Dietary intake, nutritional status and mental wellbeing of homeless adults in Reading, UK

Abstract

Malnutrition has been reported in the homeless, yet the specific nutritional issues faced by each homeless community are unclear. This is in part due to nutrient intake often being compared with dietary reference values as opposed to a comparative housed population. In addition, the complex interplay between nutrient intake, reward mediated behaviour and mental illness is frequently overlooked. This study aimed to compare the dietary intake, nutritional status and mental wellbeing of homeless and housed adults. Homeless (n 75) and matched housed (n 75) adults were recruited from Reading (UK). Nutrient intake was determined using the European Prospective Investigation into Cancer and Nutrition Norfolk FFQ. The Patient Health Questionnaire: Somatic Anxiety Depressive Symptoms (PHQ-SADS) assessed for signs of mental illness. Demographic, behavioural and physiological information was collected using closed-ended questions and anthropometric measurements. Overall, dietary intake was poorer in homeless adults who reported higher intakes of salt (8·0 v. 6·4 g, P=0·017), SFA (14·6 v. 13·0 %, P=0·002) and alcohol (5·3 v. 1·9 %, P<0·001) and lower intakes of fibre (13·4 v. 16·3 g, P<0·001), vitamin C (79 v. 109 mg, P<0·001) and fruit (96 v. 260 g, P<0·001) than housed. Smoking, substance misuse and PHQ-SADS scores were also higher in the homeless (P<0·001). Within the homeless population, street homeless (n 24) had lower SFA (13·7 v.15·0 %, P=0·010), Ca (858 v. 1032 mg, P=0·027) and milk intakes (295 v. 449 g, P=0·001) than hostel residents (n 51), which may reflect the issues with food storage. This study highlights the disparity between nutritional status in homeless and housed populations and the need for dietary intervention in the homeless community.

Health assessments and screening tools for adults experiencing homelessness: a systematic review

“…Of 2122 identified studies, 37 were identified as potentially-relevant (Table 1). These studies reported on 73 health screening or health assessment tools, across 11 domains: oral health [22–32]; health related quality of life, and health status [9, 33–48]; nutrition [49–56]; psychological and cognitive function [9, 22, 34, 35, 41, 42, 44, 56–59]; substance use [28, 33–36, 51, 57]; injury [29, 30, 36, 58]; chronic conditions [33, 44, 45, 60, 57]; demography and anthropometry [34–40, 44, 49, 51–55, 60]; functional decline and frailty [9, 37, 38, 54]; hearing and vision [9, 36, 61]; and pelvic floor health [9].…”

Serosurvey of Anti-Toxoplasma gondii Antibodies in Homeless Persons of São Paulo City, Southeastern Brazil

“…In addition, healthier and more expensive items, such as meat, fish, vegetables, and fruits have been less often consumed by homeless ( 33 , 36 , 38 , 39 ), which may be a contributing factor to the low T. gondii seroprevalence found in this study. Hence, it is reasonable to speculate that the beneficial shelters, hostels, and meal services may have offered protection to the homeless population ( 36 , 40 ) but not as nutritional good food habits when compared to the general population.…”

Serosurvey of anti-Toxoplasma gondii antibodies in homeless persons of São Paulo city, southeastern Brazil

“…In addition, healthier and more expensive items such as meat, sh, vegetables, and fruits have been less often consumed by homeless [33,36,38,39], which may bea contributing factor to the low T. gondii seroprevalence found in this study. Hence, it is reasonable to speculate that the bene cial shelters, hostels, and meal services may have offered protection to the homeless population [36,40] but not as nutritional good food habits when compared to the general population.…”