Prison deprivation and protein nutritional status of inmates of a developing community prison

Objective: This study assesses the protein nutritional status of inmates of a small prison, in the light of a changing serum protein pattern in the environment. Design: Survey of prison inmates. Setting: A male prison and low social class hospital workers. Subjects: 81 inmates and 62 randomly selected controls, of which 42 of the former and 28 of the latter were further randomly selected. Methods: Nutritional and confinement history were obtained by a questionnaire. Weights and heights were measured and serum and urine samples collected for protein estimations. Results: The prisoners were confined for 229.1 (SD 210.1) days. 48.1% had BMI less than or equal to 20 kg/m(2) compared to 28.6% of controls (p = 0.04). Their diet was predominantly carbohydrate. Mean total serum protein was 81.5 gm/L (6.1) (95% CI = 79.3-83.5) (prisoners); 88.7 gm/L (8.1) (95% CI = 85.7-91.7) (controls). Serum globulin was 44.9 gm/L (6.3) (95% CI = 42.9-46.9) (prisoners); 55.4 gm/L (8.2) (95% CI = 52.3-58.5) (controls) (p < 0.001 respectively). More prisoners than controls bad severe hypoalbuminaemia (p = 0.001). All values were lower in those awaiting trial compared to convicted inmates. Total protein and albumin weakly correlated with duration of confinement (r = -0.23 and -0.15, respectively). Conclusion: The study suggests that the prisoners might be undernourished with lower serum proteins than controls, within an average of seven months confinement. The picture appears worse in those awaiting trial and with prolonged duration of confinement.