlations \u3er = .5 (p \u3c .01) between total ADHD and Aggression Questionnaire scores in both groups. There were also moderate to strong correlations between subscales of both measures, including cognitive processes such as attention and memory and various forms of aggression, which were particularly apparent in the prison sample. The relationship between ADHD and aggressive behaviour suggests that the treatment of adult ADHD may aid in the management of aggressive behaviour