TY - JOUR
T1 - Dietary Consumption among Youth with Antipsychotic-Induced Weight Gain and Changes following Healthy Lifestyle Education
AU - Bussell, Kristin
AU - Reeves, Gloria
AU - Hager, Erin
AU - Zhu, Shijun
AU - Correll, Christoph U.
AU - Riddle, Mark A.
AU - Sikich, Linmarie
N1 - Funding Information:
K.B., G.R., C.U.C., M.A.R., and L.S. all received grant funding from the NIMH and Betty Huse Foundation for the IMPACT study. K.B., G.R., E.H., S.Z., and M.A.R.: None. C.U.C. has been a con- sultant and/or advisor to or have received honoraria from: Acadia, Alkermes, Allergan, Angelini, Axsome, Gedeon Richter, Gerson Lehrman Group, Indivior, IntraCellular Therapies, Janssen/J&J, Karuna, LB Pharma, Lundbeck, MedAvante-ProPhase, MedInCell, Medscape, Merck, Mylan, Neurocrine, Noven, Otsuka, Pfizer, Recordati, Rovi, Servier, Sumitomo Dainippon, Sunovion, Super-nus, Takeda, and Teva. He provided expert testimony for Janssen and Otsuka. He served on a Data Safety Monitoring Board for Lundbeck, Rovi, Supernus, and Teva. He has received grant support from Janssen and Takeda. He is also a stock option holder of LB Pharma. L.S. is an unpaid consultant to Neuren Pharmaceuticals, an unpaid member of the publications and outreach committee for balovaptan studies for F. Hoffman-La Roche, Inc. A portion of her salary at Duke is paid for by contracts between Duke Clinical Research Institute and Akili Interactive and Tris Pharma related to pediatric clinical trials of their products. She has been a site study in licensing trials conducted by F. Hoffman-La Roche, Inc. and Curemark Pharmaceutical trials.
Funding Information:
1Department of Family and Community Health, University of Maryland School of Nursing, Baltimore, Maryland, USA. Departments of 2Psychiatry and 3Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA. 4Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, Maryland, USA. 5Department of Psychiatry, Northwell Health, The Zucker Hillside Hospital, Glen Oaks, New York, USA. 6Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA. 7Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany. 8Department of Psychiatry and Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. 9Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Chapel Hill, North Carolina, USA. iORCID ID (https://orcid.org/0000-0002-3128-0178). iiORCID ID (https://orcid.org/0000-0001-8070-673X). Funding: This study was supported by the National Institute of Mental Health Grant No. 1R01MH080270-01A2 and the Betty Huse Foundation.
Publisher Copyright:
© Copyright 2021, Mary Ann Liebert, Inc., publishers 2021.
PY - 2021/6
Y1 - 2021/6
N2 - Background: Youth treated with antipsychotic medications are high risk for weight gain, increased lipids/glucose, and development of metabolic syndrome. Little is known about the dietary intake/nutritional adequacy in this vulnerable population, and effect on weight gain. This secondary data analysis describes the baseline intake and changes in diet after receiving healthy lifestyle education/counseling over 6 months, in a sample of youth with antipsychotic-induced weight gain. Methods: The U.S. Department of Agriculture (USDA) Automated Multiple-Pass Method 24-hour dietary recall was administered to 117 youth at baseline, 3 months, and 6 months. Parent/child received personalized healthy lifestyle education sessions over 6 months. Baseline intake was compared with the USDA Recommended Daily Allowance using independent samples t-tests. Individual dietary covariates were examined for change over 6 months using longitudinal linear mixed modeling. Influence of each on body mass index (BMI) z-score change was tested in a pooled group analysis and then compared by treatment group. Results: Pooled analysis revealed baseline consumption high in carbohydrates, fat, protein, sugar, and refined grains, while low in fruit/vegetables, whole grains, fiber, and water. Change over 6 months demonstrated a statistically significant decrease in daily calories (p = 0.002), carbohydrates (p = 0.003), fat (p = 0.012), protein (p = 0.025), sugar (p = 0.008), refined grains (p = 0.008), total dairy (p = 0.049), and cheese (p = 0.027). Small increases in fruits/vegetables were not statistically significant, although the Healthy Eating Index subscores for total vegetables (p = 0.013) and dark green/orange vegetables (p = 0.034) were. No dietary covariates were predictors of change in BMI z-score. Nondietary predictors were parent weight/BMI and treatment group, with the metformin and switch groups experiencing significant decreases in BMI z-score. Conclusions: Further pediatric studies are necessary to assess the effects of antipsychotic medications on dietary intake, and test efficacy of healthy lifestyle interventions on change in nutrition. The relationship of nutrition to cardiometabolic health in this population must be further investigated. Clinical Trial Registration number: NCT 02877823.
AB - Background: Youth treated with antipsychotic medications are high risk for weight gain, increased lipids/glucose, and development of metabolic syndrome. Little is known about the dietary intake/nutritional adequacy in this vulnerable population, and effect on weight gain. This secondary data analysis describes the baseline intake and changes in diet after receiving healthy lifestyle education/counseling over 6 months, in a sample of youth with antipsychotic-induced weight gain. Methods: The U.S. Department of Agriculture (USDA) Automated Multiple-Pass Method 24-hour dietary recall was administered to 117 youth at baseline, 3 months, and 6 months. Parent/child received personalized healthy lifestyle education sessions over 6 months. Baseline intake was compared with the USDA Recommended Daily Allowance using independent samples t-tests. Individual dietary covariates were examined for change over 6 months using longitudinal linear mixed modeling. Influence of each on body mass index (BMI) z-score change was tested in a pooled group analysis and then compared by treatment group. Results: Pooled analysis revealed baseline consumption high in carbohydrates, fat, protein, sugar, and refined grains, while low in fruit/vegetables, whole grains, fiber, and water. Change over 6 months demonstrated a statistically significant decrease in daily calories (p = 0.002), carbohydrates (p = 0.003), fat (p = 0.012), protein (p = 0.025), sugar (p = 0.008), refined grains (p = 0.008), total dairy (p = 0.049), and cheese (p = 0.027). Small increases in fruits/vegetables were not statistically significant, although the Healthy Eating Index subscores for total vegetables (p = 0.013) and dark green/orange vegetables (p = 0.034) were. No dietary covariates were predictors of change in BMI z-score. Nondietary predictors were parent weight/BMI and treatment group, with the metformin and switch groups experiencing significant decreases in BMI z-score. Conclusions: Further pediatric studies are necessary to assess the effects of antipsychotic medications on dietary intake, and test efficacy of healthy lifestyle interventions on change in nutrition. The relationship of nutrition to cardiometabolic health in this population must be further investigated. Clinical Trial Registration number: NCT 02877823.
KW - dietary intake/nutrition
KW - pediatric antipsychotic treatment
KW - weight loss
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U2 - 10.1089/cap.2020.0173
DO - 10.1089/cap.2020.0173
M3 - Article
C2 - 34143682
AN - SCOPUS:85108346273
SN - 1044-5463
VL - 31
SP - 364
EP - 375
JO - Journal of child and adolescent psychopharmacology
JF - Journal of child and adolescent psychopharmacology
IS - 5
ER -