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Background: Diabetes is more common in people with schizophrenia than in the general population.

Aims: To explore the possible reasons for the association between diabetes and schizophrenia.

Method: Diet and other lifestyle factors in patients with schizophrenia were reviewed as risk factors for diabetes.

Results: People with schizophrenia show features of the metabolic syndrome at the onset of illness, before treatment. They also eat a poor diet, take little exercise and have high rates of smoking. Food intake may be increased further by antipsychotic medication. Nutritional factors appear to have a key role in the development of diabetes in patients with schizophrenia and may also affect the outcome and severity of schizophrenia. A common pathway through which diet might contribute to the development of both diabetes and schizophrenia is proposed.

Conclusions: Lifestyle factors may influence outcomes in both diabetes and schizophrenia. Lifestyle interventions are the key to improving the long-term health of people with schizophrenia.