Hostname: page-component-6b989bf9dc-g5k2d Total loading time: 0 Render date: 2024-04-14T13:56:43.711Z Has data issue: false hasContentIssue false
  • English
  • Français

Dietary inadequacies observed in homeless men visiting an emergency night shelter in Paris

Published online by Cambridge University Press:  27 September 2007

Nicole Darmon ,
J Coupel ,
M Deheeger  and
A Briend
Nicole Darmon*
Affiliation:
Institut National de la Santé et de la Recherche Médicale/Institut Scientifique et Technique de la Nutrition et de l'Alimentation, 5 rue du Vertbois, 75003 Paris, France
J Coupel
Affiliation:
Association des Cités du Secours Catholique, 17 Bd Ney, 75018 Paris, France
M Deheeger
Affiliation:
Institut National de la Santé et de la Recherche Médicale/Institut Scientifique et Technique de la Nutrition et de l'Alimentation, 5 rue du Vertbois, 75003 Paris, France
A Briend
Affiliation:
Institut National de la Santé et de la Recherche Médicale/Institut Scientifique et Technique de la Nutrition et de l'Alimentation, 5 rue du Vertbois, 75003 Paris, France Institut de Recherche pour le Développement, Paris, France
*
*Corresponding author: Email darmon@cnam.fr
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objective

To assess the dietary intake and the nutritional status of homeless men.

Setting

A night emergency shelter in Paris, France.

Design

Dietary survey (48-h) including alcohol intake and a questionnaire on age, duration of homelessness, smoking habits. Subjects were also weighed and measured.

Subjects

Ninety-seven men aged 18–72 years (mean 43.3), of whom 54% were homeless for more than 18 months, 82% were smokers and 53% were regular and/or excessive drinkers.

Results

The BMI distribution was shifted towards low values, the percentage of wasted persons being four times higher than in the reference population. The mean total energy intake was 2376 kcal (SD = 879) and included a high and highly variable percentage of energy derived from alcohol (12.0% (SD = 18.1)). Among drinkers, the mean ethanol intake was 90 g (SD = 102) and there was a significant negative correlation between ethanol and non-alcoholic energy intakes. The median intakes of potassium, calcium, zinc, vitamins B1, B2, and niacin were lower than European Population Reference Intakes but only the mean intake of vitamin B1 was significantly lower. Eighty percent of non-alcoholic energy was provided by charitable organisations. For most nutrients, the nutritional density of the shelter ration was not significantly different from the density of the foods purchased by the homeless.

Conclusions

These data suggest that the content of some nutrients should be increased in existing food assistance programs for homeless people in France.

Keywords

Homeless menNutrient intakeAlcohol intakeBody Mass IndexFood aidEmergency shelterFrance
Type
Research Article
Information
Public Health Nutrition , Volume 4 , Issue 2 , April 2001 , pp. 155 - 161
Copyright
Copyright © CABI Publishing 2001

References

1Shaw, M, Dorling, D.Mortality among street youth in the UK [letter]. Lancet 1998; 352: 743.CrossRefGoogle ScholarPubMed
2Barrow, SM, Herman, DB, Córdova, P, Struening, EL. Mortality among homeless shelter residents in New York City. Am J. Public Health 1999; 89: 529–34.CrossRefGoogle ScholarPubMed
3Hwang, SW, Lebow, JM, Bierer, MF, O'Connell, JJ, Orav, EJ, Brennan, TA. Risk factors for death in homeless adults in Boston. Arch. Intern. Med. 1998; 158: 1454–60.CrossRefGoogle ScholarPubMed
4Takano, T, Nakamura, K, Takeuchi, S, Watanabe, M.Disease patterns of the homeless in Tokyo. J. Urban Health 1999; 76: 73–84.CrossRefGoogle ScholarPubMed
5Shanks, NJ. Medical morbidity of the homeless. J. Epidemiol. Community Health 1988; 42: 183–6.CrossRefGoogle ScholarPubMed
6Vredevoe, DL, Brecht, ML, Shuler, P, Woo, M.Risk factors for disease in a homeless population. Public Health Nurs. 1992; 9: 263–9.CrossRefGoogle Scholar
7Darnton-Hill, I, Mandryk, JA, Mock, PA, Lewis, J, Kerr, CB. Sociodemographic and health factors in the well-being of homeless men in Sydney, Australia. Soc. Sci. Med. 1990; 31: 537–44.Google Scholar
8Marpsat, M, Firdion, J. Les personnes sans domicile à Paris. In: Pumain, D, Mattei, M, eds. Données Urbaines. Paris: Anthropos, 1998: 217–30.Google Scholar
9Laven, GT, Brown, KC. Nutritional status of men attending a soup kitchen: a pilot study. Am. J. Public Health 1985; 75: 875–8.CrossRefGoogle ScholarPubMed
10Wolgemuth, JC, Myers-Williams, C, Johnson, P, Henseler, C.Wasting malnutrition and inadequate nutrient intakes identified in a multiethnic homeless population. J. Am. Diet. Assoc. 1992; 92: 834–9.CrossRefGoogle Scholar
11Luder, E, Boey, E, Buchalter, B, Martinez-Weber, C.Assessment of the nutritional status of urban homeless adults. Public Health Rep. 1989; 104: 451–7.Google ScholarPubMed
12Silliman, K, Yamanoha, MM, Morrissey, AE. Evidence of nutritional risk in a population of homeless adults in rural northern California. J. Am Diet. Assoc. 1998; 98: 908–10.CrossRefGoogle Scholar
13Firdion, J, Marpsat, M, Mizrahi, A.Vie et Santé des personnes sans domicile à Paris. Bulletin d'Information en Economie de la Santé (Credes) 1998; 13: 1–4.Google Scholar
14 Observatoire du Samu Social, De la grande précarité à la grande exclusion. Etude epidémiologique à parti des données (année 1998) du logiciel du numéro d'urgence pour les sans-abri (le 115). 1999.Google Scholar
15Le Moullec, N, Deheeger, M, Preziosi, P, Hercberg, S.Validation du manuel photographique utilisé pour l'enquête alimentaire de l'étude SU.VI.MAX. Cah. Nutr. Diét 1996; 31: 158–64.Google Scholar
16Favier, J, Ireland-Ripert, J, Toque, C, Feinberg, M. CIQUAL. Répertoire Général des Aliments. Table de composition. Paris: Lavoisier, Tec & Doc, 2nd edition, 1995.Google Scholar
17Lamand, M, Tressol, J, Ireland-Ripert, J, Favier, J, Feinberg, M. CIQUAL. Répertoire Général des Aliments. Tome 4. Table de composition minérale. Paris: Lavoisier, Tec & Doc, First edition, 1996.Google Scholar
18Rolland-Cacheza, MF, Cole, TJ, Sempé, M, Tichet, J, Rossignol, C, Charraud, A.Body Mass Index variations: centiles from birth to 87 years. Eur. J. Clin. Nutr. 1991; 45: 13–21.Google Scholar
19Cole, TJ. The LMS method for constructing normalized growth standards. Eur. J. Clin. Nutr. 1990; 44: 45–60.Google ScholarPubMed
20Scientific Committee for Food. Nutrient and energy intakes for the European Community. Luxembourg: Commission of the European Communities, 1993.Google Scholar
21Dupin, H, Abraham, J, Giachetti, I. Apports Nutritionnels Conseillés pour la population française. Paris: Lavoisier Tec & Doc, 2nd edition, 1992.Google Scholar
22Food and Nutrition Board. Recommended Dietary Allowances. Washington D.C.: National Academy Press, 10th edition, 1989.Google Scholar
23 Déontologie et bonnes pratiques en épidémiologie, recom-mandations de l'Association des épidémiologistes de langue française. ADELF Report, 1998.Google Scholar
24Volatier, J-L, Verger, P.French food and nutrient intake data. Br. J. Nutr. 1999; 81: S57–9.CrossRefGoogle ScholarPubMed
25Hercberg, S, Preziosi, P, Galan, P, Deheeger, M, Dupin, H.Apports nutritionnels d'un échantillon représentatif de la population du Val-de-Marne: II. Les apports en macronutriments [Dietary intake of a representative sample of the population of Val-de-Marne; II. Energetic nutrient intakes]. Rev. Epidémiol. Santé. Publique 1991; 39: 233–44.Google Scholar
26Galan, P, Lafond, J, Arnaud, J, Preziosi, P, Durlach, V, Duport, N, Valeix, P, Bouzid, D, Favier, A, Hercberg, S.Apports alimentaires et statut biologique en magnésium dans la population adulte en France. Cah. Nutr. Diet. 1999; 32: 88–93.Google Scholar
27Naveau, S, Borotto, E, Giraud, V, Bardou, M, Aubert, A, Lazizi, Y, Capron, F, Poynard, T, Chaput, JC. Descriptive epidemiology of patients with alcoholic liver disease hospitalized in a hepato-gastroenterology service. Gastroenterol. Clin. Biol. 1999; 23: 544–51.Google Scholar
28Guilland, JC, Boggio, V, Moreau, D, Klepping, J.Evaluation de l'apport alimentaire vitaminique en Bourgagne (France) [Evaluation of dietary vitamin intake in Burgundy (France)] Ann. Nutr. Metab. 1986; 30: 21–46.CrossRefGoogle Scholar
29Darnton-Hill, I, Ash, S.Dietary and alcohol intake patterns of a sample of homeless men in Sydney, Australia. J. Hum. Nutr. Diet. 1988; 1: 397–408.CrossRefGoogle Scholar
30Fichter, M, Quadflieg, N, Greifenhagen, A, Koniarczyk, M, Wölz, J.Alcoholism among homeless men in Munich, Germany. Eur. Psychiatry 1997; 12: 64–74.CrossRefGoogle ScholarPubMed
31Rushton, C, Wheeler, E.The dietary intake of homeless males sleeping rough in Central London. J. Hum. Nutr. Diet. 1993; 6: 443–56.Google Scholar
32WHO. Physical status: the use and interpretation of anthropometry. Report of a WHO expert committee. Technical report Series no 854. Geneva: World Health Organization, 1999.Google Scholar
33Addolorato, G, Capristo, E, Greco, AV, Stefanini, GF, Gasbarrini, G.The influence of chronic alcohol abuse on body weight and energy metabolism: is excess ethanol consumption a risk factor for obesity or malnutrition? J. Intern. Med. 1998; 244: 387–95.CrossRefGoogle ScholarPubMed
34Gloria, L, Cravo, M, Camilo, ME, Resende, M, Cardoso, JN, Oliveira, AG, Leitão, CN, Mira, FC. Nutritional deficiencies in chronic alcoholics: relation to dietary intake and alcohol consumption. Am. J. Gastroenterol. 1997; 92: 485–9.Google ScholarPubMed
35Goldsmith, RH, Iber, FL, Miller, PA. Nutritional status of alcoholics of different socioeconomic class. J. Am Coll. Nutr. 1983; 2: 215–20.CrossRefGoogle ScholarPubMed
36Gruchow, HW, Sobocinski, KA, Barboriak, JJ, Scheller, JG. Alcohol consumption, nutrient intake and relative body weight among US adults. Am. J. Clin. Nutr. 1985; 42: 289–95.CrossRefGoogle ScholarPubMed
37Kanis, J, Johnell, O, Gullberg, B, Allander, E, Elffors, L, Ranstam, J, Dequeker, J, Dilsen, G, Gennari, C, Vaz, AL et al. Risk factors for hip fracture in men from southern Europe: the MEDOS study. Mediterranean Osteoporosis Study. Osteoporos. Int. 1999; 9: 45–54.CrossRefGoogle ScholarPubMed
38Spencer, H, Rubio, N, Rubio, E, Indreika, M, Seitam, A.Chronic alcoholism. Frequently overlooked cause of osteoporosis in men. Am J. Med. 1986; 80: 393–7.CrossRefGoogle ScholarPubMed
39de Vernejoul, MC, Bielakoff, J, Herve, M, Gueris, J, Hott, M, Modrowski, D, Kuntz, D, Miravet, L, Ryckewaert, A.Evidence for defective osteoblastic function. A role for alcohol and tobacco consumption in osteoporosis in middle-aged men. Clin. Orthop. 1983; 179: 107–15.Google Scholar
40Crilly, RG, Delaquerrière, RL. Current bone mass and body weight changes in alcoholic males. Calcif. Tissue Int. 1990; 46: 169–72.CrossRefGoogle ScholarPubMed
41Cross, CE, Halliwell, B.Nutrition and human disease: how much extra vitamin C might smokers need? Lancet 1993; 341: 1091.CrossRefGoogle ScholarPubMed
42Lecomte, E, Herbeth, B, Pirollet, P, Chancerelle, Y, Arnaud, J, Musse, N, Paille, F, Siest, G, Artur, Y.Effect of alcohol consumption on blood antioxidant nutrients and oxidative stress indicators. Am. J. Clin. Nutr. 1994; 60: 255–61.CrossRefGoogle ScholarPubMed
43de Bree, A, van Dusseldorp, M, Brouwer, IA, van Het, H, Steegers, TR. Folate intake in Europe: recommended, actual and desired intake. Eur. J. Clin. Nutr. 1997; 51: 643–60.CrossRefGoogle ScholarPubMed
44Darnton-Hill, I, Truswell, AS. Thiamin status of a sample of homeless clinic attenders in Sydney. Med. J. Aust. 1990; 152: 5–9.CrossRefGoogle ScholarPubMed
45Cook, CC, Hallwood, PM, Thomson, AD. B Vitamin deficiency and neuropsychiatric syndromes in alcohol misuse. Alcohol Alcohol 1998; 33: 317–36.CrossRefGoogle ScholarPubMed
46Cravo, ML, Glória, LM, Selhub, J, Nadeau, MR, Camilo, ME, Resende, MP, Cardoso, JN, Leitão, CN, Mira, FC. Hyperhomocysteinemia in chronic alcoholism: correlation with folate, vitamin B-12, and vitamin B-6 status. Am J. Clin. Nutr. 1996; 63: 220–4.Google Scholar
47Connelly, L, Price, J.Preventing the Wernicke–Korsakoff syndrome in Australia: cost-effectiveness of thiamin-supplementation alternatives. Aust. N. Z. J. Public Health 1996; 20: 181–7.Google Scholar
48Taylor, ML, Koblinsky, SA. Dietary intake and growth status of young homeless children. J. Am. Diet. Assoc. 1993; 93: 464–6.CrossRefGoogle ScholarPubMed
49Lecomte, T, Mizrahi, A.Recours aux soins et morbidité des personnes sans domicile permanent en région parisienne [Recourse to care and morbidity of the homeless in the Paris district]. Bull. Acad. Natl. Med. 1997; 181: 1715–27.Google Scholar
50Fain, O, Thomas, M.Le scorbut actuellement. Cah. Nutr. Diet. 1997; 32: 300–5.Google Scholar
51Wiecha, JL, Dwyer, JT, Jacques, PF, Rand, WM. Nutritional and economic advantages for homeless families in shelters providing kitchen facilities and food. J. Am. Diet. Assoc. 1993; 93: 777–83.CrossRefGoogle ScholarPubMed
52Derrickson, JP, Widodo, MM, Jarosz, LA. Providers of food to homeless and hungry people need more dairy, fruit, vegetable, and lean-meat items. J. Am. Diet. Assoc. 1994; 94: 445–6.CrossRefGoogle ScholarPubMed
53Jacobs, SL, Gray, DK, Kuhnlein, HV. Nutrient intake of food bank users is related to frequency of food bank use, household size, smoking, education and country of birth. J. Nutr. 1999; 129: 883–9.Google Scholar
54Harper, CG, Sheedy, DL, Lara, AI, Garrick, TM, Hilton, JM, Raisanen, J.Prevalence of Wernicke–Korsakoff syndrome in Australia: has thiamine fortification made a difference? Med. J. Aust. 1998; 168: 542–5.CrossRefGoogle ScholarPubMed