Abstract
BackgroundThe existing literature on weight management interventions targeting physical activity and healthy eating in mental health care appears to provide only limited evidence. The aim of the study was to examine the effectiveness of a 10-week health promotion intervention, followed by a 6-month follow-up period in individuals with mental disorders living in sheltered housing in the Flanders region (Belgium).MethodsThe study had a cluster preference randomized controlled design. Twenty-five sheltered housing organisations agreed to participate (16 in the intervention group, nine in the control group). In the intervention group, 225 individuals agreed to participate, while in the control group 99 individuals entered into the study. The main outcomes were changes in body weight, Body Mass Index, waist circumference and fat mass. Secondary outcomes consisted of changes in physical activity levels, eating habits, health-related quality of life and psychiatric symptom severity.ResultsA significant difference was found between the intervention group and the control group regarding body weight (−0.35 vs. +0.22 kg; p=0.04), Body Mass Index (−0.12 vs. +0.08 kg/m2; p=0.04), waist circumference (−0.29 vs. + 0.55 cm; p<0.01), and fat mass (−0.99 vs. −0.12%; p<0.01). The decrease in these outcomes in the intervention group disappeared during the follow up period, except for fat mass. Within the intervention group, a larger decrease in the primary outcomes was found in the participants who completed the intervention. No significant differences between the two groups in changes in the secondary outcomes were found, except for the pedometer-determined steps/day. In the intervention group, the mean number of daily steps increased, while it decreased in the control group.ConclusionsThe study demonstrated that small significant improvements in the primary outcomes are possible in individuals with mental disorders. Integration of health promotion activities targeting physical activity and healthy eating into daily care are, however, necessary to maintain the promising results.Trial registrationThis study is registered at ClinicalTrials.gov NCT 01336946
Highlights
The existing literature on weight management interventions targeting physical activity and healthy eating in mental health care appears to provide only limited evidence
Several studies have shown that individuals with mental disorders (MD) including schizophrenia, bipolar disorders, depression, and anxiety disorders are at a greater risk of being overweight (Body Mass Index 25–29.9 kg/m2) or obese (Body Mass Index ≥30 kg/m2) than the general population [1,2,3]
This paper describes the results of a health promotion intervention targeting physical activity (PA) and healthy eating in individuals with MD living in sheltered housing in the Flanders region (Belgium)
Summary
The existing literature on weight management interventions targeting physical activity and healthy eating in mental health care appears to provide only limited evidence. Beside the side effects of these drugs, the high prevalence of overweight and obesity in this population is associated with lower physical activity (PA) levels and more unhealthy eating habits. The former include less moderate or vigorous PA than the general population or PA guidelines [10,11,12], the latter include eating fresh fruit, vegetables, wholegrain bread and, milk products less frequently, eating more instant meals [13,14,15] and fat [16], and having less variety of food in the diet [17].
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