Dr. Wolfgang Marx

I think it's not enough just to...

say, all right, well, this works in the confines of randomized controlled trial.

It's also about, well, how is this implemented in a sustainable and feasible way?

And so I think the first part of that is providing that individualized approach, meeting people where they are,

And this is, you know, in terms of food preferences, in terms of the social and sort of functional considerations, like, you know, with time restricted eating, if you're, you know, eating out or you preparing meals for kids and all the rest of it, it's,

might be somewhat hard to sustain that diet when you're working within a situation with family and friends and all the rest of it that aren't adhering to that same sort of time-restricted window.

So strategies for managing these sorts of things, food preferences, all the rest of it,

I think another important consideration at a higher level is around equity.

We know that people with mental disorders experience a substantially higher risk of food insecurity compared to the general public.

And so I think when we're recommending diets and dietary prescriptions,

We need to ensure that these diets, these food ingredients are accessible, are affordable, that they can be delivered in a way that's sustainable and within the consideration of food insecurity.

The other thing that researchers need to do more of is around that implementation and sort of real world trial design.

And this is something where we've moved into where instead of that sort of highly rigorous or highly refined, randomized, controlled trial,

We're moving to those more sort of real world trials where we look at how these trials, what is the effect of these studies of this dietary intervention within a population that has all sorts of comorbidities that may not fit that perfect clinical diagnosis delivered as part of primary care or secondary care.

within the medical system so we can get that better understanding of how does this actually implement into the real world setting.

And then I think the final area is around that training and mental health system integration.

We really need a skilled clinical workforce and system referral pathways and

dietitian and allied health support integrated within psychiatric care so that people with these mental disorders can receive that support and it's not just left up to them.

I absolutely agree with Ian's perspective, which is that a lot of the great scientific discoveries, not just within psychiatry, but in medicine in general, come from anecdotes, from chance discoveries and all the rest of it.

And so I really encourage researchers and clinicians to treat that with the respect and care that it deserves.