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Dietary energy intakes in children with mental health conditions treated with second-generation antipsychotics

University of British Columbia

Approximately one in six Canadian children suffer from mental health conditions (MHC), including: anxiety, bipolar disorder, and depression. Second-generation antipsychotics (SGAs) are increasingly used to treat children with MHCs. Recent evidence suggests that SGAs are implicated in rapid weight gain, increased measures of adiposity, and cardiometabolic dysfunction in the pediatric population. The mechanisms for these adverse side effects have yet to be elucidated. One postulation is that SGAs may increase dietary energy intakes; however, little is known about the diets of SGA-treated children. My thesis research explored dietary intake and its potential association with adiposity and cardiometabolic dysfunction, in SGA-treated children. This cross-sectional study recruited SGA-treated (n=25) and SGA-naïve (n=20) children (6-19 yrs) with MHCs, from the Psychiatry Department at BC Children’s Hospital. Demographics, medical history, and anthropometrics were obtained. In a subset, fasting plasma lipids, glucose, and insulin were obtained and the homeostatic model assessment of insulin resistance (HOMA-IR) was calculated. Three 24-hour food records were collected and analyzed for average three-day total energy (kcal), macronutrient, saturated fat, sugar, fibre, and sodium intakes. There were no statistically significant differences between groups for energy intakes (mean ± SD; 2036.5±715.8 vs. 1725.5 ± 545.6, P = 0.352) or macronutrient, saturated fat, sugar, fibre, and sodium intakes; adjusting for sex, height, pubertal status, and psychostimulant medications. SGA-treated children had higher zBMI (p=0.001), waist circumference (p=0.019), and HOMA-IR (p=0.009), compared to SGA-naïve children. There were no associations of energy intake and measures of adiposity. There were positive associations of sodium intake and HOMA-IR (p=0.017; 95% CI: 0.013, 0.109) and saturated fat intake and low-density lipoprotein cholesterol (LDL-c) (p=0.041; 95% CI: 0.004, 0.170), in the SGA-treated group; adjusting for sex, pubertal status, overweight/obesity, height, and psychostimulant treatment. These data suggest that SGA-treated children do not have greater dietary energy intakes compared to SGA-naïve children, and dietary energy intakes may not be responsible for greater measures of adiposity in SGA-treated children. However, the positive associations of sodium intake with HOMA-IR, and saturated fat intake with LDL-c, in SGA-treated children, suggest that dietary intakes in SGA-treated children may contribute to cardiometabolic dysfunction in this high-risk population.

Text

2014-12-23

Attribution-NonCommercial-NoDerivs 2.5 Canada

http://hdl.handle.net/2429/51651

Human Nutrition

University of British Columbia

UBCV

http://creativecommons.org/licenses/by-nc-nd/2.5/ca/