Health and Nutrition Survey in a Group of Urban Homeless Adults

Homeless persons eat foods from municipal and privately run shelters, fast-food restaurants, delicatessens, and garbage bins. Data on the adequacy of the diets and the nutritional status of homeless persons are sparse. Therefore, we surveyed the nutritional adequacy of the dietary intake, the quality of shelter meals, and objective clinical parameters indicative of nutritional status in a heterogeneous group of urban homeless persons. The group comprised mentally ill persons, alcohol and illicit drug users, and temporarily unemployed persons. Although 86 of the 96 subjects (90%) in our survey reported that they obtained enough to eat, a low dietary adequacy score, which was based on the basic four food groups, of 10.7 (norm = 16) indicated that the quality of their diets was inadequate. Shelter meals and diet records showed a high level of saturated fat and cholesterol. Serum cholesterol levels above the desirable limit of 5.17 mmol/L (200 mg) were observed in 79 subjects (82%). In addition to a prevalence of hypertension and obesity (observed in 37 subjects [39%], these homeless persons were at high risk for development of or worsening of cardiovascular disease. We conclude that homeless persons who obtain meals at shelters are getting enough to eat. However, the shelter meals should be modified to meet the nutritional needs and dietary prescriptions of the large number of clients who suffer from various health disorders.