Nutritional deficiencies in homeless persons with problematic drinking: a systematic reviewReportar como inadecuado

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International Journal for Equity in Health

, 16:71

First Online: 05 May 2017Received: 18 January 2017Accepted: 24 April 2017DOI: 10.1186-s12939-017-0564-4

Cite this article as: Ijaz, S., Jackson, J., Thorley, H. et al. Int J Equity Health 2017 16: 71. doi:10.1186-s12939-017-0564-4


BackgroundA significant proportion of homeless people drink alcohol excessively and this can lead to malnutrition and consequent medical problems. The aim of this review was to assess the evidence on the range of nutritional deficiencies in the homeless problem-drinking populations.

MethodsWe conducted a comprehensive search of nine scientific literature databases and 13 grey literature sources. We included studies of any design that included homeless population with problem-drinking and reported measures of nutritional deficiencies in urine or blood. Study selection and data extraction was done by one reviewer and checked by another. Data on malnutrition profile were summarized narratively.

ResultsWe found nine studies reporting nutritional deficiencies in homeless populations with problem-drinking. The oldest study was from the 1950s and the most recent from 2013. The following nutrients were reported across studies: vitamins B1, B2, B6, B9, B12, C, A, and E; haemoglobin; and albumin. The most common deficiencies reported were of vitamin B1 prevalence of deficiency was 0, 2, 6, 45, and 51% in five studies and vitamin C 29, 84, and 95% in three studies. None of the studies were assessed to be at a low risk of bias.

ConclusionsThe limited, low quality and relatively old evidence suggests that homeless people who drink heavily may be deficient in vitamin C, thiamine, and other nutrients. New, well conducted studies are needed in order to optimally inform public health interventions aimed at improving deficiencies in this population.

Trial RegistrationPROSPERO CRD42015024247

KeywordsHomeless Alcohol Systematic review Problem drinking Malnutrition AbbreviationsAandEAccident and emergency





B5Pantothenic acid



B9Folic acid



HPLCHigh performance liquid chromatography

IQRInterquartile range


NRNot reported

P5PPyridoxal 5 phosphate

PLPPyridoxal 5 phosphate

TDPThiamine diphosphate


TPPThiamine pyrophosphate

Vit ARetinol-beta carotene

Vit CAscorbic acid

Vit DErgo-cholecalciferol

Vit ETocopherols

Electronic supplementary materialThe online version of this article doi:10.1186-s12939-017-0564-4 contains supplementary material, which is available to authorized users.

Autor: Sharea Ijaz - Joni Jackson - Helen Thorley - Katie Porter - Clare Fleming - Alison Richards - Adrian Bonner - Jelena Savov


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