S155. DIETARY PATTERNS AND OBESITY IN INDIVIDUALS WITH SCHIZOPHRENIA
Authors: Amirah Abdul Rashid Nur , Lee Jimmy 
Published: May 2020

Abstract

Background
It is well established that individuals with schizophrenia, compared to the general population, have reduced lifespan of up to 20–25 years. High mortality rates in schizophrenia is mainly attributed to physical illnesses which include cardiovascular diseases and diabetes. Obesity is a major risk factor for these diseases and is highly prevalent in the schizophrenia population. Although the mechanisms underlying weight gain in schizophrenia is unclear, it is generally accepted that the high obesity rate is a result of various factors which include metabolic effects of antipsychotic treatment, inadequate physical activity and unhealthy diets. This study aimed to (i) examine dietary practices of individuals with schizophrenia in comparison to the general population and (ii) to examine dietary practice correlates with Body Mass Index (BMI) classification of overweight/obese.

Methods
A sample of 107 community-dwelling individuals with schizophrenia were enrolled in this cross-sectional study. Height and weight were taken, and BMI was calculated. A 24-hour food recall which allows derivation of nutritional information, and the Dietary Practices Questionnaire (DPQ) which examines dietary habits, were administered based on participants’ usual diet. Dietary information was compared against the general Singapore population based on the National Nutrition Survey 2010 and the National Health Survey 2010. Logistic regression was performed to study the relationship between dietary practice and BMI status; the model was adjusted for age, gender, antipsychotic medication and energy intake.

Results
Nutritional information reported by participants showed that the total daily energy (1895.3kcal ± 684), macronutrient intake (protein: 68.6g ± 35, carbohydrate: 251.8g ± 104.8 and total fat: 67.5g ± 31.8) and dietary fibre intake (16.1g ± 9.0) was lower than both the recommended Singapore guidelines and intake of the general population. In terms of dietary habits, participants were often eating out and frequented fast food places as much as the general population, and do not usually skip breakfast. The proportion of participants who do not consume sweet desserts (32.7% vs 14.9%) and deep-fried food (21.5% vs 9.6%) were higher than the general population, however the proportion of individuals reporting no intake of sweetened drinks was higher in the latter (20.6% vs 54.6%). The proportion of overweight/obese participants (Male: 70%, Female: 66%) was about twice that of the general population (Male:46.6%, Female: 33.8%). Based on the dietary habits explored, participants who did not consume deep-fried food were less likely to be overweight/obese compared to those who do (OR: 0.3, 95% CI:0.09–0.82, p=0.02).

Discussion
Despite potential inaccuracies due to recall or social desirability bias, the results seem to suggest that individuals with schizophrenia were below the recommended energy intake; their nutritional intake and dietary habits were either similar or lower/poorer than the recommended guidelines or the general population. Consumption of deep-fried food was the only dietary habit identified as a potential factor towards overweight/obesity. Despite this, the rate of overweight/obese individuals with schizophrenia were high. As overweight/obesity is the result of imbalance between energy intake and expenditure, future research should explore other lifestyle factors such as physical activity, in addition to dietary practices.