Dietary intervention may improve cardiometabolic health in schizophrenia

A nutritional program that focused on increased intake of prebiotics and probiotics improved cardiometabolic health in patients with schizophrenia spectrum disorders, according to a study published in BMC Psychiatry.

Evidence indicates that patients with psychiatric disorders, particularly long-term mental disorders, have higher rates of disability, morbidity and mortality — all of which can exacerbate the risk for cardiometabolic diseases such as metabolic syndrome, Alfonso Sevillano-Jiménez, of Reina Sofia University Hospital in Spain, and colleagues wrote. Lifestyle modifications are not a major focus of clinical practice in this patient population, but perhaps more emphasis should be placed on dietary interventions, including those that may modulate the gut microbiota, the researchers noted.

“In this regard, the use of ‘psychobiotics,’ a term that refers to the set of probiotic and/or prebiotic substances whose administration has health benefits for psychiatric patients, is noteworthy,” they wrote.

Using a randomized, double-blind, controlled trial, Sevillano-Jiménez and colleagues sought to evaluate the effects of a high-symbiotic diet on cardiometabolic health in 50 patients with schizophrenia spectrum disorders who were in confinement and under social restriction during the COVID-19 pandemic.

Advanced practice nurses developed nutritional education and intervention. Then, for 6 months, patients in the control group received conventional dietary counseling on an individual basis. In the intervention group, an individual nutritional education program with a high content of prebiotics and probiotics, such as dairy and fermented foods, green leafy vegetables, high-fiber fruit and whole grains, was established.

Forty-four patients — 21 in the control group and 23 in the intervention group — completed follow-up. In the intragroup analysis, results revealed significant improvement in all anthropometric variables in the intervention group after 6 months.

Additionally, in the intervention group, the researchers found a 27.4% reduction in the prevalence of risk factors for metabolic syndrome, including significant reductions in waist circumference, abdominal circumference, triglycerides and HDL cholesterol. The intervention group also experienced a reduction in diastolic blood pressure. Glycemic profiles worsened in both study groups, but this was less pronounced in the intervention group, according to the data.

These results, Sevillano-Jiménez and colleagues noted, suggest that increasing intake of prebiotics and probiotics is beneficial for cardiometabolic health in patients with schizophrenia spectrum disorders.

“Nursing plays a prominent role in achieving optimal health outcomes, being a cornerstone in the multi-modal approach and modulating lifestyles, through dietary-nutritional education,” they wrote, adding that further studies with larger sample sizes are necessary.