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Nutrition interventions in people with severe mental illness: Novel strategies for addressing physical health co-morbidity in a high-risk population

Published online by Cambridge University Press:  23 March 2020

S. Teasdale ,
P. Ward ,
K. Samaras ,
S. Rosenbaum ,
J. Curtis ,
O. Lederman ,
A. Watkins  and
B. Stubbs
S. Teasdale*
Affiliation:
South Eastern Sydney Local Health District, Mental Health, Bondi Junction, Australia
P. Ward
Affiliation:
University of New South Wales, Psychiatry, Sydney, Australia
K. Samaras
Affiliation:
Garvan Institute of Medical Research, Diabetes and Obesity Program, Darlinghurst, Australia
S. Rosenbaum
Affiliation:
University of New South Wales, Psychiatry, Sydney, Australia
J. Curtis
Affiliation:
South Eastern Sydney Local Health District, Mental Health, Bondi Junction, Australia
O. Lederman
Affiliation:
South Eastern Sydney Local Health District, Mental Health, Bondi Junction, Australia
A. Watkins
Affiliation:
South Eastern Sydney Local Health District, Mental Health, Bondi Junction, Australia
B. Stubbs
Affiliation:
Kings College, London, Psychosis Studies, London, United Kingdom
*
* Corresponding author.

Abstract

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Introduction

Nutrition interventions are critical for weight management and cardiometabolic risk reduction in people experiencing severe mental illness (SMI). As mental health teams evolve to incorporate nutrition interventions, evidence needs to guide clinical practice.

Aims

A systematic review and meta-analysis was performed to assess whether nutrition interventions improve:

  • – anthropometric and biochemical measures,

  • – nutritional intake of people experiencing SMI.

To evaluate the effectiveness of a dietician-led nutrition intervention, as part of a broader lifestyle intervention, in the early stages of antipsychotic prescription.

Method

An electronic database search was conducted to identify all trials with nutritional components. Included trials were pooled for meta-analysis. Meta-regression analyses were run on potential anthropometric moderators. Weekly individualised dietetic consultations plus group cooking classes were then offered to clients attending a Community Early Psychosis Programme, who had recently commenced antipsychotics for a 12-week period.

Results

From pooled trials, nutrition interventions resulted in significant weight loss (19 studies, g = –0.39, P < 0.001), reduced BMI (17 studies, g = –0.40, P < 0.001), decreased waist circumference (10 studies, g = –0.27, P < 0.001) and lower blood glucose levels (5 studies, g = –0.37, P = 0.02). Dietician-led interventions (g = –0.90) and trials focussing on preventing weight gain (g = –0.61) were the most effective. The 12-week nutrition intervention resulted in a 47% reduction in discretionary (junk) food intake (P < 0.001) and reductions in daily energy (–24%, P < 0.001) and sodium intakes (–26%, P < 0.001), while improving diet quality (P < 0.05).

Conclusion

Evidence supports the inclusion of nutrition interventions as part of standard care for preventing weight gain and metabolic deterioration among people with SMI.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
EV1335
Information
European Psychiatry , Volume 33 , Issue S1: Abstracts of the 24th European Congress of Psychiatry , March 2016 , pp. S620
Copyright
Copyright © European Psychiatric Association 2016
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