Comparing nutrient intake and body weight status amongst adolescent substance users, institutionalised abstainers and never users
Abstract
Background: Improved nutrition intake in drug rehabilitation programmes enhances quality sobriety and prevents relapses. However, little is known about the nutritional status of substance users and institutionalised abstainers. Previous nutritional studies have mainly focused on methamphetamine, whereas ketamine has not been investigated despite its popularity amongst adolescents.
Objectives: To compare nutrient intake and underweight status amongst three groups of adolescents –current substance users, institutionalised abstainers and never users (controls) – and examine the association between ketamine use and nutrient intake.
Design: This is a cross-sectional questionnaire survey which was conducted using face-to-face interview. Substance users (n = 202) and never users (n = 100) were invited through the outreach social workers of three non-government organisations. Abstainers (n = 50) were recruited from three drug rehabilitation centres. Nutrient intake was assessed through two 24-h recalls. Other information collected included anthropometrics, socio-demographic characteristics and substance type used over the previous month.
Results: Only 20.8 and 15.9% of male and female substance users met the daily energy requirements. Male users were less likely to meet the recommended intake of energy [odds ratio (OR) = 0.37] and protein (OR = 0.10) than controls. Overall, abstainers had better intake of beneficial nutrients than substance users. However, abstainers were more likely to overconsume harmful nutrients, such as cholesterol and sodium. Regarding weight status, female substance users (56.1%) were more likely to be underweight than abstainers (14.8%) (OR = 8.85). Amongst underweight female substance users, 52.2% were still trying to lose more weight. Moreover, ketamine users tended to have lower intake of nutrients from animal sources than the users of other drugs.
Conclusions: Adolescent substance users are at risk of energy and nutrient inadequacy. Misconceptions about body weight are disseminating amongst them. The study findings provide valuable information for frontline workers taking care of young substance users and for institutions providing residential rehabilitation programmes.
Downloads
References
- Virmani A, Binienda ZK, Ali SF, Gaetani F. Metabolic syndrome in drug abuse. Ann N Y Acad Sci 2007; 1122: 50–68.
- Virmani A, Binienda Z, Ali S, Gaetani F. Links between nutrition, drug abuse, and the metabolic syndrome. Ann N Y Acad Sci 2006; 1074: 303–14.
- Thompson PM, Hayashi KM, Simon SL, Geaga JA, Hong MS, Sui Y, et al. Structural abnormalities in the brains of human subjects who use methamphetamine. J Neurosci 2004; 24(26): 6028–36.
- Mann JI. Nutrition recommendations for the treatment and prevention of type 2 diabetes and the metabolic syndrome: an evidenced-based review. Nutr Rev 2006; 64(9): 422–7.
- Santolaria-Fernandez FJ, Gomez-Sirvent JL, Gonzalez-Reimers CE, Batista-Lopez JN, Jorge-Hernandez JA, Rodriguez-Moreno F, et al. Nutritional assessment of drug addicts. Drug Alcohol Depend 1995; 38(1): 11–18.
- Forrester JE, Tucker KL, Gorbach SL. Dietary intake and body mass index in HIV-positive and HIV-negative drug abusers of Hispanic ethnicity. Public Health Nutr 2004; 7(7): 863–70.
- Kolarzyk E, Olas J, Janik A, Adamska-Skula M, Pach D. Assessment of nutritional state of alcohol abusers and drug poisoned patients. Przegl Lek 1999; 56(6): 433–7.
- Freeman HE, Klein RE, Townsend JW, Lechtig A. Nutrition and cognitive development among rural Guatemalan children. Am J Public Health 1980; 70(12): 1277–85.
- Nolan LJ, Stolze MR. Drug use is associated with elevated food consumption in college students. Appetite 2012; 58(3): 898–906.
- Arcan C, Kubik MY, Fulkerson JA, Hannan PJ, Story M. Substance use and dietary practices among students attending alternative high schools: results from a pilot study. BMC Public Health 2011; 11: 263.
- Position of the American Dietetic Association: nutrition intervention in treatment and recovery from chemical dependency. J Am Diet Assoc 1990; 90(9): 1274–7.
- Virmani A, Gaetani F, Binienda Z. Effects of metabolic modifiers such as carnitines, coenzyme Q10, and PUFAs against different forms of neurotoxic insults: metabolic inhibitors, MPTP, and methamphetamine. Ann N Y Acad Sci 2005; 1053: 183–91.
- Nazrul Islam SK, Jahangir Hossain K, Ahsan M. Serum vitamin E, C and A status of the drug addicts undergoing detoxification: influence of drug habit, sexual practice and lifestyle factors. Eur J Clin Nutr 2001; 55(11): 1022–7.
- Bobo WV, Miller SC. Ketamine as a preferred substance of abuse. Am J Addict 2002; 11(4): 332–4.
- Narcotics Division Security Bureau Hong Kong SAR. Newly/previously reported drug abusers by age group by common type of drugs abused (T3). Government of Hong Kong SAR.
- Sahni S, Forrester JE, Tucker KL. Assessing dietary intake of drug-abusing Hispanic adults with and without human immunodeficiency virus infection. J Am Diet Assoc 2007; 107(6): 968–76.
- De Lorenzo A, Bertini I, Puijia A, Testolin G, Testolin C. Comparison between measured and predicted resting metabolic rate in moderately active adolescents. Acta Diabetol 1999; 36(3): 141–5.
- Kim S, Haines PS, Siega-Riz AM, Popkin BM. The Diet Quality Index-International (DQI-I) provides an effective tool for cross-national comparison of diet quality as illustrated by China and the United States. J Nutr 2003; 133(11): 3476–84.
- The Chinese University of Hong Kong Department of Biochemistry. Hong Kong population-based food consumption survey 2005–2007 Final Report. Government of Hong Kong SAR 2010.
- United States Department of Agriculture. Dietary reference intakes tables. Available from: https://www.nal.usda.gov/fnic/dri-tables-and-application-reports [cited 2 July 2019].
- Spear BA. Adolescent growth and development. J Am Diet Assoc 2002; 102(3 Suppl): S23–9.
- Klesges RC, Klesges LM, Eck LH, Shelton ML. A longitudinal analysis of accelerated weight gain in preschool children. Pediatrics 1995; 95(1): 126–30.
- Moller JH, Taubert KA, Allen HD, Clark EB, Lauer RM. Cardiovascular health and disease in children: current status. A special writing group from the task force on children and youth, American Heart Association. Circulation 1994; 89(2): 923–30.
- Huncharek M, Muscat J, Kupelnick B. Colorectal cancer risk and dietary intake of calcium, vitamin D, and dairy products: a meta-analysis of 26,335 cases from 60 observational studies. Nutr Canc 2009; 61(1): 47–69.
- Eicher-Miller HA, Mason AC, Weaver CM, McCabe GP, Boushey CJ. Food insecurity is associated with iron deficiency anemia in US adolescents. Am J Clin Nutr 2009; 90(5): 1358–71.
- Chan SM, Nelson EA, Leung SS, Li CY. Postnatal iron status of Hong Kong Chinese women in a longitudinal study of maternal nutrition. Eur J Clin Nutr 2001; 55(7): 538–46.
- Dallman PR. Iron deficiency and the immune response. Am J Clin Nutr 1987; 46(2): 329–34.
- Foo LH, Khor GL, Tee ES, Prabakaran D. Iron status and dietary iron intake of adolescents from a rural community in Sabah, Malaysia. Asia Pac J Clin Nutr 2004; 13(1): 48–55.
- Hoppe M, Sjoberg A, Hallberg L, Hulthen L. Iron status in Swedish teenage girls: impact of low dietary iron bioavailability. Nutrition 2008; 24(7–8): 638–45.
- Cochrane C, Malcolm R, Brewerton T. The role of weight control as a motivation for cocaine abuse. Addict Behav 1998; 23(2): 201–7.
- Aguado L, San Antonio A, Perez L, del Valle R, Gomez J. Effects of the NMDA receptor antagonist ketamine on flavor memory: conditioned aversion, latent inhibition, and habituation of neophobia. Behav Neural Biol 1994; 61(3): 271–81.
- Story M, Van Zyl York P. Nutritional status of Native American adolescent substance users. J Am Diet Assoc 1987; 87(12): 1680–1.
Authors retain copyright of their work, with first publication rights granted to SNF Swedish Nutrition Foundation. Read the full Copyright- and Licensing Statement.