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What is it about nutrition choice that makes a homeless alcoholic?

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On what type of nutrition did homeless alcoholics grow up, such as foods and drink eaten throughout childhood? Was it highly processed, fatty, salty, sugar foods, such as the highest calorie choices of the fast food varieties together with childhood drinking of alcohol, a lack of raw vegetables and fruits, and absence of green juice drinks made from leafy vegetables such as kale and spinach? Actually, growing up a homeless alcoholic from early childhood starts with childhood drinking of alcohol and often comfort foods or greasy meats and fried foods, intense sweetness of snacks or salty, fatty snacks...but most often, simply drinking alcoholic beverages from childhood. Alcoholics, beginning in childhood, often crave intense sweetness from foods such as snacks and desserts, according to research, "Study Links Children's Sweet Tooth To Alcoholism, Depression."

One study found that children are more likely to have an intense sweet tooth if they have a family history of alcoholism, or if they've suffered from depression themselves. And another study revealed that drinking alcohol began in childhood for those who are both homeless and alcoholic. In the study, "Voices of Homeless Alcoholics Who Frequent Bellevue Hospital: A Qualitative Study," published online June 26, 2014 in Annals of Emergency Medicine, conducted at Bellevue Hospital in New York City, which has a long history of service to the city's indigent population, researchers found that for the homeless alcoholic, drinking alcohol began in childhood. Could craving for alcohol and sweets starting in childhood have a connection?

A phenomenological study offers detailed insights into homeless, alcohol-dependent patients often stigmatized by the public and policymakers as drains on the health care system, showing the constellation of reasons they are incapable of escaping social circumstances that perpetuate and exacerbate their problems. "One hundred percent of patients enrolled in the study began drinking alcohol as children, becoming alcohol-dependent shortly thereafter," said study author Ryan McCormack, MD, according to the June 27, 2014 news release, "Homeless alcoholics typically began drinking as children." McCormack is with the New York University School of Medicine in New York, N.Y.

"For people who have homes and jobs, it is difficult to imagine the level of despair these people experience day in and day out, or the all-consuming focus on getting the next drink that overrides even the most basic human survival instinct. Most do not come to my ER voluntarily, but end up there because of public intoxication. The majority of patients in this study consistently left the hospital prior to the completion of medical care."

Dr. McCormack and his team interviewed 20 homeless, alcohol-dependent patients who had four or more annual visits to Bellevue Hospital's emergency department for two consecutive years. All began drinking in childhood or adolescence, and 13 reported having alcoholic parents. Thirteen patients reported abuse in their childhood homes.

Nineteen were either forced to or chose to leave home by age 18. Only one was married. None of the subjects was employed. The three who were military veterans said that military life amplified their alcohol use. Readers may wonder about what is there about military live that increases the risk of using alcohol.

Mental illness also may be found in some, but not all homeless alcoholics

Stress usually is the first to come to mind, the other possible motivations to amplify alcohol use might be the type of jobs performed and whether the worked helped some to reach their maximum potential or promoted them above their potential or underused their abilities. But alcohol was named as the reason for homeless addicts to live on the street. Not everybody who becomes homeless has mental illnesses, and not every homeless person is an alcoholic or other type of addict. Some people just have difficulties finding or qualifying for sources of income, food, and shelter or lack transportation, and some aren't able to walk too far due to health issues.

Noteworthy was that alcohol rather than street drugs were named, and others involved in working with homeless alcoholics may wonder whether nutrition also played a part in how these people came to be homeless and alcoholic, compared to the homeless who are not addicted to alcohol, but may be homeless due to a host of other reasons from unemployment to health issues such as mental illness.

Military life amplified alcohol use for some homeless alcoholics

Alcoholism was cited as the primary reason for living on the street. Eleven patients had definitive psychiatric diagnoses in the psychotic, mood or anxiety spectrums. All 20 reported having entered detoxification programs at some point in the past. Within a year of being interviewed for this study, one-quarter of the patients had died as a direct result of their alcoholism from liver or lung cancer, vehicular trauma, assault or hypothermia.

"As their capacity to envision a future diminishes, they increasingly lose motivation for personal recovery," said Dr. McCormack, according to the news release. "An alcoholic is first a human being. We hypothesize that more accessible, lower-barrier, patient-centered interventions that support alcohol harm reduction and quality of life improvement can be translated into the emergency department setting and this population."

Annals of Emergency Medicine is the peer-reviewed scientific journal for the American College of Emergency Physicians, the national medical society representing emergency medicine. ACEP is committed to advancing emergency care through continuing education, research, and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies.

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