Systematic review of lifestyle interventions to improve weight, physical activity and diet among people with a mental health condition.

Bradley, T; Campbell, E; Dray, J; Bartlem, K; Wye, P; Hanly, G; Gibson, L; Fehily, C; Bailey, J; Wynne, O; Colyvas, K; Bowman, J

Systematic review of lifestyle interventions to improve weight, physical activity and diet among people with a mental health condition.

Bradley, T Campbell, E Dray, J

Bartlem, K Wye, P Hanly, G Gibson, L Fehily, C Bailey, J Wynne, O Colyvas, K Bowman, J

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Publisher:: Springer Nature
Publication Type:: Journal Article
Citation:: Syst Rev, 2022, 11, (1), pp. 198
Issue Date:: 2022-09-09

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Field	Value	Language
dc.contributor.author	Bradley, T
dc.contributor.author	Campbell, E
dc.contributor.author	Dray, J https://orcid.org/0000-0003-4613-2634
dc.contributor.author	Bartlem, K
dc.contributor.author	Wye, P
dc.contributor.author	Hanly, G
dc.contributor.author	Gibson, L
dc.contributor.author	Fehily, C
dc.contributor.author	Bailey, J
dc.contributor.author	Wynne, O
dc.contributor.author	Colyvas, K
dc.contributor.author	Bowman, J
dc.date.accessioned	2024-04-24T09:32:37Z
dc.date.available	2022-09-01
dc.date.available	2024-04-24T09:32:37Z
dc.date.issued	2022-09-09
dc.identifier.citation	Syst Rev, 2022, 11, (1), pp. 198
dc.identifier.issn	2046-4053
dc.identifier.issn	2046-4053
dc.identifier.uri	http://hdl.handle.net/10453/178326
dc.description.abstract	BACKGROUND: People with a mental health condition experience an elevated risk of chronic disease and greater prevalence of health and behaviours. Lifestyle interventions aim to reduce this risk by modifying health behaviours such as physical activity and diet. Previous reviews exploring the efficacy of such interventions for this group have typically limited inclusion to individuals with severe mental illness (SMI), with a focus of impact on weight. This review assessed the efficacy of lifestyle interventions delivered in community or outpatient settings to people with any mental health condition, on weight, physical activity and diet. METHODS: Eligible studies were randomised or cluster-randomised controlled trials published between January 1999 and February 2019 aiming to improve weight, physical activity or diet, for people with any mental health condition. Two reviewers independently completed study screening, data extraction and assessment of methodological quality. Primary outcome measures were weight, physical activity and diet. Secondary outcome measures were body mass index (BMI), waist circumference, sedentary behaviour and mental health. Where possible, meta-analyses were conducted. Narrative synthesis using vote counting based on direction of effect was used where studies were not amenable to meta-analysis. RESULTS: Fifty-seven studies were included (49 SMI only), with 46 contributing to meta-analyses. Meta-analyses revealed significant (< 0.05) effect of interventions on mean weight loss (-1.42 kg), achieving 5% weight loss (OR 2.48), weight maintenance (-2.05 kg), physical activity (IPAQ MET minutes: 226.82) and daily vegetable serves (0.51), but not on fruit serves (0.01). Significant effects were also seen for secondary outcomes of BMI (-0.48 units) and waist circumference (-0.87cm), but not mental health (depression: SMD -0.03; anxiety: SMD -0.49; severity of psychological symptoms: SMD 0.72). Studies reporting sedentary behaviour were not able to be meta-analysed. Most trials had high risk of bias, quality of evidence for weight and physical activity were moderate, while quality of evidence for diet was low. CONCLUSION: Lifestyle interventions delivered to people with a mental health condition made statistically significant improvements to weight, BMI, waist circumference, vegetable serves and physical activity. Further high-quality trials with greater consistency in measurement and reporting of outcomes are needed to better understand the impact of lifestyle interventions on physical activity, diet, sedentary behaviour and mental health and to understand impact on subgroups. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019137197.
dc.format	Electronic
dc.language	eng
dc.publisher	Springer Nature
dc.relation.ispartof	Syst Rev
dc.relation.isbasedon	10.1186/s13643-022-02067-3
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	11 Medical and Health Sciences
dc.subject.classification	32 Biomedical and clinical sciences
dc.subject.classification	42 Health sciences
dc.subject.mesh	Diet
dc.subject.mesh	Exercise
dc.subject.mesh	Humans
dc.subject.mesh	Life Style
dc.subject.mesh	Mental Disorders
dc.subject.mesh	Weight Loss
dc.subject.mesh	Humans
dc.subject.mesh	Weight Loss
dc.subject.mesh	Exercise
dc.subject.mesh	Diet
dc.subject.mesh	Life Style
dc.subject.mesh	Mental Disorders
dc.subject.mesh	Diet
dc.subject.mesh	Exercise
dc.subject.mesh	Humans
dc.subject.mesh	Life Style
dc.subject.mesh	Mental Disorders
dc.subject.mesh	Weight Loss
dc.title	Systematic review of lifestyle interventions to improve weight, physical activity and diet among people with a mental health condition.
dc.type	Journal Article
utslib.citation.volume	11
utslib.location.activity	England
utslib.for	11 Medical and Health Sciences
pubs.organisational-group	University of Technology Sydney
pubs.organisational-group	University of Technology Sydney/Faculty of Health
utslib.copyright.status	open_access	*
dc.date.updated	2024-04-24T09:32:28Z
pubs.issue	1
pubs.publication-status	Published online
pubs.volume	11
utslib.citation.issue	1

Abstract:

BACKGROUND: People with a mental health condition experience an elevated risk of chronic disease and greater prevalence of health and behaviours. Lifestyle interventions aim to reduce this risk by modifying health behaviours such as physical activity and diet. Previous reviews exploring the efficacy of such interventions for this group have typically limited inclusion to individuals with severe mental illness (SMI), with a focus of impact on weight. This review assessed the efficacy of lifestyle interventions delivered in community or outpatient settings to people with any mental health condition, on weight, physical activity and diet. METHODS: Eligible studies were randomised or cluster-randomised controlled trials published between January 1999 and February 2019 aiming to improve weight, physical activity or diet, for people with any mental health condition. Two reviewers independently completed study screening, data extraction and assessment of methodological quality. Primary outcome measures were weight, physical activity and diet. Secondary outcome measures were body mass index (BMI), waist circumference, sedentary behaviour and mental health. Where possible, meta-analyses were conducted. Narrative synthesis using vote counting based on direction of effect was used where studies were not amenable to meta-analysis. RESULTS: Fifty-seven studies were included (49 SMI only), with 46 contributing to meta-analyses. Meta-analyses revealed significant (< 0.05) effect of interventions on mean weight loss (-1.42 kg), achieving 5% weight loss (OR 2.48), weight maintenance (-2.05 kg), physical activity (IPAQ MET minutes: 226.82) and daily vegetable serves (0.51), but not on fruit serves (0.01). Significant effects were also seen for secondary outcomes of BMI (-0.48 units) and waist circumference (-0.87cm), but not mental health (depression: SMD -0.03; anxiety: SMD -0.49; severity of psychological symptoms: SMD 0.72). Studies reporting sedentary behaviour were not able to be meta-analysed. Most trials had high risk of bias, quality of evidence for weight and physical activity were moderate, while quality of evidence for diet was low. CONCLUSION: Lifestyle interventions delivered to people with a mental health condition made statistically significant improvements to weight, BMI, waist circumference, vegetable serves and physical activity. Further high-quality trials with greater consistency in measurement and reporting of outcomes are needed to better understand the impact of lifestyle interventions on physical activity, diet, sedentary behaviour and mental health and to understand impact on subgroups. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019137197.

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http://hdl.handle.net/10453/178326