Department of Nutrition and Dietetics, School of Food Technology and Nutrition, Technological Educational Institute of Thessaloniki, Thessaloniki, Greece.
BMC Psychiatry. 2011 Feb 18;11:31. doi: 10.1186/1471-244X-11-31.
Compared with the general population, individuals with severe mental illness (SMI) have increased prevalence rates of obesity and greater risk for cardiovascular disease. This study aimed to investigate the effects of a long term nutritional intervention on body weight, body fat and cardiovascular risk factors in a large number of patients with SMI.
Nine hundred and eighty-nine patients with a mean ± S.D age of 40 ± 11.7 yrs participated in a 9 mo nutritional intervention which provided personalised dietetic treatment and lifestyle counselling every two weeks. Patients had an average body mass index (BMI) of 34.3 ± 7.1 kg x m(-2) and body weight (BW) of 94.9 ± 21.7 kg. Fasted blood samples were collected for the measurement of glucose, total cholesterol, triglycerides and HDL-cholesterol. All measurements were undertaken at baseline and at 3 mo, 6 mo and 9 mo of the nutritional intervention.
Four hundred and twenty-three patients of 989 total patients' cases (42.8%) dropped out within the first 3 months. Two hundred eighty-five completed 6 months of the program and 145 completed the entire 9 month nutritional intervention. There were progressive statistically significant reductions in mean weight, fat mass, waist and BMI throughout the duration of monitoring (p < 0.001). The mean final weight loss was 9.7 kg and BMI decreased to 30.7 kg x m(-2) (p < 0.001). The mean final fat mass loss was 8.0 kg and the mean final waist circumference reduction was 10.3 cm (p < 0.001) compared to baseline. Significant and continual reductions were observed in fasting plasma glucose, total cholesterol and triglycerides concentrations throughout the study (p < 0.001).
The nutritional intervention produced significant reductions in body weight, body fat and improved the cardiometabolic profile in patients with SMI. These findings indicate the importance of weight-reducing nutritional intervention in decreasing the cardiovascular risk in patients with SMI.
与一般人群相比，患有严重精神疾病（SMI）的个体肥胖患病率增加，患心血管疾病的风险更高。本研究旨在调查大量 SMI 患者长期营养干预对体重、体脂肪和心血管危险因素的影响。
989 名患者平均年龄 ± 标准差为 40 ± 11.7 岁，参加了 9 个月的营养干预，每两周提供个性化的饮食治疗和生活方式咨询。患者的平均体重指数（BMI）为 34.3 ± 7.1kg/m²，体重（BW）为 94.9 ± 21.7kg。采集空腹血样测量血糖、总胆固醇、甘油三酯和高密度脂蛋白胆固醇。所有测量均在营养干预的基线、3 个月、6 个月和 9 个月进行。
989 例患者中有 423 例（42.8%）在头 3 个月内退出。285 例完成了 6 个月的项目，145 例完成了整个 9 个月的营养干预。在整个监测过程中，平均体重、脂肪量、腰围和 BMI 均呈渐进性显著下降（p<0.001）。最终平均体重减轻 9.7kg，BMI 降至 30.7kg/m²（p<0.001）。最终平均脂肪量减少 8.0kg，最终平均腰围减少 10.3cm（p<0.001），与基线相比。整个研究过程中，空腹血浆葡萄糖、总胆固醇和甘油三酯浓度均显著持续降低（p<0.001）。
营养干预可显著降低 SMI 患者的体重、体脂肪，改善心血管代谢特征。这些发现表明，在 SMI 患者中，减轻体重的营养干预对于降低心血管风险非常重要。
