Longitudinal Dietary Intake of Young People With a First Episode of Psychosis From the Time of Presentation to Six Months Follow‐Up

BACKGROUND: Antipsychotic medications stimulate appetite and weight gain, contributing to high obesity rates in people with psychotic disorders. It is unknown if these dietary effects habituate over time. This study aimed to determine the dietary intake of young people with a first-episode psychosis at the time of presentation and at three- and six-months of follow-up. METHODS: We assessed dietary patterns at baseline, 3 months, and 6 months in participants diagnosed with first-episode psychosis who had minimal prior antipsychotic exposure. We analysed data from the PHAstER randomised-controlled trial, assessing changes in food consumption and Australian Dietary Guideline compliance using signed-rank tests with corrections for multiple testing. RESULTS: Of the 77 PHAstER study participants, 70 participants (91%) provided dietary data at baseline and 46 (60%) at 3 and 6 months. Dietary intake patterns and compliance with dietary guidelines remained consistent across all three timepoints. At baseline, few met recommended intake of three major food groups: vegetables (13%), dairy (20%) and fruit (24%). 64% of participants had a high intake of discretionary food (food high in saturated fat/sugars). At baseline, but not at three- or six-months, higher education levels were associated with healthier dietary patterns. CONCLUSION: Participants consistently reported unhealthy diets that did not adhere to guidelines, with no significant change over 6 months. This study reinforces the inequity of dietary health in people with psychosis, particularly those with lower levels of education. Dietary advice and support represent interventions with high marginal gain in this cohort, and should be part of routine clinical care.