Changes in body weight, body composition and cardiovascular risk factors after long-term nutritional intervention in patients with severe mental illness: an observational study

Abstract

BackgroundCompared with the general population, individuals with severe mental illness (SMI) have increased prevalence rates of obesity and greater risk for cardiovascular disease. This study aimed to investigate the effects of a long term nutritional intervention on body weight, body fat and cardiovascular risk factors in a large number of patients with SMI.MethodsNine hundred and eighty-nine patients with a mean ± S.D age of 40 ± 11.7 yrs participated in a 9 mo nutritional intervention which provided personalised dietetic treatment and lifestyle counselling every two weeks. Patients had an average body mass index (BMI) of 34.3 ± 7.1 kg.m-2 and body weight (BW) of 94.9 ± 21.7 kg. Fasted blood samples were collected for the measurement of glucose, total cholesterol, triglycerides and HDL- cholesterol. All measurements were undertaken at baseline and at 3 mo, 6 mo and 9 mo of the nutritional intervention.ResultsFour hundred and twenty-three patients of 989 total patients' cases (42.8%) dropped out within the first 3 months. Two hundred eighty-five completed 6 months of the program and 145 completed the entire 9 month nutritional intervention. There were progressive statistically significant reductions in mean weight, fat mass, waist and BMI throughout the duration of monitoring (p < 0.001). The mean final weight loss was 9.7 kg and BMI decreased to 30.7 kg.m-2 (p < 0.001). The mean final fat mass loss was 8.0 kg and the mean final waist circumference reduction was 10.3 cm (p < 0.001) compared to baseline. Significant and continual reductions were observed in fasting plasma glucose, total cholesterol and triglycerides concentrations throughout the study (p < 0.001).ConclusionThe nutritional intervention produced significant reductions in body weight, body fat and improved the cardiometabolic profile in patients with SMI. These findings indicate the importance of weight-reducing nutritional intervention in decreasing the cardiovascular risk in patients with SMI.

Effectiveness of a community‐based nurse‐led lifestyle‐modification intervention for people with serious mental illness and metabolic syndrome

“…Another important finding was the decrease in fasting plasma triglycerides in the IG, which was significant when compared to the CG, and the increase in HDL cholesterol, which was less significant ( P = 0.046). This is in line with other trials in which nutritional interventions show statistically significant improvements in plasma triglyceride levels 6 to 9 months after the intervention and a less significant increase in HDL (Hassapidou et al ). Moreover, other lifestyle programmes that also include at least 20 min per week of physical activity reveal discrete changes in triglycerides and HDL levels, which could be related to weight and waist circumference loss (Forsberg et al ; Richards et al, ).…”

“…However, like in our study, these changes are not significant (Bruins et al ). Some studies link the decrease in blood glucose levels to the weight loss that occurs in participants after lifestyle interventions (Hassapidou et al ; Scheen & De Hert ). Our findings for blood pressure levels also coincide with other research.…”

Multiple risk-behavior profiles of smokers with serious mental illness and motivation for change.

“…Interventions that teach common skills for behavior change that can be easily applied across a variety of target behaviors (e.g., examining pros and cons of behavior; Noar, Chabot, & Zimmerman, 2008) may be particularly useful for facilitating behavior change in this population. Single behavior interventions have demonstrated success among persons with SMI (Faulkner, Cohn, & Remington, 2007; Hall et al, 2006; Hassapidou et al, 2011; McFall et al, 2010; Tsoi et al, 2010; Vancampfort et al, 2010). Psychiatric hospitalization provides an opportunity for reaching, engaging, and treating single risk behaviors, such as smoking (J.…”

“…Although extant single behavior interventions in SMI samples have been successful in reducing tobacco use (Hall et al, 2006; McFall et al, 2010; Tsoi et al, 2010), decreasing weight and body fat (Faulkner, Cohn, & Remington, 2007; Hassapidou et al, 2011), and promoting physical activity (Vancampfort et al, 2010), we are unaware of research examining the extent to which individuals with SMI are ready and able to address multiple risk behaviors for change.…”

Perspectives of a tailored lifestyle program for people with severe mental illness receiving housing support

“…[21][22][23] In the light of the fact that the psychiatric professionals have an already established interpersonal relationship with the person with SMI, they are in a key position to motivate, support, and organize lifestyle habits. 5,24,25 Although lifestyle interventions have shown to positively impact lifestyle habits among persons with SMI, [26][27][28][29] there is a need for more information about programs that are integrated in daily nursing care. The risk for lifestyle-related health problems among persons with SMI highlights the need for tailored lifestyle programs that include education in health and cognitive support.…”