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PROgram to Enhance Cardiovascular Risk Trough an Intervention of Nutrition in Bipolar Disorder

Not Applicable
Not yet recruiting
Conditions
Bipolar Depression
Bipolar Disorder (BD)
Interventions
Behavioral: Nutritional intervention
Registration Number
NCT06488573
Lead Sponsor
University of Sao Paulo
Brief Summary

Individuals with Bipolar Disorder (BD) have twice the risk of being affected by metabolic comorbidities and a 1.8-fold increased risk of mortality from cardiovascular diseases when compared to the general population. These factors are fundamental in the 14-year reduction in the life expectancy of people with TB reported in recent meta-analyses. This occurs mainly due to the increased inflammation associated with the disease, the adverse effects of pharmacological treatments and unhealthy lifestyle habits that are more common in people diagnosed with BD. Nutrition has been studied as an adjunctive treatment in other psychiatric disorders, but there is a lack of studies about the role of nutrition in TB. Considering that diet can impact metabolic health, this randomized controlled study aims to evaluate the effect of a nutritional intervention on cardiovascular risk in patients with TB. The intervention is based on the dietary pattern recommended in the Dietary Guidelines for the Brazilian Population and will be applied by a registered dietitian. According to the literature, the sample size will be 72 individuals with TB (36 in the control group with usual treatment + 36 in the intervention group added to the usual treatment). The intervention will be carried out in 7 individual sessions and 8 group sessions with specific themes. The primary aim of this protocol will be an intervention to contribute to cardiovascular health - verified by serum markers, anthropometric measurements and the Framingham Cardiovascular Risk Score (algorithm used to estimate an individual's 10-year cardiovascular risk). The secondary stages will be the adherence of the intervention and the impact on the quality of life of the participants. The possible positive results of this nutritional intervention can open new clinical perspectives. Meaning that might show that better food choices can protect the cardiovascular health of individuals with TB, leading to a reduction in morbidity and mortality associated with the disease.

Detailed Description

Not available

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
74
Inclusion Criteria
  • Clinical diagnosis of Bipolar disorder types I and II diagnosis
  • Adults of both genders, from 18 to 60 years old
  • In typical pharmacotherapy for BD, for at least one month
  • Agreement to participate in the study with signature of the consent form
Exclusion Criteria
  • Patients with "very good or excellent" diet quality assessed by the diet quality scale (ESQUADA): >275 out of a score of 375
  • Patients in a state of hypomania or mania: score >8 (Young Mania Rating Scale - YMRS)
  • Patients with severe depression >21 Montgomery-Åsberg Depression Rating Scale
  • Patients at low cardiovascular risk (<7 points for men or <9 points for women on the Framingham Global Risk Score)
  • Low weight or eutrophic body mass index: <25kg/m² as in similar studies
  • Pregnant or breastfeeding women
  • Patients diagnosed with anorexia and bulimia nervosa
  • Patientes diagnosed with Irritable Bowl Syndrome or other diagnosed conditions that affect the gastrointestinal function

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Nutritional interventionNutritional interventionNutritional intervention based on the Brazilian Dietary Guidelines
Primary Outcome Measures
NameTimeMethod
C reactive proteinBaseline, week 12, week 24 and follow up at week 52

C reactive protein

GlycemiaBaseline, week 12, week 24 and follow up at week 52

Glycemia

TriglyceridesBaseline, week 12, week 24 and follow up at week 52

Triglycerides

HOMA IRBaseline, week 12, week 24 and follow up at week 52

HOME IR

Body weightBaseline, week 12, week 24 and follow up at week 52

Body weight

Apoliporpotein BBaseline, week 12, week 24 and follow up at week 52

Apoliporpotein B

Glycated hemoglobin A1CBaseline, week 12, week 24 and follow up at week 52

Glycated hemoglobin A1C

Cardiovascular riskBaseline, week 12, week 24 and follow up at week 52

Framingham Global Risk Score (-3 to 21; higher scores mean worse outcome)

Total cholesterol and fractionsBaseline, week 12, week 24 and follow up at week 52

Total cholesterol and fractions

Body fat percentageBaseline, week 12, week 24 and follow up at week 52

Body fat percentage

waist circumferenceBaseline, week 12, week 24 and follow up at week 52

waist circumference

Secondary Outcome Measures
NameTimeMethod
Dietary assessment - dietary intakeBaseline, week 12, week 24 and follow up at week 52

3-day food record from last week (calories and macronutrients)

Quality of life WHOQOLBaseline, week 12, week 24 and follow up at week 52

WHOQOL Bref Portuguese (0-100; higher scores mean better outcome)

Dietary assessment - dietary adehrenceBaseline, week 12, week 24 and follow up at week 52

NUTRINET (0-72; higher scores mean worse outcome)

Dietary assessment - dietary qualityBaseline, week 12, week 24 and follow up at week 52

ESQUADA (0-375; higher scores mean better outcome)

Trial Locations

Locations (1)

Fernanda Gabriel

🇧🇷

São Paulo, SP, Brazil

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