Dietary intake of people with severe mental illness: systematic review and meta-analysis

<jats:sec id="S0007125019000205_sec_a1"><jats:title>Background</jats:title><jats:p>Severe mental illness (SMI) is thought to be associated with lower diet quality and adverse eating behaviours contributing towards physical health disparities. A rigorous review of the studies looking at dietary intake in psychotic disorders and bipolar disorder is lacking.</jats:p></jats:sec><jats:sec id="S0007125019000205_sec_a2"><jats:title>Aims</jats:title><jats:p>To conduct a systematic, comprehensive evaluation of the published research on dietary intake in psychotic disorders and bipolar disorder.</jats:p></jats:sec><jats:sec id="S0007125019000205_sec_a3" sec-type="methods"><jats:title>Method</jats:title><jats:p>Six electronic databases were searched for studies reporting on dietary intakes in psychotic disorders and bipolar disorder. Dietary-assessment methods, and dietary intakes, were systematically reviewed. Where possible, data was pooled for meta-analysis and compared with healthy controls.</jats:p></jats:sec><jats:sec id="S0007125019000205_sec_a4" sec-type="results"><jats:title>Results</jats:title><jats:p>In total, 58 eligible studies were identified. People with SMI were found to have significantly higher dietary energy (mean difference 1332 kJ, 95% CI 487–2178 kJ/day, <jats:italic>P</jats:italic> = 0.002, <jats:italic>g</jats:italic> = 0.463) and sodium (mean difference 322 mg, 95% CI 174–490 mg, <jats:italic>P</jats:italic> < 0.001, <jats:italic>g</jats:italic> = 0.414) intake compared with controls. Qualitative synthesis suggested that higher energy and sodium intakes were associated with poorer diet quality and eating patterns.</jats:p></jats:sec><jats:sec id="S0007125019000205_sec_a5" sec-type="conclusion"><jats:title>Conclusions</jats:title><jats:p>These dietary components should be key targets for preventative interventions to improve weight and other physical health outcomes in people with SMI.</jats:p></jats:sec><jats:sec id="S0007125019000205_sec_a6"><jats:title>Declaration of interest</jats:title><jats:p>S.B.T. and E.T. have clinical dietitian appointments within the South Eastern Sydney Local Health District and do not receive any further funding.</jats:p></jats:sec>