Abstract:
Background: Studies show that healthy eating contributes to positive health outcomes for persons with schizophrenia-spectrum disorders. However, evidence suggests that they are more likely to have unhealthy dietary habits and are more at risk of weight gain and co-morbidities. In New Zealand (NZ), few studies have examined the dietary habits of persons with schizophrenia-spectrum disorders, and none have examined the contributors to these habits. Aim: To review the literature on the dietary habits of persons with schizophrenia-spectrum disorders and to measure dietary habits and the main barriers and facilitators of healthy eating in a group of NZ adults with schizophrenia-spectrum disorders. Methods: A systematic literature review was undertaken to determine dietary habits for persons with schizophrenia-spectrum disorders. A pilot study examining the dietary habits of NZ adults with schizophrenia-spectrum disorders was conducted in Auckland, NZ. Participants completed an questionnaire on dietary habits and perceived barriers and facilitators of healthy eating. Descriptive statistics were used to summarise the quantitative dietary habit data and a general inductive approach was used to analyse qualitative responses. Results: Seventeen studies published between 2011-2018 were reviewed. The systematic review confirmed that patients with schizophrenia were more likely to have a poorer diet compared to study controls. Dietary patterns were characterised by a greater intake of calories, saturated fats and poor fruit and vegetable consumption, showing no improvement since the previous review. The causes of poor diet were not well explored. In the pilot study, a sample of n=8 adults completed the questionnaire. Overall, participants had poor dietary habits which did not meet the Ministry of Health Eating and Activity guidelines. Barriers to healthy eating included financial barriers, food- and nutrition-related knowledge deficits and negative symptoms preventing motivators to change. Facilitators included support from family, friends and the health care team. Conclusion: Overall, the dietary habits of people with schizophrenia-spectrum disorders in this NZ study did not meet national recommendations for healthy eating. There is a need for a larger study to confirm these results and inform nutrition interventions within the NZ context. Insights from this pilot study will be useful for the development of similar studies in the future.