Examining Nutrition Knowledge, Skills, and Eating Behaviours in People with Severe Mental Illness: A Cross-Sectional Comparison among Psychiatric Inpatients, Outpatients, and Healthy Adults

Abstract

Compared to the general population, people with severe mental illness (SMI) have an increased risk of weight gain and metabolic syndrome, but also of malnutrition, in part due to unhealthy lifestyle behaviours. The aim of this cross-sectional study was to identify barriers to healthy eating, including nutrition knowledge and skills in people with SMI. For this purpose, we compared the means of anthropometric data such as body mass index, waist-to-hip ratio, and interview data on nutrition knowledge and skills, health-related variables, eating behaviours, personality, motivation, and attitudes in 65 inpatients and 67 outpatients of the Psychiatric Hospital of the University of Zurich and 64 healthy adults using ANOVA and chi-squared tests. The results showed that patients with SMI had worse nutritional status and lifestyle compared to the healthy controls, including disordered (e.g., night eating) and unhealthy (e.g., high intake of sugary foods) eating habits. However, levels of nutrition knowledge, cooking and food skills, and motivation to eat healthily were not significantly lower in the psychiatric patients than in the healthy adults and were not associated with weight change. Based on our findings, nutritional support for people with SMI is urgently needed and should include not only educational but also behavioural and long-term approaches.

Importance of good hosting: reviewing the bi-directionality of the microbiome-gut-brain-axis

“…In general, people with a severe psychiatric disorder have a poorer diet (higher calorie intake; more processed foods with higher salt and sugar content; less fruit, vegetables, and fiber) compared to the general population ( Firth et al, 2018 ; Teasdale et al, 2019 ). A recent study demonstrated that people with severe mental illness had disordered (night eating) and unhealthy (high intake of sugary foods) eating habits compared to healthy people, in spite of their knowledge of healthy nutrition and normal cooking skills ( Mötteli et al, 2023 ). However, these observations have not been limited to severe mental illnesses where, arguably, medication may play a role ( Tomizawa et al, 2021 ; Minichino et al, 2023 ).…”

Development and Validation of a Food Frequency Questionnaire for Evaluating the Nutritional Status of Patients with Serious Mental Illnesses (DIETQ-SMI) in Bahrain

“…This approach is important because the unique challenges faced by individuals with schizophrenia, bipolar affective disorder, and other related severe disorders are known to impact their dietary behaviors and nutritional status in unique ways [18,25,26]. As previously mentioned, specific psychiatric symptoms, specific medication side effects, cognitive deficits, substance abuse, including caffeine and nicotine (tobacco smoking), the neighborhood in which one lives, and social isolation can all influence food choices and nutrient intake [14,27,28].…”

Women with Schizophrenia Have Difficulty Maintaining Healthy Diets for Themselves and Their Children: A Narrative Review

“…A review of 822 studies of diet and psychosis in 2020 [10] found poor quality dietary patterns in individuals with psychosis, high intake of refined carbohydrates and total fat, and low intake of fibre, ω-3 and ω-6 fatty acids, vegetables, fruit, and important-to-health vitamins and minerals (vitamin B 12 and B 6 , folate, vitamin C, zinc, and selenium). On average, individuals with SMI also exhibit considerably less knowledge about nutrition than their healthy peers [11]. Because this suggests that routine checks on patients' food intake may need to become a routine component of psychiatric practice, I undertook a narrative review of the literature on (A) the causes of poor dietary habits in schizophrenia-related disorders, (B) the presence of special dietary needs, (C) the general health consequences of poor nutrition in this population, and (D) potential interventions that show promise in ameliorating the situation.…”