Physical activity and fruit and vegetable intake in people with severe mental illness: Results from a multicountry survey in India, Bangladesh, and Pakistan

BackgroundPeople with severe mental illness (SMI) are at higher risk of developing non-communicable diseases, leading to increased comorbidities and elevated mortality rates. Their health often declines due to poor dietary habits, such as low intake of fruits and vegetables (FV), combined with insufficient physical activity (PA).AimsWe report the prevalence of low FV intake and PA (as per WHO criteria) and their sociodemographic and clinical risk factors in people with SMI in South Asia.MethodsA cross-sectional survey was conducted between June 2019 and January 2022 across tertiary mental health institutions in Bangladesh, India, and Pakistan among adults diagnosed with SMI. We collected data on sociodemographics, body mass index, physical comorbidities, and health behaviours. PA and FV were measured too while logistic regression analysis was used to identify factors associated with low FV intake and PA.ResultsAmong 3989 participants, the prevalence of participants who met the WHO recommendations for FV intake was 4.9% (196/3989), and for PA was 45.6% (1817/3989). Older adults (55 + years) were less likely to meet PA recommendations compared to younger adults (18-24 years) (odds ratio (OR) = 0.56, 95%CI = 0.40-0.80, <i>p</i> = 0.001), and those with higher income levels had higher odds of meeting PA recommendations compared to those with lower income (OR = 2.23, 95%CI = 1.49-3.34, <i>p</i> < 0.001). Additionally, individuals who reported adequate FV intake were significantly more likely to meet PA recommendations (OR = 2.90, 95% CI = 2.02-4.16, <i>p</i> < 0.001).ConclusionA majority of people with SMI did not meet the WHO recommendations for PA and FV intake. The associated factors, including age, income, and dietary habits, emphasise the complexity of addressing health behaviours in this vulnerable population in South Asia.