Abstract
BACKGROUND: Delivery of dietary interventions using e-health for severe mental illness populations show promise. Yet the details of what has been trialled and the effectiveness of such interventions in this population group has not been systematically reviewed. OBJECTIVE: To systematically review and synthesise published research to determine the evidence of e-health delivered nutritional interventions on diet, physical and mental health outcomes in adults living with severe mental illness. DESIGN: Five electronic databases were searched to March 2025 to identify studies in adults living with severe mental illness, interventions including a dietary focus and delivered via e-health, and reporting diet, mental health, or anthropometric outcome/s. The completeness of intervention reporting was evaluated using the TIDieR (Template for Intervention Description and Replication) framework. RESULTS: Eleven studies (n = 1827 individuals, 56% female) were included, including randomised controlled trials (n = 6) and pre/post studies (n = 5). Most interventions were delivered by health professionals (n = 8 studies) and the duration was highly varied (6 weeks - 12 months). Anthropometrics were the most common outcome (n = 8 studies; with five reporting significant improvements) followed by physical activity (n = 6 studies; with two reporting significant improvements), mental health and cardiovascular outcomes (n = 5 studies each; with five and four of these studies, respectively, reporting significant improvements in outcomes). Diet was assessed in only three studies, one reporting significant changes. Ten studies incorporated smartphone technology including using phone calls (n = 5 studies), text messages (n = 3 studies), smartphone applications or multimodal delivery. CONCLUSION: This review identified opportunities to inform clinical service including more opportunity to harness other aspects of technology for the entire scope of the nutrition care process (e.g. better dietary assessment and use of features such as text message and assessing outcome measures).