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Objective assessment of dietary exposure and cardiometabolic risk in homeless adults

Homelessness is frequently associated with nutritionally imbalanced diets. Previously 24-hour recalls and food frequency question-naires (FFQ) were used to retrospectively quantify nutritional intake in homeless adults, however these methods are prone to misre-porting. Furthermore, memory recall may be confounded in the homeless community whereby greater incidences of reward mediated behaviour are reported (1) . We aimed to pilot the use of dried blood spot (DBS) sampling to assess dietary exposure and cardiometabolic risk factors in homeless adults (n = 20) residing in hostel accommodation, and sex- and age-matched housed adults (n = 20) recruited from Reading, UK. Self-reported diet was determined using the EPIC-Norfolk FFQ, and diet quality via the Healthy Eating Index (HEI-2015). DBS were analysed for c-reactive protein (CRP), total cholesterol and fatty acids using LC-MS (Vitas AS, Norway). Vascular function was assessed using a portable digital-volume-pulse monitor (Mobil-O-Graph®). The Health Science Engineering & Technology ECDA at the University of Hertfordshire (aLMS/SF/UH/02498(1)), Research and Ethics Committee at the University of Reading (UREC 17/31) and The Salvation Army Ethics Committee granted ethical approval for the study, which was conducted according to the guidelines laid down in the Declaration of Helsinki. Hostel residents were matched for (mean 43years), (40%