Nutrition and the homeless: the underestimated challenge

Abstract

Homelessness is present in most societies and represents a situation in which the basic needs for survival including food are often limited. It is logical to surmise that the homeless person's diet is likely to be nutritionally deficient and yet there is a relative paucity in research regarding this issue with studies varying in both their methodology and homeless population. Despite these differences, diets of the homeless are frequently characterised as high in saturated fat and deficient in fibre and certain micronutrients, all of which can have negative implications for the homeless individual's health and/or mental state. The conclusion from intervention studies is that there is no consensus as to the most effective method for assessing dietary intake. In order to address this, the present review aims to provide a greater understanding of the existing literature surrounding nutrition and the homeless and to act as a foundation from which further research can be conducted. An evaluation of the main findings and challenges surrounding the assessment of the nutritional status of the homeless will be provided followed by a review of the physical and mental consequences of the homeless diet. Current and potential interventions aimed at increasing the nutritional quality of food consumed by the homeless will be addressed with a focus on the role of the nutritional science community in assisting in this endeavour.

Cardiovascular disease in homeless versus housed individuals: a systematic review of observational and interventional studies

“… 2 There are likely to be multiple potential causes of the association between homelessness and increased CVD risk, including multiple social (eg, health literacy) and environmental determinants, and acute challenges (health, social and structural) which are prioritised above chronic disease management. There are several unique healthcare challenges associated with homeless populations, including high smoking rates, 14 15 nutritional deficiencies, 16 illicit drug use 14 and increased structural, professional and service design barriers, 17 18 all of which are likely to be relevant as potential targets for action against CVD. 19 Socioeconomic determinants of health, or the ‘causes of the causes’ continue to be neglected, perhaps none more than homelessness.…”

High-Prevalence Vitamin D Deficiency among Korean Emergency Department Homeless, with a Comparison to a Healthy Korean Population

“…Particularly, insufficient intakes of essential micronutrients and combined deficiencies are common. Various kinds of vitamin deficiencies among the homeless have been reported [1,2,3,12].…”

“…Nutrition deficiencies are among the major problems of the homeless, and adequate nutritional support is essential to their care [1,2,3]. However, macronutrients usually are the major nutritional concerns, with essential micronutrients often being overlooked [4].…”

Factors Associated to Health Needs from Homeless Perspective in Spain

“…Food intake is usually poor and unbalanced among homeless. It is characterized by high saturated fats, with deficiencies in proteins and micronutrients, which can have negative effects on physical and mental health (Seale, Fallaize, & Lovegrove, 2016). Despite the lack of statistical significance between homeless nutrition and self-perceived health, the provision of adequate nutritional quality food remains a public health priority.…”