Nutrition interventions in people experiencing severe mental illness

People experiencing severe mental illness (SMI) have a reduced life expectancy of 15-years when compared to the general population, primarily driven by preventable cardiovascular disease and other cardiometabolic complications. There is a large body of literature describing poor physical health in people experiencing SMI, but the lifestyle factors contributing to this, and interventions to improve physical health in this vulnerable population, require further elucidation. Dietary intake is ranked second only to child and maternal malnutrition in Global Burden of Disease analyses for its impact on cardiovascular disease, diabetes and some cancers. With this in mind, dietary modification is seen as routine care in people in the general population diagnosed with these non-communicable diseases. The dietary intake in people experiencing SMI, particularly in the earlier stages of illness, where weight gain is most rapid, is not well described, despite psychotropic medications having significant impacts on appetite, taste preferences and eating behaviours. Traditionally, dietitians have not been core members of the mental health treatment workforce, however, with mental health services moving towards improving both physical and mental health, a role for dietitians might be justified. This body of work aims to, i) describe the dietary intake of people experiencing SMI, and ii) examine the role of nutrition interventions in improving the physical health of people with SMI, including what role dietitians might play. This thesis includes a narrative review of the published literature and five empirical studies performed as part of the doctoral studies - a systematic review and meta-analysis of dietary intake studies in SMI which found less healthy diets and higher energy intakes in people experiencing SMI; an analysis of unhealthy dietary intake early in the course of SMI; a systematic review and meta-analysis of nutrition interventions, showing that interventions delivered by dietitians in the early stages of illness are most effective at improving nutrition outcomes; an intervention study that abrogated antipsychotic-induced weight gain at 12 weeks, with two-year follow-up data presented on the same cohort. In summary, the investigations conducted as part of this dissertation demonstrate that nutrition interventions should be considered part of routine care in people experiencing SMI.

Grantor dc:publisher

UNSW, Sydney

Year dc:date

2018

Author dc:creator

• Teasdale, Scott

• Mental illness
• Nutrition
• Diet
• Psychosis
• Schizophrenia

Statement dc:rights

• open access
• CC BY-NC-ND 3.0
• free_to_read

Licence

• https://purl.org/coar/access_right/c_abf2
• https://creativecommons.org/licenses/by-nc-nd/3.0/au/

Language dc:language

EN

Identifier

https://doi.org/10.26190/unsworks/21117

OAI identifier oai:identifier

oai:unsworks.library.unsw.edu.au:1959.4/61597