Current Gastroenterology Reports

, Volume 2, Issue 4, pp 331–336 | Cite as

Nutritional effects of alcoholism

  • Yngve Falck-Ytter
  • Arthur J McCullough
Article

Abstract

Alcohol is the most frequently used drug worldwide and remains a socially acceptable hepatotoxin. Although the toxic effects of alcohol on various organs (liver, pancreas, heart, and intestine) are well recognized, the role of alcohol in overall energy and protein metabolism is less well understood. In particular, the efficiency of alcohol as a source of calories and as a substrate for energy production appears to be influenced by the amount of both alcohol and fat consumption as well as by gender. The relationship between alcohol intake and body weight is complex, but it is a clinical dilemma with important nutritional implications for weight management in addition to specific organ toxicity.

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References and Recommended Reading

  1. 1.
    McCullough AJ: Alcoholic liver disease. In Schiff's Diseases of the Liver. Edited by Schiff ER, Sorrell MF, Maddrey, WC: Philadelphia: Lippincott-Raven; 1999:941–971.Google Scholar
  2. 2.
    Liao Y, McGee DL, Cao G, Cooper RS: Alcohol intake and mortality: findings from the National Health Interview Surveys (1988 and 1990). Am J Epidemiol 2000, 151:651–659. Refer to annotation below.PubMedGoogle Scholar
  3. 3.
    Rimm EB, Williams P, Fosher K, et al.: Moderate alcohol intake and lower risk of coronary heart disease: meta-analysis of effects on lipids and hemostatic factors. Br Med J 1999, 319:1523–1528. These two articles review the potential beneficial effects of alcohol on the cardiovascular system in relation to overall mortality.Google Scholar
  4. 4.
    Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System (BRFSS) Online Prevalence Data, 1995–1998. Accessed at www2.cdc/gov/nccdphp/brfss.Google Scholar
  5. 5.
    Health, United States, 1998, with Socioeconomic Status and Health Chartbook. Hyattsville, MD: National Center for Health Statistics; 1998.Google Scholar
  6. 6.
    Moore AA, Hays RD, Greendale GA, et al.: Drinking habits among older persons: findings from the NHANES I Epidemiologic Followup Study (1982-1984). National Health and Nutrition Examination Survey. J Am Geriatr Soc 1999, 47:412–416.PubMedGoogle Scholar
  7. 7.
    Berneis K, Ninnis R, Keller U: Ethanol exerts acute protein sparing effects during post-absorptive but not during anabolic conditions in man. Metabolism 1997, 46:750–755.PubMedCrossRefGoogle Scholar
  8. 8.
    Murgatroyd PR, Van De Ven ML, Goldberg GR, Prentice AM: Alcohol and the regulation of energy balance: overnight effects on diet-induced thermogenesis and fuel storage. Br J Nutr 1996, 75:33–45. Discusses the influence of alcohol on energy balance.PubMedCrossRefGoogle Scholar
  9. 9.
    Suter PM, Jequier E, Schutz Y: Effect of ethanol on energy expenditure. Am J Physiol 1994, 66:R1204-R1212.Google Scholar
  10. 10.
    Shelmet JJ, Reichard GA, Skutches CL, et al.: Ethanol causes acute inhibition of carbohydrate, fat, and protein oxidation and insulin resistance. J Clin Invest 1988, 81:1137–1145.PubMedCrossRefGoogle Scholar
  11. 11.
    Preedy VR, Reilly ME, Patel VB, et al.: Protein metabolism in alcoholism: effects on specific tissues and the whole body. Nutrition 1999, 15:604–608. Comprehensive review of the effect of alcohol on overall and tissue-specific protein metabolism.PubMedCrossRefGoogle Scholar
  12. 12.
    McCullough AJ, Bugianesi E: Protein-calorie malnutrition and the etiology of cirrhosis. Am J Gastroenterol 1997, 2:734–738.Google Scholar
  13. 13.
    Volpi E, Lucidi P, Cruciani G, et al.: Moderate and large doses of ethanol differentially affect hepatic protein metabolism in humans. J Nutr 1998, 128:198–203.PubMedGoogle Scholar
  14. 14.
    Reilly ME, Erylmaz EI, Amir A, et al.: Skeletal muscle ribonuclease activities in chronically ethanol-treated rats. Alcohol Clin Exp Res 1998, 22:876–883.PubMedGoogle Scholar
  15. 15.
    Patel VB, Corbett JM, Dunn MJ: Protein profiling in cardiac tissue in response to the chronic effects of alcohol. Electrophoresis 1997, 18:2788–2794.PubMedCrossRefGoogle Scholar
  16. 16.
    Westerterp-Plantenga MS, Verwegen CR: The appetizing effect of an aperitif in overweight and normal-weight humans. Am J Clin Nutr 1999, 69:205–212.PubMedGoogle Scholar
  17. 17.
    Tremblay A, St-Pierre S: The hyperphagic effect of a high-fat diet and alcohol intake persists after control for energy density. Am J Clin Nutr 1996, 63:479–482.PubMedGoogle Scholar
  18. 18.
    Jequier E: Alcohol intake and body weight: a paradox. Am J Clin Nutr 1999, 69:173–174. This editorial provides a brief overview of the seemingly pardoxical effects of alcohol on body weight.PubMedGoogle Scholar
  19. 19.
    Flanagan DE, Moore VM, Godsland IF, et. al.: Alcohol consumption and insulin resistance in young adults. Eur J Clin Invest 2000, 30:297–301.PubMedCrossRefGoogle Scholar
  20. 20.
    Gin H, Rigalleau V, Caubet O, et al.: Effects of red wine, tannic acid, or ethanol on glucose tolerance in noninsulin- dependent diabetic patients and on starch digestibility in vitro. Metabolism 1999, 48:1179–1783.PubMedCrossRefGoogle Scholar
  21. 21.
    Fuchs CS, Stampfer MJ, Colditz GA, et al.: Alcohol consumption and mortality among women. N Engl J Med 1995, 332:1245–1250.PubMedCrossRefGoogle Scholar
  22. 22.
    Williams PT: Interactive effects of exercise, alcohol, and vegetarian diet on coronary artery disease risk factors in 9242 runners: the National Runners' Health Study. Am J Clin Nutr 1997, 66:1197–1206.PubMedGoogle Scholar
  23. 23.
    Rumpler WV, Clevidence BA, Muesing RA, Rhodes DG: Changes in women's plasma lipid and lipoprotein concentrations due to moderate consumption of alcohol are affected by dietary fat level. J Nutr 1999, 129:1713–1717.PubMedGoogle Scholar
  24. 24.
    Mansfield E, McPherson R, Koski KG: Diet and waist-to-hip ratio: important predictors of lipoprotein levels in sedentary and active young men with no evidence of cardiovascular disease. J Am Diet Assoc 1999, 99:1373–1379.PubMedCrossRefGoogle Scholar
  25. 25.
    Falck-Ytter Y, McCullough AJ: The effects of alcohol on body composition. Am J Gastroenterol 2000, in press. This editorial provides a concise discussion of the efficiency of different doses of alcohol on energy substrates.Google Scholar
  26. 26.
    McCarty MF: The alcohol paradox. Am J Clin Nutr 1999, 69:940–941.Google Scholar
  27. 27.
    Addolorato G, Capristo E, Greco AV, et al.: 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 1998, 244:387–395.PubMedCrossRefGoogle Scholar
  28. 28.
    Lieber CS: Perspectives: do alcohol calories count? Am J Clin Nutr 1991, 54:976–982. Refer to annotation below.PubMedGoogle Scholar
  29. 29.
    Addolorato G, Capristo E, Marini M, et al.: Body composition changes induced by chronic ethanol abuse: evaluation by dual energy x-ray absorptiometry. Am J Gastroenterol 2000, in press. Refer to annotation below.Google Scholar
  30. 30.
    Addolorato G, Capristo E, Greco AV, et al.: Three months of abstinence from alcohol normalizes energy expenditure and substrate oxidation in alcoholics: a longitudinal study. Am J Gastroenterol 1998, 93:2476–2481. Three important contributions regarding the effect of alcohol on body composition.PubMedCrossRefGoogle Scholar
  31. 31.
    Addolorato G, Capristo E, Caputo F, et al.: Nutritional status and body fluid distribution in chronic alcoholics compared with controls. Alcohol Clin Exp Res 1999; 23:1232–1237.PubMedCrossRefGoogle Scholar
  32. 32.
    Chavin KD, Yang S, Lin HZ, et al.: Obesity induces expression of uncoupling protein-2 in hepatocytes and promotes liver ATP depletion. J Biol Chem 1999, 274:5692–5700.PubMedCrossRefGoogle Scholar
  33. 33.
    Cortez-Pinto H, Yang SQ, Lin HZ, et al.: Lipids up-regulate uncoupling protein 2 expression in rat hepatocytes. Gastroenterology 1999, 116:1184–1193.PubMedCrossRefGoogle Scholar
  34. 34.
    McCullough AJ, Falck-Ytter Y: Body composition and hepatic steatosis as a precursor for fibrotic liver disease. Hepatology 1999, 29:1328–1330.PubMedCrossRefGoogle Scholar
  35. 35.
    Bunout D: Nutritional and metabolic effects of alcoholism: their relationship with alcoholic liver disease. Nutrition 1999, 15:583–589. Easy-to-read review of a number of complex issues regarding alcohol and nutrition.PubMedCrossRefGoogle Scholar
  36. 36.
    Charlton MR: Energy and protein metabolism in alcoholic liver disease. Clin Liver Dis 1998, 2:781–798.CrossRefGoogle Scholar
  37. 37.
    Wohl D, Falck-Ytter Y, McCullough AD: Nutrition in liver disease. Clin Perspect Gastroenterol 1999, Sept/Oct:267–274.Google Scholar
  38. 38.
    McCullough AJ, Raguso C: Effect of cirrhosis on energy expenditure. Am J Clin Nutr 1999, 69:1066–1068.PubMedGoogle Scholar
  39. 39.
    McCullough AJ, Mullen KD, Kalhan SC: Defective nonoxidative leucine degradation and endogenous leucine and leucine flux in cirrhosis during an amino acid infusion. Hepatology 1998, 28:1357–1364.PubMedCrossRefGoogle Scholar
  40. 40.
    Andersen H, Borre M, Jakobsen J, et al.: Decreased muscle strength in patients with alcoholic liver cirrhosis in relation to nutritional status, alcohol abstinence, liver function, and neuropathy. Hepatology 1998, 27:1200–1206.PubMedCrossRefGoogle Scholar
  41. 41.
    Keshavarzian B, Holmes EW, Patel M, et al.: Leaky gut in alcoholic cirrhosis: a possible mechanism for alcoholinduced liver damage. Am J Gastroenterol 1999, 94:200–207.PubMedCrossRefGoogle Scholar
  42. 42.
    Johnson CD, Hosking S: National statistics for diet, alcohol consumption, and chronic pancreatitis in England and Wales, 1960-88. Gut 1991, 32:1401–1405.PubMedGoogle Scholar
  43. 43.
    Hirsch S, de la Maza MP, Gattas V, et al.: Nutritional support in alcoholic cirrhotic patients improves host defenses. J Am Coll Nutr 1999, 18:434–441.PubMedGoogle Scholar
  44. 44.
    Laso FJ, Iglesias-Osma C, Ciudad J, et al.: Chronic alcoholism is associated with an imbalanced production of Th-1/Th-2 cytokines by peripheral blood T cells. Alcohol Clin Exp Res 1999, 23:1306–1311.PubMedGoogle Scholar
  45. 45.
    Constant J: The alcoholic cardiomyopathies: genuine and pseudo. Cardiology 1999, 91:92–95.PubMedCrossRefGoogle Scholar
  46. 46.
    Suter PM, Vetter W: Alcohol and ischemic stroke. Nutr Rev 1999, 57:310–314.PubMedGoogle Scholar
  47. 47.
    Lieber CS: Metabolism of alcohol. Clin Liver Dis 1998, 2:673–702.CrossRefGoogle Scholar
  48. 48.
    Cravo ML, Camilo ME: Hyperhomocysteinemia in chronic alcoholism: relations to folic acid and vitamins B6 and B12 status. Nutrition 2000, 16:296–302.PubMedCrossRefGoogle Scholar
  49. 49.
    Schenker S, Halff GA: Nutritional therapy in alcoholic liver disease. Semin Liver Dis 1993, 13:196–207.PubMedCrossRefGoogle Scholar
  50. 50.
    Klein S, Iber FL: Alcoholism and associated malnutrition in the elderly. Nutrition 1991, 7:75–79.PubMedGoogle Scholar

Copyright information

© Current Science Inc. 2000

Authors and Affiliations

  • Yngve Falck-Ytter
    • 1
  • Arthur J McCullough
    • 1
  1. 1.Robert Schwartz Center for Metabolism and Nutrition, Division of GastroenterologyMetro Health Medical Center and Case Western Reserve UniversityClevelandUSA

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