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Bussell K, Reeves G, Hager E, Zhu S, Correll CU, Riddle MA, Sikich L. Dietary Consumption Among Youth with Antipsychotic-Induced Weight Gain and Changes Following Healthy Lifestyle Education. J Child Adolesc Psychopharmacol 2021; 31:364-375. [PMID: 34143682 PMCID: PMC8233214 DOI: 10.1089/cap.2020.0173] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background: Youth treated with antipsychotic medications are high risk for weight gain, increased lipids/glucose, and development of metabolic syndrome. Little is known about the dietary intake/nutritional adequacy in this vulnerable population, and effect on weight gain. This secondary data analysis describes the baseline intake and changes in diet after receiving healthy lifestyle education/counseling over 6 months, in a sample of youth with antipsychotic-induced weight gain. Methods: The U.S. Department of Agriculture (USDA) Automated Multiple-Pass Method 24-hour dietary recall was administered to 117 youth at baseline, 3 months, and 6 months. Parent/child received personalized healthy lifestyle education sessions over 6 months. Baseline intake was compared with the USDA Recommended Daily Allowance using independent samples t-tests. Individual dietary covariates were examined for change over 6 months using longitudinal linear mixed modeling. Influence of each on body mass index (BMI) z-score change was tested in a pooled group analysis and then compared by treatment group. Results: Pooled analysis revealed baseline consumption high in carbohydrates, fat, protein, sugar, and refined grains, while low in fruit/vegetables, whole grains, fiber, and water. Change over 6 months demonstrated a statistically significant decrease in daily calories (p = 0.002), carbohydrates (p = 0.003), fat (p = 0.012), protein (p = 0.025), sugar (p = 0.008), refined grains (p = 0.008), total dairy (p = 0.049), and cheese (p = 0.027). Small increases in fruits/vegetables were not statistically significant, although the Healthy Eating Index subscores for total vegetables (p = 0.013) and dark green/orange vegetables (p = 0.034) were. No dietary covariates were predictors of change in BMI z-score. Nondietary predictors were parent weight/BMI and treatment group, with the metformin and switch groups experiencing significant decreases in BMI z-score. Conclusions: Further pediatric studies are necessary to assess the effects of antipsychotic medications on dietary intake, and test efficacy of healthy lifestyle interventions on change in nutrition. The relationship of nutrition to cardiometabolic health in this population must be further investigated. Clinical Trial Registration number: NCT02877823.
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Affiliation(s)
- Kristin Bussell
- Department of Family and Community Health, University of Maryland School of Nursing, Baltimore, Maryland, USA.,Department of Psychiatry and University of Maryland School of Medicine, Baltimore, Maryland, USA.,Address correspondence to: Kristin Bussell, PhD, Department of Family and Community Health, University of Maryland School of Nursing, 655 W. Lombard St., Baltimore, MD 21201, USA
| | - Gloria Reeves
- Department of Psychiatry and University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Erin Hager
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Shijun Zhu
- Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, Maryland, USA
| | - Christoph U. Correll
- Department of Psychiatry, Northwell Health, The Zucker Hillside Hospital, Glen Oaks, New York, USA.,Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA.,Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Mark A. Riddle
- Department of Psychiatry and Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Linmarie Sikich
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Chapel Hill, North Carolina, USA
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Brown T, O'Malley C, Blackshaw J, Coulton V, Tedstone A, Summerbell C, Ells LJ. Exploring the evidence base for Tier 3 specialist weight management interventions for children aged 2-18 years in the UK: a rapid systematic review. J Public Health (Oxf) 2018; 40:835-847. [PMID: 29228233 DOI: 10.1093/pubmed/fdx166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Indexed: 11/13/2022] Open
Abstract
Background The impact of specialist weight management services (Tier 3) for children with severe and complex obesity in the UK is unclear. This review aims to examine the impact of child Tier 3 services in the UK, exploring service characteristics and implications for practice. Methods Rapid systematic review of any study examining specialist weight management interventions in any UK setting including children (2-18 years) with a body mass index >99.6th centile or >98th centile with comorbidity. Results Twelve studies (five RCTs and seven uncontrolled) were included in a variety of settings. Study quality was moderate or low and mean baseline body mass index z-score ranged from 2.7 to 3.6 units. Study samples were small and children were predominantly older (10-14 years), female and white. Multidisciplinary team composition and eligibility criteria varied; dropout ranged from 5 to 43%. Improvements in zBMI over 1-24 months ranged from -0.13 to -0.41 units. Conclusions Specialist weight management interventions for children with severe obesity demonstrated a reduction in zBMI, across a variety of UK settings. Studies were heterogeneous in content and thus conclusions on service design cannot be drawn. There is a paucity of evidence for Tier 3 services for children, and further research is required.
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Affiliation(s)
- Tamara Brown
- School of Social Sciences, Durham University, Durham, UK.,FUSE, UKCRC Centre for Translational Research in Public Health, Newcastle University, Newcastle Upon Tyne, UK.,School of Health and Social Care, Teesside University, Middlesbrough, UK
| | - Claire O'Malley
- School of Social Sciences, Durham University, Durham, UK.,FUSE, UKCRC Centre for Translational Research in Public Health, Newcastle University, Newcastle Upon Tyne, UK.,School of Health and Social Care, Teesside University, Middlesbrough, UK
| | - Jamie Blackshaw
- Health and Wellbeing, Public Health England, 2nd Floor, Skipton House, 80 London Road, London, UK
| | - Vicki Coulton
- Health and Wellbeing, Public Health England, 2nd Floor, Skipton House, 80 London Road, London, UK
| | - Alison Tedstone
- Health and Wellbeing, Public Health England, 2nd Floor, Skipton House, 80 London Road, London, UK
| | - Carolyn Summerbell
- School of Social Sciences, Durham University, Durham, UK.,FUSE, UKCRC Centre for Translational Research in Public Health, Newcastle University, Newcastle Upon Tyne, UK
| | - Louisa J Ells
- FUSE, UKCRC Centre for Translational Research in Public Health, Newcastle University, Newcastle Upon Tyne, UK.,School of Health and Social Care, Teesside University, Middlesbrough, UK
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Salomon C, Bellamy J, Evans E, Reid R, Hsu M, Teasdale S, Trollor J. 'Get Healthy!' A physical activity and nutrition program for older adults with intellectual disability: pilot study protocol. Pilot Feasibility Stud 2018; 4:144. [PMID: 30151237 PMCID: PMC6109457 DOI: 10.1186/s40814-018-0333-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 08/12/2018] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Older adults with intellectual disability have high rates of lifestyle-related illness yet remain poorly engaged in physical activity and nutrition interventions. There is a need to clarify what types of healthy lifestyle interventions are feasible and effective to implement in this population and how outcome measures can best be tracked. This paper describes the pilot feasibility study protocol for implementing a 12-week physical activity and healthy eating program, 'Get Healthy!' with older adults with intellectual disability. METHODS The primary study aims are to assess the feasibility of implementing and monitoring the 'Get Healthy!' program with adults with mild to moderate intellectual disability, aged 40 years and over, and their carers. Secondary study aims are to assess the impact of the intervention across the following parametres: body mass index, waist circumference, cardiovascular fitness, physical activity (amount and intensity) and sedentary behaviours, resting blood pressure, functional strength/capacity, dietary intake (energy intake, food group consumption and diet quality), dietary and physical activity knowledge, and quality of life. Between 8 and 10 participants in total will be recruited into the 12-week program that will be run in metropolitan NSW, Australia. A combination of objective and subjective measures will be used to assess program feasibility and impact at set timepoints (baseline, mid and end-program). DISCUSSION Results from the feasibility pilot will be used to refine the study methodology and 'Get Healthy!' program content for future use in a sufficiently powered trial. Findings may be of interest to a broad range of disability and allied health workers engaged in supporting and monitoring healthy lifestyle change in adults with intellectual disability. TRIAL REGISTRATION ACTRN: ACTRN12618000349246. Registered March 8, 2018- Retrospectively registered, UTN: U1111-1209-3132.
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Affiliation(s)
- Carmela Salomon
- Department of Developmental Disability Neuropsychiatry, 34 Botany St, UNSW Sydney, Sydney, 2052 Australia
| | - Jessica Bellamy
- Department of Developmental Disability Neuropsychiatry, 34 Botany St, UNSW Sydney, Sydney, 2052 Australia
- Department of Exercise Physiology, School of Medical Sciences, Wallace Wurth Level 2, UNSW Sydney, Sydney, 2052 Australia
| | - Elizabeth Evans
- Department of Developmental Disability Neuropsychiatry, 34 Botany St, UNSW Sydney, Sydney, 2052 Australia
| | - Renae Reid
- Department of Developmental Disability Neuropsychiatry, 34 Botany St, UNSW Sydney, Sydney, 2052 Australia
| | - Michelle Hsu
- Department of Developmental Disability Neuropsychiatry, 34 Botany St, UNSW Sydney, Sydney, 2052 Australia
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, The University of Sydney, Sydney, 2006 Australia
| | - Scott Teasdale
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, 26 Llandaff Street, Bondi Junction, 2022 Australia
- School of Psychiatry, UNSW, Hospital Road, Randwick, 2013 Australia
| | - Julian Trollor
- Department of Developmental Disability Neuropsychiatry, 34 Botany St, UNSW Sydney, Sydney, 2052 Australia
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