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Effects of nutritional education on weight change and metabolic abnormalities among patients with schizophrenia in Japan: A randomized controlled trial.

Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira City, Tokyo, 187-8551, Japan; Department of Neuropsychiatry, Hirosaki University School of Medicine, 5 Zaifu-cho, Hirosaki City, Aomori, 036-8562, Japan; Japanese Society of Clinical Neuropsychopharmacology, 2 Sanbancho, Chiyoda-ku, Tokyo, 102-0075, Japan. Electronic address: nsuga3@yahoo.co.jp. Department of Health and Nutrition, Yamagata Prefectural Yonezawa University of Nutrition Sciences, 6-15-1 Torimachi, Yonezawa City, Yamagata, 992-0025, Japan; Japan Psychiatric Dietetic Association, 4-11-11 Komone, Itabashi-ku, Tokyo, 173-0037, Japan. Department of Neuropsychiatry, Hirosaki University School of Medicine, 5 Zaifu-cho, Hirosaki City, Aomori, 036-8562, Japan; Japanese Society of Clinical Neuropsychopharmacology, 2 Sanbancho, Chiyoda-ku, Tokyo, 102-0075, Japan. Japan Psychiatric Hospital Association, 3-15-14 Shibaura, Minato-ku, Tokyo, 108-8554, Japan. Japanese Society of Clinical Neuropsychopharmacology, 2 Sanbancho, Chiyoda-ku, Tokyo, 102-0075, Japan; Department of Psychiatry, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan. Japanese Society of Clinical Neuropsychopharmacology, 2 Sanbancho, Chiyoda-ku, Tokyo, 102-0075, Japan; Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan.

Journal of psychiatric research. 2018;:77-83
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Abstract

OBJECTIVE Patients with schizophrenia have a higher prevalence of metabolic syndrome (MetS) than the general population. Minimizing weight gain and metabolic abnormalities in a population with an already high prevalence of obesity is of clinical and social importance. This randomized controlled trial investigated the effect of monthly nutritional education on weight change and metabolic abnormalities among patients with schizophrenia in Japan. METHODS From July 2014 to December 2014, we recruited 265 obese patients who had a DSM-IV diagnosis of schizophrenia or schizoaffective disorder. Participants were randomly assigned to a standard care (A), doctor's weight loss advice (B), or an individual nutritional education group (C) for 12 months. The prevalence of MetS and body weight were measured at baseline and 12 months. RESULTS After the 12-month treatment, 189 patients were evaluated, and the prevalence of MetS based on the ATP III-A definition in groups A, B, and C was 68.9%, 67.2%, and 47.5%, respectively. Group C showed increased weight loss (3.2 ± 4.5 kg) over the 12-month study period, and the change in weight differed significantly from that of group A; additionally, 26.2% of the participants in group C lost 7% or more of their initial weight, compared with 8.2% of those in group A. CONCLUSION Individual nutrition education provided by a dietitian was highly successful in reducing obesity in patients with schizophrenia and could be the first choice to address both weight gain and metabolic abnormalities induced by antipsychotic medications.

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Publication Type : Randomized Controlled Trial

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