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

Abstract

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

Depression, Anxiety, and Lifestyle Among Essential Workers: A Web Survey From Brazil and Spain During the COVID-19 Pandemic

“…The fast growing field of lifestyle psychiatry [ 37 ] has been providing evidence on how health behaviors (eg, diet, physical activity, smoking, and sleep) relate to the prevalence, incidence, and adverse outcomes of mental health disorders [ 38 - 40 ]. For instance, consistent results point to the beneficial effects of physical activity in preventing the onset of depression as well as improving its symptoms [ 40 ]. As many people around the world are under confinement due to the COVID-19 pandemic, changes in lifestyle behaviors have attracted more research interest [ 41 ].…”

Adiposity in Depression or Depression in Adiposity? the Role of Immune-Inflammatory-Microbial Overlap

“…Green same applies to other lifestyle factors -exercise and a regular routine appear to be associated with a harmonious bacterial ecosystem 74,75 . Results of research on prebiotics suggested a decreased fasting glucose, improved insulin sensitivity and lipid profile, reduced inflammation markers and modulation of neuroinflammation 76,77 .…”

Adiposity in Depression or Depression in Adiposity? The Role of Immune-Inflammatory-Microbial Overlap

“…The introduction of a healthy diet, as an intervention targeting the microbiota, is an established way of alleviating symptoms of metabolic disease [85] and is perceived as an adjunctive method in the treatment of depression [86]. Similarly, exercise and a regular routine appear to be associated with a harmonious bacterial ecosystem [87,88].…”