title: A nutrition intervention is effective in improving dietary components linked to cardiometabolic risk in youth with first-episode psychosis.
abstract: Severe mental illness is characterised by a 20-year mortality gap due to cardiometabolic disease. Poor diet in those with severe mental illness is an important and modifiable risk factor. The present study aimed to (i) examine baseline nutritional intake in youth with first-episode psychosis (FEP), (ii) evaluate the feasibility and acceptability of nutritional intervention early in FEP and (iii) to evaluate the effectiveness of early dietary intervention on key nutritional end points. Participants were recruited over a 12-month period from a community-based programme specifically targeting young people aged 15-25 years with newly diagnosed FEP. Individual dietetic consultations and practical group sessions were offered as part of a broader lifestyle programme. Dietary assessments were conducted before and at the end of the 12-week intervention. Participants exceeded recommended energy and Na intakes at baseline. Retention within the nutrition intervention was 67 %, consistent with other interventions offered to FEP clients. There was a 47 % reduction in discretionary food intake (-94 g/d, P<0·001) and reductions in daily energy (-24 %, P<0·001) and Na (-26 %, P<0·001) intakes. Diet quality significantly improved, and the mean change was 3·6 (95 % CI 0·2, 6·9, P<0·05), although this finding was not significant after Bonferroni's correction. Increased vegetable intake was the main factor contributing to improved diet quality. Nutrition intervention delivered shortly after initiation of antipsychotic medication is feasible, acceptable and effective in youth with FEP. Strategies to prevent weight gain and metabolic decline will contribute to prevent premature cardiometabolic disease in this vulnerable population.
authors.affiliation: 1Early Psychosis Programme,South Eastern Sydney Local Health District,Bondi Community Centre,Bondi Junction,NSW 2022,Australia.
authors.forename: Scott B
authors.initials: SB
authors.lastname: Teasdale
authors.affiliation: 2School of Psychiatry,University of New South Wales,NSW 2052,Australia.
authors.forename: Philip B
authors.initials: PB
authors.lastname: Ward
authors.affiliation: 1Early Psychosis Programme,South Eastern Sydney Local Health District,Bondi Community Centre,Bondi Junction,NSW 2022,Australia.
authors.forename: Simon
authors.initials: S
authors.lastname: Rosenbaum
authors.affiliation: 1Early Psychosis Programme,South Eastern Sydney Local Health District,Bondi Community Centre,Bondi Junction,NSW 2022,Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Watkins
authors.affiliation: 1Early Psychosis Programme,South Eastern Sydney Local Health District,Bondi Community Centre,Bondi Junction,NSW 2022,Australia.
authors.forename: Jackie
authors.initials: J
authors.lastname: Curtis
authors.affiliation: 1Early Psychosis Programme,South Eastern Sydney Local Health District,Bondi Community Centre,Bondi Junction,NSW 2022,Australia.
authors.forename: Megan
authors.initials: M
authors.lastname: Kalucy
authors.affiliation: 5Department of Endocrinology,St Vincent's Hospital,Darlinghurst,NSW 2010,Australia.
authors.forename: Katherine
authors.initials: K
authors.lastname: Samaras
mesh_terms: D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D004032:Diet / Q000592:standards*; D000072001:Diet, Healthy; D004435:Eating; D002149:Energy Intake; D005240:Feasibility Studies; D005247:Feeding Behavior; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008019:Life Style; D008297:Male; D009765:Obesity / Q000209:etiology / Q000517:prevention & control; D015397:Program Evaluation; D011618:Psychotic Disorders / Q000150:complications / Q000188:drug therapy; D012307:Risk Factors; D012964:Sodium / Q000008:administration & dosage; D016896:Treatment Outcome; D015430:Weight Gain; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D012964:Sodium
keywords: APM antipsychotic medication; Diet; Dietary and nutritional intervention; EPP Early Psychosis Program; FEP first-episode psychosis; First-episode psychosis; KBIM Keeping the Body in Mind; Nutrition; SMI severe mental illness; Schizophrenia