Impact of high prebiotic and probiotic dietary education in the SARS-CoV-2 era: improved cardio-metabolic profile in schizophrenia spectrum disorders

Abstract

Background The development of new aetiological premises, such as the microbiota-gut-brain axis theory, evidences the influence of dietary and nutritional patterns on mental health, affecting the patient's quality of life in terms of physical and cardiovascular health. The aim was to determine the impact of a nutritional programme focused on increasing the intake of prebiotic and probiotic food on cardio-metabolic status in individuals with schizophrenia spectrum disorders in the contextual setting of the SARS-CoV-2 era. Methods A randomised clinical trial (two-arm, double-blind, balanced-block, six-month intervention) was conducted in a group of 50 individuals diagnosed with schizophrenia spectrum disorder during the SARS-CoV-2 confinement period. The control group received conventional dietary counselling on an individual basis. In the intervention group, an individual nutritional education programme with a high content of prebiotics and probiotics (dairy and fermented foods, green leafy vegetables, high-fibre fruit, whole grains, etc.) was established. Data on cardiovascular status were collected at baseline, three and six months. In addition, anthropometric parameters were analysed monthly. Results Forty-four subjects completed follow-up and were analysed. Statistical differences (p < 0.05) were found in all anthropometric variables at baseline and six months of intervention. A 27.4% reduction in the prevalence of metabolic syndrome risk factors in all its components was evidenced, leading to a clinically significant improvement (decrease in cardiovascular risk) in the intervention group at six months. Conclusions The development of a nutritional programme focused on increasing the dietary content of prebiotics and probiotics effectively improves the cardio-metabolic profile in schizophrenia spectrum disorders. Therefore, nursing assumes an essential role in the effectiveness of dietary interventions through nutritional education and the promotion of healthy lifestyles. Likewise, nursing acquires a relevant role in interdisciplinary coordination in confinement contexts. Trial registration The study protocol complied with the Declaration of Helsinki for medical studies; the study received ethical approval from referral Research Ethics Committee in November 2019 (reg. no. 468) and retrospectively registered in clinicaltrials.gov (NCT04366401. First Submitted: 28th April 2020; First Registration: 25th June 2020).

An Update on Prebiotics and on Their Health Effects

“…In particular, the consumption of raw materials with prebiotics (green leafy vegetables, high-fiber fruit, whole grains) improved the general cardio-metabolic profile in patients with schizophrenia spectrum disorders [31], while inulin, resistant starch, resistant maltodextrin, and rice bran played an active role in reducing the markers of inflammation (plasma zonulin and stool calprotectin), positively affected gut microbiota composition with an increase in SCFA, had a clinical impact leading to reduced severity of motor and non-motor Parkinson's disease symptoms and improved gastrointestinal function [32].…”

Nutraceuticals in Psychiatric Disorders: A Systematic Review

“…Huang et al, in their two trials on patients receiving olanzapine therapy at the first psychotic episode, showed that administering probiotics (Bifidobacteri, Lactobacilli, Enterococci) improved the metabolic profile of the patient and that the concomitant administration of dietary fiber helps prevent the weight gain expected when administering antipsychotic therapies such as olanzapine [44]. The other three studies on the effect of probiotics [49,53,55] showed an improvement in PANSS score [49,53] and metabolic profile [49,53,55]. In addition to probiotics, some of these studies included the concomitant administration of vitamin D [49], selenium [53], and prebiotics [55].…”

“…The other three studies on the effect of probiotics [49,53,55] showed an improvement in PANSS score [49,53] and metabolic profile [49,53,55]. In addition to probiotics, some of these studies included the concomitant administration of vitamin D [49], selenium [53], and prebiotics [55].…”

Nutritional Impact and Eating Pattern Changes in Schizophrenic Spectrum Disorders after Health Education Program on Symbiotic Dietary Modulation Offered by Specialised Psychiatric Nursing–Two-Arm Randomised Clinical Trial

“…The reason for not including these data was that the main objective was to assess the intervention's efficacy in modifying this population's dietary patterns with such particular characteristics. However, readers interested in this type of information can consult a recent paper in which these results have been included [47].…”