Skip to main content

Advertisement

SpringerLink
Log in

Nutritional intake and status in persons with alcohol dependency: data from an outpatient treatment programme

  • Original Contribution
  • Published:
European Journal of Nutrition Aims and scope Submit manuscript

Abstract

Purpose

Malnutrition increases the risk of developing alcohol-related complications. The aim of this study was to describe nutrient intake, nutritional status and nutrition-related complications in a Danish population of outpatients with alcohol dependency.

Methods

This was a cross-sectional study with a 6-month follow-up enrolling persons with alcohol dependency (n = 80) admitted to a hospital-based outpatient clinic. Body mass index, the waist-to-hip ratio and handgrip strength (HGS) were measured, a 7-day food diary was collected, and biochemical testing was conducted. Dual-energy X-ray absorptiometry was performed to determine body composition and bone mineral density (BMD).

Results

In total, 64 % of the patients with alcohol dependency had vitamin D insufficiency (25-OH-vit D <50 nmol/l). Compared with surveys of the general population, the patients with alcohol dependency had lower energy intake (p = 0.008), s-zinc levels (p < 0.001), s-magnesium levels (p = 0.02), Z-scores for BMD (lumbar spine, p = 0.03; total hip, p = 0.009) and HGS (p < 0.001). Osteopenia was observed in 52 % of individuals, and overt osteoporosis was noted in 7 %. Comparing baseline data with data from the follow-up (n = 30), we found a decrease in s-CRP (p = 0.002) and s-alanine amino transferase (p = 0.01) levels and an increase in s-parathyroid hormone levels (p = 0.02).

Conclusions

Patients with alcohol dependency have an altered nutritional status and risk of complications, as evidenced by osteopenia/osteoporosis and reduced muscle strength. Treatment at an outpatient clinic improved the variables related to liver function, but no change was observed in nutritional status over time. These findings suggest that specific screening and targeted treatment regimens for nutritional deficits could be beneficial.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Gonzalez-Reimers E, Garcia-Valdecasas-Campelo E, Santolaria-Fernandez F, Sanchez-Perez MJ, Rodriguez-Rodriguez E, Gomez-Rodriguez MA, Vina-Rodriguez J (2008) Prognostic value of nutritional status in alcoholics, assessed by double-energy X-ray absorptiometry. Alcohol Alcohol 43:314–319

    Article  CAS  Google Scholar 

  2. Santolaria F, Perez-Manzano JL, Milena A, Gonzalez-Reimers E, Gomez-Rodriguez MA, Martinez-Riera A, eman-Valls MR, De La Vega-Prieto MJ (2000) Nutritional assessment in alcoholic patients. Its relationship with alcoholic intake, feeding habits, organic complications and social problems. Drug Alcohol Depend 59:295–304

    Article  CAS  Google Scholar 

  3. Becker U, Gronbaek M, Johansen D, Sorensen TI (2002) Lower risk for alcohol-induced cirrhosis in wine drinkers. Hepatology 35:868–875

    Article  Google Scholar 

  4. Lieber CS (2000) ALCOHOL: its metabolism and interaction with nutrients. Annu Rev Nutr 20:395–430

    Article  CAS  Google Scholar 

  5. Rotily M, Durbec JP, Berthezene P, Sarles H (1990) Diet and alcohol in liver cirrhosis: a case-control study. Eur J Clin Nutr 44:595–603

    CAS  Google Scholar 

  6. Biery JR, Williford JH Jr, McMullen EA (1991) Alcohol craving in rehabilitation: assessment of nutrition therapy. J Am Diet Assoc 91:463–466

    CAS  Google Scholar 

  7. Mobarhan SA, Russell RM, Recker RR, Posner DB, Iber FL, Miller P (1984) Metabolic bone disease in alcoholic cirrhosis: a comparison of the effect of vitamin D2, 25-hydroxyvitamin D, or supportive treatment. Hepatology 4:266–273

    Article  CAS  Google Scholar 

  8. Corrao G, Bagnardi V, Zambon A, Torchio P (1998) Meta-analysis of alcohol intake in relation to risk of liver cirrhosis. Alcohol Alcohol 33:381–392

    Article  CAS  Google Scholar 

  9. Santolaria F, Gonzalez-Reimers E, Perez-Manzano JL, Milena A, Gomez-Rodriguez MA, Gonzalez-Diaz A, Vega L, Martinez-Riera A (2000) Osteopenia assessed by body composition analysis is related to malnutrition in alcoholic patients. Alcohol 22:147–157

    Article  CAS  Google Scholar 

  10. Romero JC, Santolaria F, Gonzalez-Reimers E, az-Flores L, Conde A, Rodriguez-Moreno F, Batista N (1994) Chronic alcoholic myopathy and nutritional status. Alcohol 11:549–555

    Article  CAS  Google Scholar 

  11. Peng S, Plank L, McCall J, Gillanders L, McIlroy K, Gane E (2007) Body composition, muscle function, and energy expenditure in patients with liver cirrhosis: a comprehensive study. Am J Clin Nutr 85:1257–1266

    CAS  Google Scholar 

  12. Jarvis CM, Hayman LL, Braun LT, Schwertz DW, Ferrans CE, Piano MR (2007) Cardiovascular risk factors and metabolic syndrome in alcohol- and nicotine-dependent men and women. J Cardiovasc Nurs 22:429–435

    Article  Google Scholar 

  13. McLellan A, Cacciola JC, Alterman AI, Rikoon SH, Carise D (2006) The addiction severity index at 25: origins, contributions and transitions. Am J Addict Psychiatry 15:113–124

    Article  Google Scholar 

  14. Bohannon RW, Peolsson A, Massy-Westropp N, Desrosiers J, Bear-Lehman J (2006) Reference values for adult grip strength measured with a Jamar dynamometer: a deskriptive meta-analysis. Physiotherapy 92:11–15

    Article  Google Scholar 

  15. Lyhne N, Christensen T, Groth M, Fagt S, Biltoft-Jensen A, Hartkopp H, Hinsch H, Matthissen J, Møller A (2005) Danskernes Kostvaner 2000–2002. Danmarks Fødevareforskning. Silkeborg Bogtryk, Søborg, pp 6–165

    Google Scholar 

  16. Alexander J, Andersen SA, Aro A, Becker W, Fogelholm M, Lyhne N, Meltzer HM, Pedersen A, Pedersen JI, Pórsdóttir I (2004) Nordic nutrition recommendations 2004 Integrating nutrition and physical activity. Norden, Copenhagen, pp 5–424

    Google Scholar 

  17. Fagt S, Matthiessen J, Biltoft-Jensen A, Groth MV, Christensen T, Hinsch H, Hartkopp H, Trolle E, Lyhne N, Møller A (2004) Udviklingen i danskernes kost 1985–2001 -med fokus på sukker og alkohol samt motivation og barrierer for sund livsstil. Danmarks Fødevare-og Veterinærforskning. Silkeborg Bogtryk, Søborg, pp 6–127

    Google Scholar 

  18. Marshall D, Johnell O, Wedel H (1996) Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures. BMJ 312:1254–1259

    Article  CAS  Google Scholar 

  19. Bendixen H, Holst C, Sorensen TI, Raben A, Bartels EM, Astrup A (2004) Major increase in prevalence of overweight and obesity between 1987 and 2001 among Danish adults. Obes Res 12:1464–1472

    Article  Google Scholar 

  20. Christensen AI, Severin M, Holmberg T, Eriksen L, Toftager M, Zachariassen A, Ekholm O, Tolstrup JS, Grønbæk M, Curtis T (2009) KRAM-undersøgelsen i tal og billeder. TrygFonden smba, Copenhagen, pp 7–254

    Google Scholar 

  21. Bjorntorp P (1985) Regional patterns of fat distribution. Ann Intern Med 103:994–995

    Article  CAS  Google Scholar 

  22. Dawson-Hughes B (2013) What is the optimal dietary intake of vitamin D for reducing fracture risk? Calcif Tissue Int 92:184–190

    Article  CAS  Google Scholar 

  23. Mosekilde L, Brot C, Hyldstrup L, Mortensen LS, Molgard C, Rasmussen SE, Mejborn H, Rasmussen LB (2005) The vitamin D status of the Danish population needs to be improved. Ugeskr Laeger 167:895–897

    Google Scholar 

  24. Pedersen A, Fagt S, Groth M, Christensen T, Biltoft-Jensen A, Matthissen J, Andersen NL, Kørup K, Hartkopp H, Ygil K, Hinsch H, Saxholt E, Trolle E (2010) Danskernes kostvaner 2003–2008. DTU Fødevareinstituttet. Rosendahls - Schultz Grafik A/S, Søborg, pp 6–196

    Google Scholar 

  25. Norman K, Stobaus N, Gonzalez MC, Schulzke JD, Pirlich M (2011) Hand grip strength: outcome predictor and marker of nutritional status. Clin Nutr 30:135–142

    Article  Google Scholar 

  26. Bergheim I, Parlesak A, Dierks C, Bode JC, Bode C (2003) Nutritional deficiencies in German middle-class male alcohol consumers: relation to dietary intake and severity of liver disease. Eur J Clin Nutr 57:431–438

    Article  CAS  Google Scholar 

  27. Addolorato G, Capristo E, Greco A, Stefanini G, Gasbarrini G (1998) Influence of chronic alcohol abuse on body weight and energy metabolism: is excess ethanol consumption a risk factor for obesity or malnutrition. J Intern Med 244:387–395

    Article  CAS  Google Scholar 

  28. Malik P, Gasser RW, Kemmler G, Moncayo R, Finkenstedt G, Kurz M, Fleischhacker WW (2009) Low bone mineral density and impaired bone metabolism in young alcoholic patients without liver cirrhosis: a cross-sectional study. Alcohol Clin Exp Res 33:375–381

    Article  CAS  Google Scholar 

  29. Naveau S, Giraud V, Borotto E, Aubert A, Capron F, Chaput JC (1997) Excess weight risk factor for alcoholic liver disease. Hepatology 25:108–111

    Article  CAS  Google Scholar 

  30. Bennasar-Veny M, Lopez-Gonzalez AA, Tauler P, Cespedes ML, Vicente-Herrero T, Yanez A, Tomas-Salva M, Aguilo A (2013) Body adiposity index and cardiovascular health risk factors in Caucasians: a comparison with the body mass index and others. PLoS ONE 8:e63999

    Article  CAS  Google Scholar 

  31. Addolorato G, Capristo E, Marini M, Santini P, Scognamiglio U, Attilia L, Messineo D, Sasso F, Gasbarrini G, Ceccanti M (2000) Body composition changes induced by chronic ethanol abuse: evaluation by dual energy x-ray absorptiometry. Am J Gastroenterol 95:2323–2327

    Article  CAS  Google Scholar 

  32. Moorhouse M, Loh E, Lockett D, Grymala J, Chudzik G, Wilson A (2000) Carbohydrate craving by alcohol-dependent men during sobriety: relationship to nutrition and serotonergic function. Alcohol Clin Exp Res 24:635–643

    Article  CAS  Google Scholar 

  33. Mehta AJ, Yeligar SM, Elon L, Brown LA, Guidot DM (2013) Alcoholism causes alveolar macrophage zinc deficiency and immune dysfunction. Am J Respir Crit Care Med 188:716–723

    Article  CAS  Google Scholar 

  34. Marchesini G, Fabbri A, Bianchi G, Brizi M, Zoli M (1996) Zinc supplementation and amino acid-nitrogen metabolism in patients with advanced cirrhosis. Hepatology 23:1084–1092

    Article  CAS  Google Scholar 

  35. Morud J, Adermark L, Ericson M, Soderpalm B (2013) Alterations in ethanol-induced accumbal transmission after acute and long-term zinc depletion. Addict Biol. doi:10.1111/adb.12096

  36. Poikolainen K, Alho H (2008) Magnesium treatment in alcoholics: a randomized clinical trial. Subst Abuse Treat Prev Policy 3:1

    Article  Google Scholar 

  37. Huisman EJ, Trip EJ, Siersema PD, van Hoek B, van Erpecum KJ (2011) Protein energy malnutrition predicts complications in liver cirrhosis. Eur J Gastroenterol Hepatol 23:982–989

    Article  CAS  Google Scholar 

  38. Sirola J, Rikkonen T, Tuppurainen M, Jurvelin JS, Alhava E, Kroger H (2008) Grip strength may facilitate fracture prediction in perimenopausal women with normal BMD: a 15-year population-based study. Calcif Tissue Int 83:93–100

    Article  CAS  Google Scholar 

  39. Thomsen JL, Albrektsen SB (1995) External appearance of forensic autopsy material of alcoholics. Forensic Sci Int 71:65–71

    Article  CAS  Google Scholar 

  40. Hoidrup S, Gronbaek M, Gottschau A, Lauritzen JB, Schroll M (1999) Alcohol intake, beverage preference, and risk of hip fracture in men and women. Copenhagen Centre for Prospective Population Studies. Am J Epidemiol 149:993–1001

    Article  CAS  Google Scholar 

  41. Hickish T, Colston KW, Bland JM, Maxwell JD (1989) Vitamin D deficiency and muscle strength in male alcoholics. Clin Sci (Lond) 77:171–176

    CAS  Google Scholar 

Download references

Acknowledgments

The authors wish to thank the patients and staff at the Alcohol Unit, Hvidovre Hospital, for participation and dedicated help with the project. We also want to thank the Clinical Research Centre, Hvidovre Hospital, for statistical advice from Steen Ladelund. The Danish Ministry of Health funded the study.

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Author information

Authors and Affiliations

  1. Gastrounit, Medical Division, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark

    Anne Wilkens Knudsen, Inge Nordgaard-Lassen & Ulrik Becker

  2. Department of Endocrinology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark

    Jens-Erik Beck Jensen

  3. Clinical Nutrition Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark

    Jens Kondrup

  4. National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark

    Ulrik Becker

  5. Medical Department F, Copenhagen University Hospital Gentofte, Hellerup, Denmark

    Thomas Almdal

Authors
  1. Anne Wilkens Knudsen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jens-Erik Beck Jensen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Inge Nordgaard-Lassen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Thomas Almdal
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jens Kondrup
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ulrik Becker
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Anne Wilkens Knudsen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wilkens Knudsen, A., Jensen, JE.B., Nordgaard-Lassen, I. et al. Nutritional intake and status in persons with alcohol dependency: data from an outpatient treatment programme. Eur J Nutr 53, 1483–1492 (2014). https://doi.org/10.1007/s00394-014-0651-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00394-014-0651-x

Keywords

Search

Navigation