Interventions for preventing or treating malnutrition in problem drinkers who are homeless or vulnerably housed: protocol for a systematic review

Thorley, Helen; Porter, Katie; Fleming, Clare; Jones, Tim; Kesten, Joanna M; Marques, Elsa; Richards, Alison; Savović, Jelena

doi:10.1186/s13643-015-0114-3

Cited by 11 publications

(12 citation statements)

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“…Encouraging older adults without diseases to quit smoking has the potential to reduce the risk of the development of diseases and improve quality of life, besides to emphasizing the adoption of a healthy lifestyle as an important strategy in the relationship between smoking and BMI. The relationship between underweight/ malnutrition and alcohol abuse is described in the literature 23 . It is estimated that alcohol abuse contributed to 5.9% of deaths worldwide in 2012, which occurred mainly due to heart disease and diabetes (33.4%), gastrointestinal disease (16.2%) and malignant tumors in various sites (12.5%) 24 .…”

Section: Discussionmentioning

confidence: 99%

“…A study conducted in the city of Campinas, Brazil, reports a similar finding, as alcohol use once a week was associated with aspects of happiness and a good assessment of one's health status 27 . However, there is ample evidence that alcohol use, particularly binge drinking, increases the risk of accidents and violence 28 and has harmful consequences for the gastrointestinal system, such as gastritis, diarrhea and poor nutrient absorption 23 , which can further aggravate weight loss/malnutrition in older adults. It should be stressed that the study only identified surviving individuals and their current level of exposure.…”

Section: Discussionmentioning

confidence: 99%

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Prevalence and factors associated with underweight among Brazilian older adults

Francisco

Assumpção

Borim

et al. 2019

Ciênc. saúde coletiva

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The aim of this study was to estimate the prevalence of underweight among older adults according to socio-demographic characteristics in different regions of Brazil as well as determine associated contextual and individual factors. Cross-sectional population-based study with older adults (≥ 65 years) interviewed by telephone survey in 2014. The body mass index was calculated based on weight and height. Associations were determined using Pearson’s chi-square test, considering a 5% significance level. Adjusted prevalence ratios were estimated using multilevel Poisson regression. Mean age was 73.3 years and the prevalence of underweight was 15.6% (95%CI: 14.1-17.1%). Higher prevalence rates of underweight were found among women, individuals aged ≥ 80 years, smokers and those who reported the regular consumption of beans. The prevalence rate of underweight was lower among those who reported abusive alcohol intake and those with a medical diagnosis of hypertension. The northern region of the country had the highest prevalence of underweight after adjusting for associated individual factors. The findings demonstrate the subgroups with higher prevalence rates of underweight that demand greater attention from the health services in terms of recovering of an adequate nutritional status.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prevalence and factors associated with underweight among Brazilian older adults

Francisco

Assumpção

Borim

et al. 2019

Ciênc. saúde coletiva

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“…Problem-drinking is a commonly used term with no agreed definition. We therefore included all definitions of problem-drinking, as defined by included study authors [ 28 ].…”

Section: Methodsmentioning

confidence: 99%

“…References of included studies were screened and authors were contacted to find any additional studies or data. The search was published in the protocol [ 28 ] and is up to date until 16th November 2016.…”

Section: Methodsmentioning

confidence: 99%

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Interventions for preventing or treating malnutrition in homeless problem-drinkers: a systematic review

Ijaz

Thorley

Porter

et al. 2018

Int J Equity Health

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BackgroundExcessive drinking leads to poor absorption of nutrients and homeless problem-drinkers often have nutritionally inadequate diets. Depletion of nutrients such as vitamin B1 can lead to cognitive impairment, which can hinder efforts to reduce drinking or engage with services. This review aimed to assess effectiveness of interventions designed to prevent or treat malnutrition in homeless problem-drinkers.MethodsWe systematically searched nine electronic databases and 13 grey literature sources for studies evaluating interventions to improve nutrition in homeless populations, without regional or language restrictions. Screening for inclusion was done in duplicate. One reviewer extracted data and assessed risk of bias, and another checked the extractions. Primary outcomes were nutrition status/deficiency, liver damage, and cognitive function. Secondary outcomes included abstinence, comorbidities, resource use, acceptability and engagement with intervention. Results were synthesised narratively.ResultsWe included 25 studies (2 Randomised Controlled Trials; 15 uncontrolled before and after; 7 surveys; 1 case-control). Nine studies evaluated educational and support interventions, five food provision, and three supplement provision. Eight studies evaluated a combination of these interventions. No two interventions were the same, and all studies were at high risk of bias. Nutritional status (intake/ deficiency) were reported in 11 studies and liver function in one.Fruit and vegetable intake improved with some education and support interventions (n = 4 studies) but not others (n = 2). Vitamin supplements appeared to improve vitamin deficiency levels in the blood (n = 2). Free or subsidised meals (n = 4) and food packs (n = 1) did not always fulfil dietary needs, but were usually considered acceptable by users. Some multicomponent interventions improved nutrition (n = 3) but acceptability varied (n = 3). No study reported cost effectiveness.ConclusionsThe evidence for any one intervention for improving malnutrition in homeless problem-drinkers was based on single studies at high risk of bias. Various food and supplement provision interventions appear effective in changing nutritional status in single studies. Educational and multicomponent interventions show improved nutritional behaviour in some studies but not others. Further better quality evidence is required before these interventions can be recommended for implementation. Any future studies should seek the end user input in their design and conduct.Trial registrationRegistered with PROSPERO: CRD42015024247.

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Community-based supplementary feeding for food insecure, vulnerable and malnourished populations - an overview of systematic reviews

Visser

McLachlan

Maayan

et al. 2018

Cochrane Database of Systematic Reviews

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BackgroundSupplementary feeding may help food insecure and vulnerable people by optimising the nutritional value and adequacy of the diet, improving quality of life and improving various health parameters of disadvantaged families. In low‐ and middle‐income countries (LMIC), the problems supplementary feeding aims to address are entangled with poverty and deprivation, the programmes are expensive and delivery is complicated.Objectives1. To summarise the evidence from systematic reviews of supplementary feeding for food insecure, vulnerable and malnourished populations, including children under five years of age, school‐aged children, pregnant and lactating women, people with HIV or tuberculosis (or both), and older populations.2. To describe and explore the effects of supplementary feeding given to people in these groups, and to describe the range of outcomes between reviews and range of effects in the different groups.MethodsIn January 2017, we searched the Cochrane Database of Systematic Reviews, MEDLINE, Embase and nine other databases. We included systematic reviews evaluating community‐based supplementary feeding, and concerning food insecure, vulnerable and malnourished populations. Two review authors independently undertook selection of systematic reviews, data extraction and 'Risk of bias' assessment. We assessed review quality using the AMSTAR tool, and used GRADEpro 'Summary of findings' tables from each review to indicate the certainty of the evidence for the main comparisons. We summarised review findings in the text and reported the data for each outcome in additional tables. We also used forest plots to display results graphically.Main resultsThis overview included eight systematic reviews (with last search dates between May 2006 and February 2016). Seven were Cochrane Reviews evaluating interventions in pregnant women; children (aged from birth to five years) from LMIC; disadvantaged infants and young children (aged three months to five years); children with moderate acute malnutrition (MAM); disadvantaged school children; adults and children who were HIV positive or with active tuberculosis (with or without HIV). One was a non‐Cochrane systematic review in older people with Alzheimer's disease. These reviews included 95 trials relevant to this overview, with the majority (74%) of participants from LMIC.The number of included participants varied between 91 and 7940 adults, and 271 and more than 12,595 children. Trials included a wide array of nutritional interventions that varied in duration, frequency and format, with micronutrients often reported as cointerventions. Follow‐up ranged from six weeks to two years; three trials investigated outcomes at four to 17 years of age. All reviews were rated as high quality (AMSTAR score between eight and 11). The GRADE certainty ratings ranged from very low to moderate for individual comparisons, with the evidence often comprising only one or two small trials, thereby resulting in many underpowered analyses (too small to detect small but important differences...

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Interventions for preventing or treating malnutrition in problem drinkers who are homeless or vulnerably housed: protocol for a systematic review

Cited by 11 publications

References 32 publications

Prevalence and factors associated with underweight among Brazilian older adults

Prevalence and factors associated with underweight among Brazilian older adults

Interventions for preventing or treating malnutrition in homeless problem-drinkers: a systematic review

Community-based supplementary feeding for food insecure, vulnerable and malnourished populations - an overview of systematic reviews

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