ATMS Journal Summer 2023 (Public Version) | Page 14

due to the significant relationship between the gut and the central nervous system . 5 Probiotics are involved in the modulation of microbiota within the microbiota-gut-brain axis . 47 Probiotics are clinically indicated for use in several areas , including overall mental health , 45 depression , 49 , 94 , 95 anxiety , 94-96 mood , 94 stress , 49 , 97 post-partum depression and anxiety , 98 autism spectrum disorder , 95 obsessive-compulsive disorder , 95 memory , 95 , 97 sleep , 94 fatigue , 94 94 , 96

anger , aggression , 99 system inflammation and oxidative stress . 100 Probiotics mediate their anti-inflammatory effects via the modulation of proinflammatory cytokines and restoration of gut permeability . 47 A recent review found that when treated with prebiotics and probiotics , individuals with anxiety or depression could improve their mood and decrease the severity of their symptoms . This improvement was via multiple mechanisms , but largely through attenuating the inflammatory response and increasing serotonin availability . 5 Probiotics are involved in the intestinal synthesis and metabolism

49 , 99 of certain neurotransmitters ,

101 , 102

nutrients , hormones and vitamins . The intestinal system and the brain are intimately connected via the gut-brain axis . This axis involves bidirectional communication via neural , 102 , 103 endocrine and immune pathways . 99 , 102 The vagus nerve , the main pathway between the gastrointestinal and the brain , 49 interacts with the intestinal microbiota . 49

Water Water and hydration are very important . Hydration via regularly drinking water is essential for metabolism , 104 cellular homeostasis , 104 temperature regulation , 104 , 105 and circulatory function . 104 Water acts as a carrier for nutrients and waste products 105 and for substrate transport across membranes . 104 NHMRC guidelines for adequate water intake is 2.1 L / day for females and 2.6 L / day for males . 106

Lifestyle medicine

Lifestyle medicine addresses key health behaviours , especially the root

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causes . 107 , 108 The practice of lifestyle medicine requires skills and competency in addressing complex and multiple health risk behaviours in the management of chronic disease . 109 Lifestyle Medicine offers a potentially safe and low-cost option for enhancing the management of mental health . 11 Lifestyle Medicine provides a connection between public health promotion and clinical treatments , involving the application of environmental , behavioural , and psychological principles to enhance physical and mental wellbeing . 11 Lifestyle medicine is intended to be person focused , enabling and requiring its clients to be intimately involved in their health trajectory alongside their healthcare professionals . 110 In this section , the use of lifestyle medicines , such as exercise , meditation , music , social interaction , yoga , and sleep in the management of mental health and wellbeing will be discussed .

Exercise Physical activity and exercise are very important for overall health . 111 Exercise has been found to lessen depression 24 , 112 and anxiety , 24 improve emotional health 113 and cognition , 113 and decrease the risk of heart disease , 111 type 2 diabetes , 111 and the development of osteoporosis . 113 Physical activity in adolescents presents an opportunity to socialise , relieve stress , and build confidence . 24 Organised sports have been associated with decreased depression , increased self-esteem , and improved social abilities . 24

Movement helps to reduce depression due to the release of endorphins into the body during physical activity . 113 Aerobic exercise and training has been associated with better mental functioning , both cognitive and emotional . 113 Research has found positive effects of exercising on mental and physical health in older people . 4 Physical exercise promotes increased blood flow through the brain , which in turn provides nutrient supply and oxygen . 113 Physical exercise regulates the stimulation of the sympathetic nervous system and the reactivity of the HPA axis , promoting neurogenesis , and ensuring the correct level of neurotransmitters in the brain , including serotonin , dopamine , endorphins , and noradrenaline ( norepinephrine ). 113

Meditation Meditation has been found to promote wellbeing 114 and quality of life . 115 , 116 It has

40 , 116 , 117 also been found to reduce stress , anxiety , 40 , 116 depression , 40 , 115 , 116 , 118 negative mood states , 116 and post-traumatic stress disorder , 118 and improve cognition .

114,116,117,119

Additionally , meditation has been found to relieve pain , chronic pain , chronic pelvic pain , fibromyalgia , migraine , 116 and reduce heart rate variability . 120

Music Music has numerous health benefits 121 and has been found to benefit people with stress , 122 anxiety and depression . 122-124 Some of the associated health benefits of music include higher levels of wellbeing , 121 , 125 positive wellbeing , 125 cognitive function , 126

194 | vol29 | no4 | JATMS