Severely Mentally Ill Face Significant Nutritional Challenges

April 28, 2017

By Reuters Staff

NEW YORK—People living with severe mental illness face a range of nutritional challenges that might contribute to their 20-year mortality gap compared with the general population, researchers from Australia report.

Preventable cardiometabolic disease contributes to this mortality gap, yet trials and guidelines for dietary interventions targeting physical health in severe mental illness have been scarce, according to Dr. Scott B. Teasdale from South Eastern Sydney Local Health District and the University of New South Wales and colleagues.

The team used a literature review to assess the dietary challenges experienced in severe mental illness and discussed potential strategies to improve mental and physical health.

Severe weight gain, insatiable hunger, alterations in taste and smell, cravings for processed sugary or high-fat foods and disordered eating behaviors - all associated with antipsychotic medications - contribute to adverse physical health, they note in the Journal of Human Nutrition and Dietetics, online April 17.

Besides careful management of medications, mindfulness-based interventions and enhancement of shopping and meal planning skills can play an important role in addressing many of these challenges, the researchers say. Factors directly and indirectly related to the mental illness - delusions, hallucinations, poor oral health, for example - can also affect food intake.

Dr. Teasdale and colleagues also note that high rates of overweight and obesity in people living with severe mental illness contribute to higher rates of metabolic syndrome, increasing the need for routine metabolic monitoring and appropriate lifestyle intervention and management strategies.

Research supports the use of dietary interventions, including individualized nutrition counseling, in people with severe mental illness, employing the same elements that promote positive cardiometabolic health in the general population.

Among the recommended strategies, the researchers suggest replacing less healthy eating options with a Mediterranean-style diet and encouraging individuals to move more and sit less.

"Dietitians need to work closely with mental health teams to maximize intervention effectiveness through additional motivation and reinforcement of messages and goals," the authors conclude.

Dr. Teasdale did not respond to a request for comments.


J Hum Nutr Diet 2017.

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