title: 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: BACKGROUND
  Compared 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.
  
  
  METHODS
  Nine 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 x 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.
  
  
  RESULTS
  Four 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 x 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).
  
  
  CONCLUSIONS
  The 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.
authors.affiliation: Department of Nutrition and Dietetics, School of Food Technology and Nutrition, Technological Educational Institute of Thessaloniki, Thessaloniki, Greece. mnhas@nutr.teithe.gr
authors.forename: Maria
authors.initials: M
authors.lastname: Hassapidou
authors.forename: Konstantina
authors.initials: K
authors.lastname: Papadimitriou
authors.forename: Niki
authors.initials: N
authors.lastname: Athanasiadou
authors.forename: Valasia
authors.initials: V
authors.lastname: Tokmakidou
authors.forename: Ioannis
authors.initials: I
authors.lastname: Pagkalos
authors.forename: George
authors.initials: G
authors.lastname: Vlahavas
authors.forename: Fotini
authors.initials: F
authors.lastname: Tsofliou
mesh_terms: D000328:Adult; D001786:Blood Glucose; D001823:Body Composition; D001835:Body Weight; D004038:Diet, Reducing; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008019:Life Style; D008055:Lipids / Q000097:blood; D008297:Male; D001523:Mental Disorders / Q000097:blood / Q000150:complications*; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications / Q000628:therapy*; D012307:Risk Factors; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D001786:Blood Glucose; D008055:Lipids