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

  • Rosalind Fallaize (a1) (a2), Josephine V. Seale (a1), Charlotte Mortin (a1), Lisha Armstrong (a1) and Julie A. Lovegrove (a1)...

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.

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Corresponding author
* Corresponding author: J. A. Lovegrove, fax +44 118 931 0080, email
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R. Fallaize and J. Seale are joint first authors.

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1. Department for Communities and Local Government (2016) Statutory homelessness: October to December Quarter 2015 England. (accessed June 2016).
2. Department for Communities and Local Government (2016) Rough sleeping statistics: Autumn 2015 England (accessed June 2016).
3. Rushton, CM & Wheeler, E (1993) The dietary intake of homeless males sleeping rough in Central London. J Hum Nutr Diet 6, 443456.
4. Langnäse, K & Müller, MJ (2001) Nutrition and health in an adult urban homeless population in Germany. Public Health Nutr 4, 805811.
5. Hickey, C & Downey, D (2003) Hungry for Change: Social Exclusion, Food Poverty and Homelessness in Dublin; a Pilot Research Study. Dublin: Focus Ireland.
6. Darmon, N, Coupel, J, Deheeger, M, et al. (2001) Dietary inadequacies observed in homeless men visiting an emergency night shelter in Paris. Public Health Nutr 4, 155161.
7. Luder, E, Boey, E, Buchalter, B, et al. (1989) Assessment of the nutritional status of urban homeless adults. Public Health Rep 104, 451.
8. Wolgemuth, JC, Myers-Williams, C, Johnson, P, et al. (1992) Wasting malnutrition and inadequate nutrient intakes identified in a multiethnic homeless population. J Am Diet Assoc 92, 834839.
9. Koh, KA, Hoy, JS, O’Connell, JJ, et al. (2012) The hunger–obesity paradox: obesity in the homeless. J Urban Health 89, 952964.
10. Tsai, J & Rosenheck, RA (2013) Obesity among chronically homeless adults: is it a problem? Public Health Rep 128, 29.
11. Hwang, SW (2001) Homelessness and Health. Can Med Assoc J 164, 229233.
12. Homeless, Link (2015) The unhealthy state of homelessness: health audit results 2014. London: Homeless Link. (accessed July 2017).
13. Kushel, MB, Vittinghoff, E & Haas, JS (2001) Factors associated with the health care utilization of homeless persons. JAMA 285, 200206.
14. Thomas, B (2011) Homelessness: A silent killer - A research briefing on mortality amongst homeless people. London: Crisis.
15. Hibbs, JR, Benner, L, Klugman, L, et al. (1994) Mortality in a cohort of homeless adults in Philadelphia. N Engl J Med 331, 304309.
16. Hwang, SW, Orav, EJ, O’Connell, JJ, et al. (1997) Causes of death in homeless adults in Boston. Ann Intern Med 126, 625628.
17. Krausz, RM, Clarkson, AF, Strehlau, V, et al. (2013) Mental disorder, service use, and barriers to care among 500 homeless people in 3 different urban settings. Soc Psychiatry Psychiatr Epidemiol 48, 12351243.
18. Lykkesfeldt, J, Christen, S, Wallock, LM, et al. (2000) Ascorbate is depleted by smoking and repleted by moderate supplementation: a study in male smokers and nonsmokers with matched dietary antioxidant intakes. Am J Clin Nutr 71, 530536.
19. German Nutrition Society (DGE) (2015) New reference values for vitamin C intake. Ann Nutr Metab 67, 1320.
20. Kubisová, D, Adámková, V, Lánská, V, et al. (2007) Higher prevalence of smoking and lower BMI, waist circumference, cholesterol and triacylglyceride levels in Prague’s homeless compared to a majority of the Czech population. BMC Public Health 7, 51.
21. Sprake, EF, Russell, JM & Barker, ME (2014) Food choice and nutrient intake amongst homeless people. J Hum Nutr Diet 27, 242250.
22. Bingham, SA, Welch, AA, McTaggart, A, et al. (2001) Nutritional methods in the European prospective investigation of cancer in Norfolk. Public Health Nutr 4, 847858.
23. Mulligan, AA, Luben, RN, Bhaniani, A, et al. (2014) A new tool for converting food frequency questionnaire data into nutrient and food group values: FETA research methods and availability. BMJ Open 4, e004503.
24. Kroenke, K, Spitzer, RL, Williams, JB, et al. (2010) The patient health questionnaire somatic, anxiety, and depressive symptom scales: a systematic review. Gen Hosp Psychiatry 32, 345359.
25. World Health Organization Expert Committee (1995) Physical Status: the Use and Interpretation of Anthropometry. Geneva: WHO.
26. Lauretani, F, Russo, CR, Bandinelli, S, et al. (2003) Age-associated changes in skeletal muscles and their effect on mobility: an operational diagnosis of sarcopenia. J Appl Physiol 95, 18511860.
27. Hippisley-Cox, J, Coupland, C, Vinogradova, Y, et al. (2008) Predicting cardiovascular risk in England and Wales: prospective derivation and validation of QRISK2. BMJ 336, 14751482.
28. Tarasuk, V, Dachner, N & Li, J (2005) Homeless youth in Toronto are nutritionally vulnerable. J Nutr 135, 19261933.
29. Faul, F, Erdfelder, E, Lang, A-G, et al. (2007) G* Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 39, 175191.
30. The Committee on Medical Aspects of Food and Nutrition Policy (COMA) (1991) Dietary Reference Values for Food Energy and Nutrients: Report of the Panel on Dietary Reference Values of the Committee on Medical Aspects of Food Policy. London: HMSO.
31. Food Standards Agency (2006) Research into food poverty and homelessness in Northern Ireland – final report. Belfast: Deloitte MCS Limited. (accessed July 2017).
32. Pelham-Burn, SE, Frost, CJ, Russell, JM, et al. (2014) Improving the nutritional quality of charitable meals for homeless and vulnerable adults. a case study of food provision by a food aid organisation in the UK. Appetite 82, 131137.
33. Malmauret, L, Leblanc, J, Cuvelier, I, et al. (2002) Dietary intakes and vitamin status of a sample of homeless people in Paris. Eur J Clin Nutr 56, 313.
34. Wiecha, JL, Dywer, JT, Jacques, PF, et al. (1993) Nutritional and economic advantages for homeless families in shelters providing kitchen facilities and food. J Am Diet Assoc 93, 777783.
35. Evans, NS & Dowler, EA (1999) Food, health and eating among single homeless and marginalized people in London. J Hum Nutr Diet 12, 179199.
36. Hoyumpa, A (1980) Mechanisms of thiamin deficiency in chronic alcoholism. Am J Clin Nutr 33, 27502761.
37. Darnton-Hill, I & Truswell, A (1990) Thiamin status of a sample of homeless clinic attenders in Sydney. Med J Aus 152, 59.
38. National Institute of Clinical Excellence (2010) Alcohol-Use Disorders: Diagnosis and Management of Physical Complications [CG100]. London: NICE Publications.
39. Cook, NR, Cutler, JA, Obarzanek, E, et al. (2007) Long term effects of dietary sodium reduction on cardiovascular disease outcomes: observational follow-up of the trials of hypertension prevention (TOHP). BMJ 334, 885.
40. National Institute of Clinical Excellence (2011) Hypertension: Clinical Management of Primary Hypertension in Adults. NICE Guidelines, CG127. London: NICE Publications.
41. Stenholm, S, Mehta, NK, Elo, IT, et al. (2014) Obesity and muscle strength as long-term determinants of all-cause mortality – a 33-year follow-up of the Mini-Finland Health Examination Survey. Int J Obes 38, 11261132.
42. La Gory, M, Ritchey, FJ & Mullis, J (1990) Depression among the homeless. J Health Soc Behav 31, 87102.
43. Konttinen, H, Männistö, S, Sarlio-Lähteenkorva, S, et al. (2010) Emotional eating, depressive symptoms and self-reported food consumption. A population-based study. Appetite 54, 473479.
44. Faugier, J & Sargeant, M (1997) Sampling hard to reach populations. J Adv Nurs 26, 790797.
45. Office for National Statistics (2012) 2011 census: key statistics for Wales, March 2011 – ethnic group and identity. (accessed June 2017).
46. Friel, S, Kelleher, C, Nolan, G, et al. (2003) Social diversity of Irish adults nutritional intake. Eur J Clin Nutr 57, 865875.
47. McKeown, NM, Day, NE, Welch, AA, et al. (2001) Use of biological markers to validate self-reported dietary intake in a random sample of the European Prospective Investigation into Cancer United Kingdom Norfolk cohort. Am J Clin Nutr 74, 188196.
48. Johnson, LJ, Myung, E, McCool, AC, et al. (2009) Nutrition education for homeless women – challenges and opportunities: a pilot study. J Foodservice Bus Res 12, 155169.
49. Loopstra, R, Reeves, A, Taylor-Robinson, D, et al. (2015) Austerity, sanctions, and the rise of food banks in the UK. BMJ 350, h1775.
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British Journal of Nutrition
  • ISSN: 0007-1145
  • EISSN: 1475-2662
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