Such interventions include programmes based on a variety of approaches including provision of health education, and cognitive behavioural therapy (CBT), and may also include practical components such as participation in physical activity. Lifestyle interventions are one means of supporting changes to physical health by promoting improvements in weight, physical activity and diet. ![]() There is a need for evidence of effective interventions to address these health risks for people with a mental health condition. ![]() These conditions result from health risks such as overweight and obesity, poor nutrition and physical inactivity, which have been reported to have a higher prevalence among this group. People with mental health conditions experience a significant reduction in life expectancy, which has been largely attributed to elevated risk of chronic conditions such as cardiovascular disease and diabetes. It is estimated that 17% of the population will experience a mental health condition, encapsulating more commonly encountered conditions such as depression and anxiety, as well as less common potentially severe conditions such as schizophrenia and psychotic disorders. 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. Lifestyle interventions delivered to people with a mental health condition made statistically significant improvements to weight, BMI, waist circumference, vegetable serves and physical activity. 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. Studies reporting sedentary behaviour were not able to be meta-analysed. 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). 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). ![]() Resultsįifty-seven studies were included (49 SMI only), with 46 contributing to meta-analyses. Narrative synthesis using vote counting based on direction of effect was used where studies were not amenable to meta-analysis. Where possible, meta-analyses were conducted. Secondary outcome measures were body mass index (BMI), waist circumference, sedentary behaviour and mental health. Primary outcome measures were weight, physical activity and diet. Two reviewers independently completed study screening, data extraction and assessment of methodological quality. MethodsĮligible 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. 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. 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. Lifestyle interventions aim to reduce this risk by modifying health behaviours such as physical activity and diet. People with a mental health condition experience an elevated risk of chronic disease and greater prevalence of health and behaviours.
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