Nutrition and health in an adult urban homeless population in Germany

Abstract

Objective: To assess the association between nutrition and health in an adult urban homeless population. Design: Cross-sectional ± nutritional state (body mass index (BMI), triceps skinfold (TSF), upper arm circumference), dietary habits (food frequency), socio-demographic data and self-stated diseases were assessed. Setting: Four sites for homeless people in Kiel and Hamburg, Germany. Subjects: Sample of 75 homeless people (60 males, 15 females) aged 19±62 years. Results: A lack of food was not found in the majority of the homeless. Seventy-six per cent of the study population showed a normal dietary pattern. Critical food groups were fresh fruit and vegetables, rice and noodles. However, 52 or 29% of the homeless were malnourished (i.e. they were below the 25th or 5th percentile of arm muscle area). In addition, 22.7% of the homeless were obese (i.e. BMI>30 kg m 22 and/or TSF>90th percentile). Almost two-thirds of the population suffered from at least one chronic disease (prevalence of nutrition-related disorders 33.3%, gastrointestinal disorders 32.0%, dental diseases 22.7%, psychiatric disorders 18.7%, wasting diseases 6.7%). Smoking (prevalence rate 82%), drinking alcohol (51%) and drug abuse (20%) were frequent among homeless people. Food intake was not related to nutritional state, the prevalence of chronic diseases or addiction habits. By contrast, a poor nutritional state was associated with drug abuse and the prevalence of wasting diseases. Conclusion: Prevention of nutritional problems should be directed to health-related problems such as the prevention or treatment of chronic diseases and addiction habits.

Risk factors for cardiovascular disease among the homeless and in the general population of the city of Porto, Portugal

“…The low proportion of women and low education level in both homeless samples is in accordance with previous observations 14,49 . The proportion of non-Portuguese individuals among the homeless was higher than in the general population (12.3% vs. 5%) 50 , which can be explained by the immigration of a large number of citizens from Portuguese ex-colonies and eastern European countries, most of which currently have difficulties finding employment and do not have any social or family relations in Portugal which in turn makes them more vulnerable to homelessness.…”

“…A lower average body mass index and waist circumference compared to the general population sample is in accordance with the previous reports of poor nutritional status among the homeless 49,56 . Higher prevalence of hypertension and higher average blood pressure values observed in the general population are essentially due to the high proportion of overweight and obese individuals 57 .…”

“…The proportion of non-Portuguese individuals among the homeless was higher than in the general population (12.3% vs. 5%) 50 , which can be explained by the immigration of a large number of citizens from Portuguese ex-colonies and eastern European countries, most of which currently have difficulties finding employment and do not have any social or family relations in Portugal which in turn makes them more vulnerable to homelessness. The high percentage of individuals that had been imprisoned or that used illicit drugs is also consistent with previous studies that reported prevalence of drug abuse ranging between 20% and 84.4% 49,51,52 and of imprisonment ranging between 23.1% and 76% 48,52 . Approximately ten percent of the homeless participants reported having HIV/AIDS, in agreement with previous studies 53,54 .…”

The effect of drug abuse on body mass index in Hispanics with and without HIV infection

“…Reported energy intake could not explain the difference in BMI among the men 1 . These findings, consistent with previous studies conducted in other populations by our own group 2 and others 3,4 , support the notion that diet alone cannot entirely explain the lower weight of drug abusers. In this follow-up report from the BIENE-STAR study, we present data on non-dietary factors that might explain the lower weight of drug abusers.…”

Nutritional Alterations in Drug Abusers With and Without HIV

“…In a later study of Hispanics also by our group, the lower BMI of drug abusers could not be attributed to differences in average dietary energy intake as measured by three-day food records [11] . In a study of homeless Germans, drug abuse and wasting diseases, but not food intake, were associated poor nutritional status [21] .…”