Effects of nutritional education on weight change and metabolic abnormalities among patients with schizophrenia in Japan: A randomized controlled trial

Sugawara, Norio; Sagae, Toyoaki; Yasui‐Furukori, Norio; Yamazaki, Manabu; Saito, Kazutaka; Mori, Takao; Sugai, Takuro; Suzuki, Yutaro; Ozeki, Yuji; Okamoto, Koichi; Someya, Toshiyuki

doi:10.1016/j.jpsychires.2017.12.002

Cited by 20 publications

(79 citation statements)

References 21 publications

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“…However, in many of the articles there was no information about the recommended exercise intensity. Participants were recruited mostly from outpatient or daily departments (17, 18, 21, 23–25, 30, 34, 36), but in almost half of the cases, the authors did not specify these data (19, 20, 26, 27, 29, 31, 32, 35, 36). Analyses of the long-term effects were conducted in four studies (21, 23, 27, 29).…”

Section: Resultsmentioning

confidence: 99%

Nonpharmacological Interventions for the Treatment of Cardiometabolic Risk Factors in People With Schizophrenia—A Systematic Review

et al. 2019

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Background: People suffering from schizophrenia are notably vulnerable to cardiometabolic risk factors (CMRF), such as obesity, high blood pressure, hyperglycemia and insulin resistance, high serum triglycerides, and low serum high-density lipoprotein (HDL), which are related to increased mortality and decreased quality of life. The increased risk of “metabolic syndrome” (MS) is related to low physical activity, an unhealthy diet, and side effects of antipsychotic drugs. Nonpharmacological interventions seem to be important in the prevention and therapy of MS. Aim: This paper provides an overview of published studies and a critical analysis of pilot programs involving nonpharmacological measures aimed at prevention and treatment of CMRF in patients with schizophrenia. Material and Method: We searched the PubMed, PsycARTICLES, and Cochrane Library databases to identify clinical trials. We included full-text studies that met the following criteria: age > 18 years, a diagnosis of schizophrenia or schizoaffective disorder, and monitored parameters associated with MS. Results: All 1,555 references were evaluated for inclusion in the review, and 20 met the inclusion criteria. Nonpharmacological interventions led to improvement in physical health and showed a promising potential for implementation in treatment programs dedicated to this particular group of patients. However, a critical analysis revealed limitations, which have implications for the direction of future research. Conclusions: Patients suffering from schizophrenia can benefit from nonpharmacological interventions aimed at counteracting CMRF, improving either metabolic parameters, cardiovascular fitness, or their health perception. Notwithstanding, to achieve long-term effects, future studies should comprise appropriate follow-up procedures.

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Section: Resultsmentioning

confidence: 99%

Nonpharmacological Interventions for the Treatment of Cardiometabolic Risk Factors in People With Schizophrenia—A Systematic Review

et al. 2019

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“…Switching antipsychotic medication to one with less potential to cause MetS or recommending nonpharmacological interventions such as nutrition education, exercise, and psychoeducation could improve metabolic abnormalities among patients with schizophrenia. [38][39][40] Therefore, a combination of prompt detection and appropriate treatment is needed for effective clinical screening for MetS. Although a higher mean age (late 50s) might limit the generalizability of our results, this study has several strengths.…”

Section: Discussionmentioning

confidence: 95%

<p>Predictive Utility of Body Mass Index for Metabolic Syndrome Among Patients with Schizophrenia in Japan</p>

Sugawara¹,

Yasui‐Furukori²,

Yamazaki³

et al. 2020

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Background: Reliable and easy screening for metabolic syndrome (MetS) is important for patients with schizophrenia. The aim of this study was to assess the predictive utility of body mass index (BMI) for MetS among patients with schizophrenia in Japan. Methods: In total, 8468 patients (4705 males, 3763 females) with schizophrenia or schizoaffective disorders based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV), or the International Classification of Diseases, tenth revision (ICD-10), were assessed for MetS using the criteria of the National Cholesterol Education Program Adult Treatment Panel III (ATP III-A). We applied a stratum-specific likelihood ratio (SSLR) analysis, which is independent of the prevalence of the target disease. Results: The mean (± standard deviation) age of these patients was 57.4 ± 13.5 years. The prevalence of MetS was 20.4%. Among males, the SSLRs predicting MetS were 0.03 (95% CI 0.02-0.06), 0.54 (95% CI 0.48-0.60), 2.77 (95% CI 2.44-3.14) and 8.75 (95% CI 7.40-10.36) for BMI <20 kg/m 2 , 20 kg/m 2 ≤ BMI < 25 kg/m 2 , 25 kg/m 2 ≤ BMI < 28 kg/ m 2 , and 28 kg/m 2 ≤BMI, respectively. For females, the SSLRs predicting MetS were 0.08 (95% CI 0.05-0.12), 0.73 (95% CI 0.66-0.82), 2.50 (95% CI 2.16-2.90) and 4.83 (95% CI 4.12-5.67) for the same BMI categories, respectively. Conclusion: The predictive utility of BMI is confirmed, and BMI has more predictive value in males than in females. Patients with a BMI of 28 kg/m 2 or greater had a significantly higher SSLR than those with a BMI less than 28 kg/m 2 .

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“…We should provide effective nutritional education on weight change and metabolic abnormalities, such as to encourage exercise, diet regulation, and related medical knowledge to help improve their lifestyle. For example, as a standard care, doctors could provide weight loss advice or an individual nutritional education group as a secondary prevention [ 17 ]. Finally, there was negative linear correlation between MAP and FBG levels and QOL scores.…”

Section: Discussionmentioning

confidence: 99%

“…It is considered a high-risk factor for diabetes, cardiovascular and cerebrovascular diseases, weight gain, and impaired glucose tolerance, all of which contribute to QOL declines in schizophrenics [ 1 ]. Metabolic diseases are more common in psychiatric patients due to disturbances of glucose and lipid metabolism related to antipsychotic drugs [ 16 ], inadequate individual nutrition education [ 17 ], and self-neglect [ 18 ]. Based on the above considerations, we aimed to investigate the relationship between the MetS and C/T ratio as the primary objective and MetS and QOL as the secondary.…”

Section: Introductionmentioning

confidence: 99%

The Relationship of Functional Status of Cortisol, Testosterone, and Parameters of Metabolic Syndrome in Male Schizophrenics

Han¹,

Liu

et al. 2020

BioMed Research International

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Background. The cross-sectional study is aimed at investigating the relationship between cortisol, testosterone, and metabolic characteristics among male schizophrenics. Methods. 174 patients were grouped based on their risk of metabolic syndrome (MetS) into the non-MetS, high-risk-MetS (HR-MetS), or MetS groups. Metabolic indices (body mass index (BMI), mean arterial pressure (MAP), cholesterol, triglyceride, and fasting blood glucose (FBG)) were associated with cortisol and testosterone levels using correlation analysis. Multiple linear regression analysis was used to associate the correlations between the WHO Quality of Life–BREF (WHOQOL–BREF) score and the five metabolic indices. Results. The WHOQOL–BREF score for the non-MetS group significantly differed from the scores of the HR-MetS and MetS groups. The triglyceride level was positively correlated with the cortisol level, while all five metabolic indices were negatively correlated with testosterone level. Stepwise regression analysis produced a model predicting WHOQOL–BREF scores with four variables including MAP, intelligence quotient (IQ), FBG, and age. The correlation analysis then showed that there was a weak linear correlation between the testosterone level and all five metabolic indices. Conclusions. Among the five metabolic indices, the risks of hypertension and hyperglycemia are correlated with the quality of life in male schizophrenics rather than those of obesity or hyperlipidemia.

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Effects of nutritional education on weight change and metabolic abnormalities among patients with schizophrenia in Japan: A randomized controlled trial

Cited by 20 publications

References 21 publications

Nonpharmacological Interventions for the Treatment of Cardiometabolic Risk Factors in People With Schizophrenia—A Systematic Review

Nonpharmacological Interventions for the Treatment of Cardiometabolic Risk Factors in People With Schizophrenia—A Systematic Review

<p>Predictive Utility of Body Mass Index for Metabolic Syndrome Among Patients with Schizophrenia in Japan</p>

The Relationship of Functional Status of Cortisol, Testosterone, and Parameters of Metabolic Syndrome in Male Schizophrenics

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