The Effects of the Dietary Approaches to Stop Hypertension (DASH) Diet on Metabolic Syndrome in Hospitalized Schizophrenic Patients: A Randomized Controlled Trial.Nutrients. 2019;11. [PMID: 31817080 DOI: 10.3390/nu11122950]

Nutrition and schizophrenia: associations worthy of continued revaluation

BACKGROUND

Accumulating evidence have shown that diet and nutrition play significant roles in mental illness, such as depression, anxiety and bipolar disorder. However, comprehensive evaluation of the relationship between nutrition and schizophrenia is lacking.

OBJECTIVE

The present review aims to synthetic elaborate the associations between nutrition and schizophrenia. Relevant studies on dietary patterns, macronutrients, micronutrients were performed through a literature search to synthesize the extracted data.

SUMMARY

Dietary interventions may help prevent the occurrence of schizophrenia, or delay symptoms: Healthy diets like nutritious plant-based foods and high-quality protein, have been linked to reducing the risk or symptoms of schizophrenia. Moreover, diet high in saturated fat and sugar is linked to more serious outcomes of schizophrenia. Additionally, when N-acetylcysteine acts as an adjuvant therapy, the overall symptoms of schizophrenia are significantly reduced. Also nascent evidence showed mental disorders may be related to intestinal microbiota dysfunction. Our study offered important insights into the dietary habits of patients with schizophrenia and the potential impact of nutritional factors on the disease. We also emphasized the need for further research, particularly in the form of large randomized double-blind controlled trials, to better understand the effects of nutrients on schizophrenia symptoms in different populations and disease types.

Inflammatory index score in children: its relationship with neophobia, dietary quality and anthropometric measurements

The aim of this study was to examine the correlation between the Diet Inflammatory Index (DII) scores and dietary quality in children, which was measured by the Mediterranean Diet Quality Index (KIDMED), also neophobia scores and anthropometric measurements. This study was conducted in primary schools in Famagusta, Cyprus. A total of 300 children (150 girls, 150 boys) in the 3rd, 4th and 5th grade were included in the study. The frequency of food consumption was measured to calculate the DII scores. Moreover, neophobia and KIDMED scores were obtained. The KIDMED score is a popular tool that is mostly used as a practical scale to assess adherence to the Mediterranean diet among children. Additionally, anthropometric measurements (body weight, height, waist circumference, neck circumference) were collected. Finally, DII scores were compared with KIDMED scores, neophobia scores, and anthropometric measurements. Anthropometric measurements and body mass index (BMI) values were found to be significantly different (p < 0.05) based on the DII scores. Children with DII scores in the 1st quartile had significantly different anthropometric measurements compared to those who had scores in the 2nd, 3rd, and 4th quartiles (p < 0.05). The DII scores of normal-weight children were higher than those of obese children. A significant negative correlation was observed between KIDMED scores and DII scores of the children (p < 0.05). Furthermore, a significant positive correlation was observed between neophobia scores and DII scores (p < 0.05). Additionally, DII scores were correlated with dietary quality and anthropometric measurements (p < 0.05). The MD enhances the anti-inflammatory properties of the diet; it has clearly demonstrated positive effects on diet quality and anthropometric measurements. Furthermore, the MD is suggested to reduce the risk of chronic diseases as a result of improving DII scores at an early age.

Dietary assessment methods for measurement of oral intake in acute care and critically ill hospitalised patients: a scoping review

Quantification of oral intake within the hospital setting is required to guide nutrition care. Multiple dietary assessment methods are available, yet details regarding their application in the acute care setting are scarce. This scoping review, conducted in accordance with JBI methodology, describes dietary assessment methods used to measure oral intake in acute and critical care hospital patients. The search was run across four databases to identify primary research conducted in adult acute or critical care settings from 1st of January 2000-15th March 2023 which quantified oral diet with any dietary assessment method. In total, 155 articles were included, predominantly from the acute care setting (n = 153, 99%). Studies were mainly single-centre (n = 138, 88%) and of observational design (n = 135, 87%). Estimated plate waste (n = 59, 38%) and food records (n = 43, 28%) were the most frequent assessment methods with energy and protein the main nutrients quantified (n = 81, 52%). Validation was completed in 23 (15%) studies, with the majority of these using a reference method reliant on estimation (n = 17, 74%). A quarter of studies (n = 39) quantified completion (either as complete versus incomplete or degree of completeness) and four studies (2.5%) explored factors influencing completion. Findings indicate a lack of high-quality evidence to guide selection and application of existing dietary assessment methods to quantify oral intake with a particular absence of evidence in the critical care setting. Further validation of existing tools and identification of factors influencing completion is needed to guide the optimal approach to quantification of oral intake in both research and clinical contexts.

Identifying effective characteristics of behavioral weight management interventions for people with serious mental illness: A systematic review with a qualitative comparative analysis

People with serious mental illness (SMI) have identified barriers to engaging in behavioral weight management interventions (BWMIs). We assessed whether BWMIs that addressed these barriers were more effective. First, we systematically reviewed qualitative literature and used a thematic analysis to identify the characteristics of BWMIs that promote engagement for adults with SMI. Second, we systematically reviewed randomized controlled trials (RCTs) of BWMIs in adults with SMI. Data on the characteristics that promoted engagement and weight outcomes were extracted. We then used a crisp-set qualitative comparative analysis (CsQCA) to identify which characteristics were associated with weight loss. For the qualitative review, 20 studies in 515 people with SMI were analyzed and nine characteristics were reported to promote engagement in BWMIs. For the systematic review, 34 RCTs testing 36 interventions in 4305 participants were included. The active interventions resulted in more weight loss (mean = -4.37 to +1 kg at 6 weeks to 18 months follow-up) compared with controls (-1.64 to +3.08 kg). The CsQCA showed BWMIs that offered regular contact, tools to support enactment, and tailored materials were associated with effectiveness. As these are all supplementary strategies, it may be possible to augment BWMIs available for the general population to engage people with SMI.

Nutrition, nutritional deficiencies, and schizophrenia: An association worthy of constant reassessment

Schizophrenia is a mental health disorder that occurs worldwide, cutting across cultures, socioeconomic groups, and geographical barriers. Understanding the details of the neurochemical basis of schizophrenia, factors that contribute to it and possible measures for intervention are areas of ongoing research. However, what has become more evident is the fact that in targeting the neurochemical imbalances that may underlie schizophrenia, the type of response seen with currently available phamacotherapeutic agents does not provide all the answers that are needed. Therefore, the possible contribution of non-pharmacological approaches to schizophrenia management is worthy of consideration. In recent times, research is beginning to show nutrition may play a possibly significant role in schizophrenia, affecting its development, progression and management; however, while attempts had been made to examine this possible relationship from different angles, articles addressing it from a holistic point of view are not common. In this review, we examine existing scientific literature dealing with the possible relationship between nutrition and schizophrenia, with a view to elucidating the impact of diet, nutritional deficiencies and excesses on the aetiology, progression, management and outcome of schizophrenia. Secondly, the effect of nutritional supplements in prevention, as sole therapy, or adjuncts in schizophrenia management are examined.

Individual Diet Modification Reduces the Metabolic Syndrome in Patients Before Pharmacological Treatment

Modification of lifestyle, including healthy nutrition, is the primary approach for metabolic syndrome (MetS) therapy. The aim of this study was to estimate how individual nutrition intervention affects the reduction of MetS components. Subjects diagnosed with MetS were recruited in the Lomza Medical Centre. The study group consisted of 90 participants and was divided into one intervention group (individual nutrition education group (INEG)) and one control group (CG). The research was conducted over 3 months. The following measurements were obtained during the first visit and after completion of the 3 months intervention: body mass, waist circumference, body composition, blood pressure, fasting glucose, and blood lipids. Dietary assessments were performed before and post-intervention using 3-day 24-h dietary recalls. Dietary knowledge was evaluated with the KomPAN questionnaire. The total polyphenol content of the diet was calculated. Sociodemographic and lifestyle characteristics were collected from a self-reported questionnaire. The physical activity was assessed by the short version of the International Physical Activity Questionnaire (IPAQ). It was found that the individual nutrition education was an effective method to improve the knowledge, dietary habits, and physical activity of the study participants. The modification of the diet in terms of higher intake of polyphenols (flavonoids and anthocyanins), fiber, polyunsaturated fatty acids (PUFA), PUFA n-3, and lower intake of saturated fatty acids (SFA) had a significant impact on the improvement of some MetS risk factors (waist circumference, fasting glucose, and HDL-cholesterol).

Metabolic Syndrome and Dietary Habits in Hospitalized Patients with Schizophrenia: A Cross-Sectional Study

Background and Objectives: The true prevalence of metabolic syndrome (MetS) and the reason for it being higher in patients with schizophrenia when compared to general population have not yet been fully determined. Although being considered as one of the major causes, currently there are limited findings regarding differences in dietary patterns of schizophrenic patients with and without MetS. The present study aimed to determine the prevalence of MetS among hospitalized patients with schizophrenia, to investigate the differences in socio-demographic, clinical, and lifestyle characteristics between participants with and without MetS, with the special emphasis being put on their dietary habits, and to ascertain the correlation between dietary habits and MetS components. Materials and Methods: A cross-sectional study included 259 hospitalized patients with schizophrenia aged ≥ 18 years. All participants underwent basic anthropometric measurements, blood sampling and blood pressure assessment, and provided relevant socio-demographic and lifestyle information. The presence of MetS was determined according to the Joint Interim Statement definition and dietary habits were assessed using a non-quantitative food frequency questionnaire. Results: The overall prevalence of MetS was 47.9%. No socio-demographic or lifestyle differences were found between participants with and without MetS. A large number of participants (42.9%) reported consuming carbonated soft drinks on a daily basis. Daily frequency of fruit (11.6%) and vegetables intake (29.3%) was far below recommended. Dietary habits of participants with and without MetS did not significantly differ, while consumption frequencies of some of the studied food and beverage items and groups significantly correlated with certain MetS components (such as statistically significant positive correlation between cured meat products consumption frequency and waist circumference, as well as between red meat consumption frequency and systolic blood pressure). Conclusions: The concept of the present study did not allow us to distinguish to what extent the participants’ dietary habits were influenced by independent procurement of food products, nor has it allowed us to quantify the portion sizes of consumed food and beverage items and groups. Nevertheless, the findings indicate the need for early identification of individuals with high MetS risk and for the incorporation of nutritional support programs into hospital treatment of patients with schizophrenia.

Associations between adherence to MIND diet and metabolic syndrome and general and abdominal obesity: a cross-sectional study

BACKGROUND

There is a lack of studies examining the association between Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) and metabolic syndrome (MetS) and obesity. Thus, this study aimed to investigate the association of adherence to the MIND diet with MetS and general and abdominal obesity.

METHODS

This cross-sectional study was performed on 836 Iranian adults, 18-75 years old. A 167-item food frequency questionnaire (FFQ) was used to assess dietary intakes of participants. Anthropometric measurements, blood pressure, fasting blood glucose and lipid profile of each participant were recorded. The guidelines of the National Cholesterol Education Program Adult Treatment Panel III (ATP III) was used to define MetS.

RESULTS

Mean age of study participants was 47.7 ± 10.7 years. The prevalence of MetS was 36.1% and mean body mass index (BMI) and waist circumference (WC) was 27.7 ± 4.69 kg/m² and 92.0 ± 12.4 cm respectively. Those who were in the third tertile of the MIND diet score compared to the first tertile had 12% lower odds of having the MetS (ORs: 0.88; 95% CI 0.62-1.24) but the association was not significant (P = 0.77). There was a significant inverse association between the MIND diet score and odds of reduced high-density lipoprotein cholesterol (HDL-C) (ORs: 0.59; 95% CI 0.41-0.85; P = 0.008) and general obesity (ORs: 1.190.80-1.78; 95% CI 0.80-1.78; P = 0.02) in crude model and after controlling for confounders.

CONCLUSIONS

We found that the MIND diet score is inversely associated with odds of reduced HDL and general obesity in Iranian adults.