Lifestyle medicine for anxiety symptoms: A meta-analysis of randomized controlled trials

Wong, Vincent Wing-Hei; Ho, Fiona Yan Yee; Shi, Nga-Kwan; Sarris, Jerome; Ng, Chee-Hong; Tam, Ophelia Kwan-Yee

doi:10.1016/j.jad.2022.04.151

Cited by 21 publications

(16 citation statements)

References 94 publications

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“…Multimodal lifestyle interventions (e.g., diet, exercise, and stress management) may be required rather than diet alone, to have a greater impact on anxiety outcomes. Although no studies to date have assessed whether multimodal lifestyle interventions are superior to diet alone for anxiety outcomes, evidence shows that lifestyle interventions do improve anxiety outcomes [ 60 , 75 , 76 ]. For instance, a meta-analysis of 4 RCTs assessing the effect of lifestyle interventions compared with a control group on anxiety levels among 148 females, reported a pooled estimate (SMD = −1.74; 95% CI: −2.62, −0.87, P < 0.001), which compared with our pooled result of −0.05, suggests there may be a superior effect of lifestyle compared with dietary-only interventions [ 59 ].…”

Section: Discussionmentioning

confidence: 99%

Diet Overall and Hypocaloric Diets Are Associated With Improvements in Depression but Not Anxiety in People With Metabolic Conditions: A Systematic Review and Meta-Analysis

Paris,

Daly,

Abbott

et al. 2024

Advances in Nutrition

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Section: Discussionmentioning

confidence: 99%

Diet Overall and Hypocaloric Diets Are Associated With Improvements in Depression but Not Anxiety in People With Metabolic Conditions: A Systematic Review and Meta-Analysis

Paris,

Daly,

Abbott

et al. 2024

Advances in Nutrition

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“…Considering the sound evidentiary support for the relationship between lifestyles and the onset and development of CMDs, there has been a growing interest in the lifestyle medicine (LM) approach as one of the potential options for managing CMD symptoms in clinical populations and promoting mental health in nonclinical populations ( 10–14 ). The LM approach is grounded in evidence-based principles and utilizes multicomponent LM interventions to mitigate the risk of mental and physical health with a lifestyle etiology ( 14–17 ). The intervention content encompasses a range of components, including lifestyle psychoeducation and fundamental pillars such as physical activity, diet and nutrition, sleep management, stress management, and motivational elements that encourage sustained participation and engagement ( 12 ).…”

Section: Introductionmentioning

confidence: 99%

Smartphone-delivered multicomponent lifestyle medicine intervention for improving mental health in a nonclinical population: a randomized controlled trial

Wong,

Tong,

Shi

et al. 2024

Front. Public Health

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ObjectiveTo prevent the exacerbation of mental health burdens, a growing body of research has recommended a balanced approach that emphasizes both the delivery of mental health treatments to individuals with common mental disorders (CMDs) and the strengthening of protective factors for CMDs among nonclinical populations. This randomized controlled trial (RCT) evaluated the efficacy of a smartphone-delivered multicomponent lifestyle medicine (LM) intervention, Lifestyle Hub, for improving mental health among a nonclinical population of Chinese adults.MethodsA total of 106 participants with Patient Health Questionnaire-9 total score < 10 and Generalized Anxiety Disorder 7-Item Scale <8 were randomly assigned to either the Lifestyle Hub intervention group (LH, n = 53) or the waitlist control group (WL, n = 53). Lifestyle Hub is an 8-week smartphone-delivered multicomponent LM intervention developed based on the transtheoretical model. The intervention components included lifestyle psychoeducation, physical activity, diet and nutrition, stress management, sleep management, and motivation and goal-setting techniques. Assessments were conducted at baseline, immediate post-intervention, and 1-month follow-up (LH only).ResultsThe linear mixed effect model based on the intention-to-treat principle indicated that Lifestyle Hub significantly improved overall mental health, depressive symptoms, anxiety symptoms, stress, insomnia severity, overall health-promoting behaviors, dietary quality, and stress management compared to the WL group at immediate post-intervention (d = 0.13–0.56). No significant between-group differences were observed in terms of functional impairment, health-related quality of life, health responsibility, physical activity level, spiritual growth, and interpersonal relations. The intervention gains in the LH group were maintained at 1-month follow-up. The LH participants indicated that Lifestyle Hub was an acceptable intervention for improving mental health, although a significantly higher level of study attrition was observed in the LH group (20.8%) relative to the WL group (5.7%).ConclusionLifestyle Hub may serve as an efficacious and acceptable intervention for improving mental health in nonclinical adult populations. To extend the benefits of LM interventions at the population level, future studies are warranted to examine a stepped-care approach to delivering LM interventions.Trial registration: This randomized controlled trial was pre-registered with ClinicalTrials.gov (NCT04295369).

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“…Interestingly, our findings indicate that assessing both depressive symptoms and anxious symptoms, may be important for MDD treatment. Lifestyle based treatments have shown benefits in reducing these symptoms and promoting a better quality of life, suggesting that these therapies should be routinely offered as a complementary strategy to pharmacotherapy (Kim et al, 2021; Sarris et al, 2014; Wong et al, 2022).…”

Section: Discussionmentioning

confidence: 99%

Self-Reported Mood and Lifestyle-Related Physical Activity of Young Adults With Major Depressive Disorder

Tavares,

de Sousa,

Schuch

et al. 2024

Percept Mot Skills

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We investigated whether mood and lifestyle-related indicators of physical health are differentially expressed according to self-reported levels of depressive symptoms among young adults with a current episode of major depression. In a cross-sectional study, we recruited 94 young adults (females = 67, 71.3%; males = 27, 28.7%; aged 18–35 years) with a current episode of major depression. We assessed their mood with the Profile of Mood States (POMS), and Beck Anxiety Inventory-(BAI), sleep with the Pittsburgh Sleep Quality Index (PSQI), physical activity with the Simple Physical Activity Questionnaire (SIMPAQ), and their cardiorespiratory fitness. Participants’ depression levels were classified as follows using established cut-points: (a) Mild Depressive Symptoms (MIDS, BDI-II 14-19 points, n = 17), (b) Moderate Depressive Symptoms (MODS, BDI-II 20–28 points, n = 37) or (c) Severe Depressive Symptoms (SEDS, BDI-II 29–63 points, n = 40). As expected, we found that young adults with SEDS, when compared to those with MODS and MIDS, showed higher depressive mood on the POMS, and they exhibited greater anxiety symptoms, lower reported ‘vigor’ on physical activity measures, worse sleep quality as expressed by their global score sleep; daytime dysfunction; and sleep disturbance, and they showed lower cardiorespiratory fitness. Those with moderate depressive symptoms only differed from those with mild symptoms with respect to hostility, fatigue and mood disturbance. Although there was a gradient whereby worse mental and physical health indicators were more closely related to the SEDS depression categorization, while healthier indicators were associated with the MIDS category, some parameters were not different between the MDD severity groups, particularly when comparing MIDS and MODS. Clinicians treating patients with MDD should consider these factors when designing lifestyle-based interventions.

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Lifestyle medicine for anxiety symptoms: A meta-analysis of randomized controlled trials

Cited by 21 publications

References 94 publications

Diet Overall and Hypocaloric Diets Are Associated With Improvements in Depression but Not Anxiety in People With Metabolic Conditions: A Systematic Review and Meta-Analysis

Diet Overall and Hypocaloric Diets Are Associated With Improvements in Depression but Not Anxiety in People With Metabolic Conditions: A Systematic Review and Meta-Analysis

Smartphone-delivered multicomponent lifestyle medicine intervention for improving mental health in a nonclinical population: a randomized controlled trial

Self-Reported Mood and Lifestyle-Related Physical Activity of Young Adults With Major Depressive Disorder

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