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

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 to dietary reference values as opposed to a comparative housed population. Additionally, 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 EPIC Norfolk Food Frequency Questionnaire. 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 (8.0g vs. 6.4g, P=0.017), SFA (14.6% vs. 13.0%, P=0.002) and alcohol (5.3% vs. 1.9%, P<0.001) and lower intakes of fibre (13.4g vs. 16.3g, P<0.001), vitamin C (79mg vs. 109mg, P<0.001) and fruit (96g vs. 260g, 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% vs.15.0%, P=0.010), calcium (858mg vs. 1032mg, P=0.027) and milk intakes (295g vs. 449g, 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.