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Changing the Obesogenic Environment to Improve Cardiometabolic Health in Residential Patients with a Severe Mental Illness: ELIPS, a Randomized Controlled Trial

Published online by Cambridge University Press:  23 March 2020

F. Jörg ,
A. Looijmans ,
A. Stiekema ,
L. Van der Meer ,
R. Schoevers  and
E. Corpeleijn
F. Jörg
Affiliation:
University Medical Center Groningen UMCG, ICPE, Groningen, The Netherlands
A. Looijmans
Affiliation:
University Medical Center Groningen UMCG, Epidemiology, Groningen, The Netherlands
A. Stiekema
Affiliation:
Lentis, Lentis Research, Groningen, The Netherlands
L. Van der Meer
Affiliation:
Lentis, Lentis Research, Groningen, The Netherlands
R. Schoevers
Affiliation:
University Medical Center Groningen UMCG, UCP, Groningen, The Netherlands
E. Corpeleijn
Affiliation:
University Medical Center Groningen UMCG, Epidemiology, Groningen, The Netherlands

Abstract

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Introduction

The life expectancy of severe mentally ill (SMI) patients is shortened up to 30 years, due to cardiometabolic diseases, partly caused by unhealthy lifestyles behaviors. In residential facilities, adopting a healthy lifestyle is hampered by the obesogenic environment; an obesity promoting environment.

Objective

To determine, the effectiveness of a 12 month lifestyle intervention addressing the obesogenic environment to improve cardiometabolic health of SMI residential patients.

Methods

The effectiveness of lifestyle interventions in psychiatry (ELIPS) trial is a multi-site, cluster randomized controlled pragmatic trial. Twenty-nine sheltered and long-term clinical care teams serving SMI patients in the Netherlands were randomized into intervention (n = 15) or control (n = 14) arm, including 736 patients (73% psychotic disorder, 63% male, 48 ± 13 years). The intervention aimed to improve the obesogenic environment using a small change approach with a focus on nutrition and physical activity. Primary outcome was waist circumference (WC) after three and twelve month's intervention. Secondary outcomes were BMI and metabolic syndrome.

Results

General linear mixed models adjusted for age, gender, housing facility and antipsychotic medication showed that WC significantly decreased with 1.51 cm (95%CI = −2.99;−0.04, Cohen's d = 0.07) in the intervention group compared to control group after three months and tended to remain lower with 1.28 cm (95%CI = −2.79; 0.23, Cohen's d = 0.06) after twelve months. Metabolic syndrome Z-score decreased after three months with 0.225 SD (95% CI = −0.4038;−0.096, Cohen's d = 0.20), mainly due to lower fasting glucose and WC. No significant effects were found on BMI.

Conclusion

A small change approach targeting the obesogenic environment of SMI residential patients reduces cardiometabolic risk.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
e-Poster Walk: Schizophrenia and other psychotic disorders - Part 3
Information
European Psychiatry , Volume 41 , Issue S1: Abstract of the 25th European Congress of Psychiatry , April 2017 , pp. S267 - S268
Copyright
Copyright © European Psychiatric Association 2017
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