The benefits of the Mediterranean diet in first episode psychosis patients taking antipsychotics

Toxicol Rep. 2022 Jan 10;9:120-125. doi: 10.1016/j.toxrep.2022.01.003. eCollection 2022.


Background: The side effects of antipsychotics (APs), related to weight gain and metabolic disturbances, can contribute to the health burden of psychotic people.

Objective: To explore a) the level of adherence to the Mediterranean Diet (MedDiet) and consumption of fermented foods by first episode of psychosis (FEPs) patients taking APs, in comparison to matched -for age and BMI- healthy controls (HCs), and b) the effect of this dietary pattern on the biochemical and metabolic profile of FEPs.

Method: The study population consisted of 33 FEPs treated with APs for less than 5 years, with no history of other chronic diseases, and an equal number of HCs. The FEPs were classified into two subgroups, according to their AP medication, depending on the documented risk of weight gain. A validated questionnaire for the adherence to Mediterranean diet and a food frequency questionnaire for selected fermented foods were completed by FEPs and HC. Anthropometric data and blood measurements were recorded for all participants.

Results and conclusions: The FEPs showed a relevant lower overall adherence to the MedDiet, but no differences in consumption of fermented foods. Type of antipsychotic therapy uncovered differences in platelet count, vitamin B12, HDL and glucose (p < 0.05) between the subgroups of FEPs and HCs, although no values were abnormal. The MedDiet score was found to act as a prognostic factor for abnormal glucose levels in FEPs treated with APs associated with weight gain (p = 0.04). These results need to be confirmed by observations after long term adherence to MedDiet.

Keywords: AP, antipsychotic; Anti-psychotics; CRP, C-reactive protein; CVD, cardiovascular disease; DM, diabetes mellitus; FEP, First Episode Psychosis; Fermented food; First episode psychosis; HC, Healthy Control; HDL-C, HDL cholesterol; Inflammation; LDL-C, LDL cholesterol; MedDiet, Mediterranean Diet; Mediterranean diet; Metabolic disturbances; TG, triglycerides; hsCRP, high-sensitivity CRP.