Efficacy of dietary interventions in individuals with substance use disorders for illicit substances or illicit use of pharmaceutical substances: A systematic review

Abstract

Background: Disordered eating habits, poor dietary intake and nutritional status, and altered body composition are highly prevalent among individuals with substance use disorders. This systematic review aimed to evaluate the efficacy of dietary interventions in adults with substance use disorders for illicit substances or illicit use of pharmaceutical substances.Methods: Eight scientific databases were searched using predetermined text word and subject heading (MeSH) searches for experimental studies published up to March 2020 that evaluated interventions aiming to improve dietary intake in adults with substance use disorders for illicit substances or illicit use of pharmaceutical substances, which included dietary intake outcomes.Results: Of 9299 articles identified, five studies were included. Three studies (60%) were conducted in outpatient/community clinic settings and two studies (40%) were conducted in inpatient/residential treatment centres. Dietary interventions ranged in duration from 5 weeks to 24 months. These included education and behaviour change advice for nutrition and other lifestyle behaviours (n = 3 studies), nutrition education and provision of healthy food choices within the residential treatment centre (n = 1 study), and polyunsaturated fatty acid supplementation (n = 1 study). Three studies (60%) reported small but significant change in one or more dietary outcome at post-intervention, including reductions in sweets, fast food or caffeine intake, as well as increases in fruit and vegetable intake. Conclusions:This review has identified a small number of studies, despite the strong evidence that dietary intervention is needed in substance use rehabilitation. More research is needed to determine the most effective intervention approaches for this group, including robust study designs.

Effectiveness of dietary interventions in mental health treatment: A rapid review of reviews

“…Three systematic reviews with a total of 20 dietary intervention studies in individuals with substance use disorders were included. 26,83,84 Two reviews were published in 2020 83,84 and one in 2021, 26 and all included studies with adult populations. Figure 4 depicts the search dates of the reviews.…”

“…84 Whatnall et al focused on any nutrition intervention in adults with substance use disorders for illicit substances or illicit use of pharmaceutical substances. 26 All three reviews reported mental health outcomes for one or more included study, while only Whatnall et al and McLean et al reported dietary outcomes for one or more included studies. 26,84 The consistent conclusion across the three reviews was the lack of and/or limited range of dietary intervention studies, with Galduroz et al…”

“…26 All three reviews reported mental health outcomes for one or more included study, while only Whatnall et al and McLean et al reported dietary outcomes for one or more included studies. 26,84 The consistent conclusion across the three reviews was the lack of and/or limited range of dietary intervention studies, with Galduroz et al…”

“…[22][23][24][25] Review evidence also suggests the effectiveness of dietary intervention in substance use disorder treatment. 26 However, lifestyle intervention is not routinely integrated into mental health care. 20,27 Growing evidence demonstrates the effectiveness of lifestyle interventions, particularly exercise interventions, compared with or adjunct to psychopharmacology and psychotherapy for people with common mental illness including depression and anxiety, as well as severe mental illness and substance use disorders.…”

“…For example, the SMILES and HELFIMED trials of dietary interventions for adults with depression reported lower health sector and societal costs, and lower cost per quality adjusted life year gained respectively when compared with comparative social support interventions 22–25 . Review evidence also suggests the effectiveness of dietary intervention in substance use disorder treatment 26 . However, lifestyle intervention is not routinely integrated into mental health care 20,27 …”