An NIHR CLAHRC West review has found that heavy drinking homeless people may experience a range of nutrient deficiencies, including vitamin B1, but the amount and quality of research on this issue is low.

People who are homeless and heavy drinkers are at risk of developing diseases associated with both a high alcohol intake and malnutrition. Alcohol dependency can lead to malnutrition as it damages the stomach and gut, reducing the body’s ability to absorb nutrients from food. This can lead to brain damage and other conditions.

Malnutrition is often only considered to be a problem for very thin people. But heavy drinkers can be overweight and malnourished because alcohol contains a lot of calories but doesn’t contain important nutrients.

Advice on preventing malnutrition is often unsuitable for homeless people, who have limited access to cooking facilities and little money. To find the best way to tackle this problem, CLAHRC West researchers reviewed the findings of studies on this topic.

The limited evidence they found shows that there are deficiencies, including vitamin B1 and many other micronutrients, at varying levels across this population that haven’t been studied in enough detail. So further research is needed to identify all potentially harmful deficiencies, what nutrients are needed and who needs them. This would help ensure that those needs are met.

They teamed up with people who have worked with homeless problem drinkers in Bristol for several years, who contributed invaluably to the design of the project and interpreting findings. Clare Fleming is a clinician at Compass Health, and Katie Porter is a Public Health Specialist at Bristol City Council.

Professor Adrian Bonner, University of Stirling, is an expert on alcohol addiction and nutrition and has worked with charities including the Salvation Army. He advised on the relationship between alcohol and nutrition in homeless drinkers.

Their findings have been published in the International Journal of Equity and Health. They are also working on a further review looking at what could be done to reduce or cure nutrient deficiencies in homeless drinkers.

Paper

‘Nutritional deficiencies in homeless persons with problematic drinking: a systematic review‘: Sharea Ijaz, Joni Jackson, Helen Thorley, Katie Porter, Clare Fleming, Alison Richards, Adrian Bonner and Jelena Savović. Published in the International Journal of Equity and Health