According to the Centers for Disease Control and Prevention (CDC), 50 percent of adults were regular drinkers (defined as 12 drinks in the past year) in 2008. While drinking in moderation does not lead to nutritional problems, heavy or excessive drinking can have devastating effects due to toxicity and nutrient loss. Heavy drinking is defined by the CDC as more than one drink a day for women and two drinks daily for men. Overall, large amounts of alcohol increase an individual's risk of cancer and can cause damage to the liver, pancreas, intestines and brain.
Digestion Problems
Alcohol alters the storage, transportation and utilization of almost all nutrients. It also tends to cause omission of adequate food and nutrients in the diet. Alcoholic beverages contain virtually no nutritional value and negatively alter the digestion process. First, nutrients do not get absorbed into the blood stream. Then alcohol causes toxicity to the liver altering nutrient processing, storage and transportation. Finally, without adequate nutrients, cells begin to die, which over time can lead to organ and tissue damage.
Others digestion problems include diarrhea due to malabsorption of nutrients and foods along with gastritis or inflammation of the stomach. Alcohol induces excessive secretion of water, bicarbonates and enzymes from the pancreas, which may lead to pancreatitis. According to the National Disgestive Diseases Information Clearinghouse (NDDIC), alcohol abuse is one of the most common causes of pancreatitis and can occur hours or up to two days after alcohol consumption.
Water-Soluble Vitamins
Water-soluble vitamins (B vitamins and vitamin C) need to be extracted from food for absorption. If an individual primarily obtains most of his calories from alcoholic beverages, food consumption declines and vitamin deficiencies form. In addition to decreased food intake, alcoholics have a decreased capability to store folate, niacin, B6 and B12. Some vitamins such as B6 are almost entirely destroyed by alcohol.
One of the most prominent and severe deficiencies is thiamin (vitamin B1), which can lead to a serious condition called Wernicke-Korsakoff syndrome. Symptoms of this syndrome include severe loss of balance, confusion and memory loss. If left untreated, it can eventually result in permanent brain damage and death. Other alcohol-induced deficiencies include pellagra from lack of niacin (vitamin B2), scurvy from lack of vitamin C and neurological conditions associated with inadequate amounts of multiple B vitamins. Individuals with drinking problems should consume a daily multivitamin until vitamins and minerals can be obtained through regular eating habits.
Fat-Soluble Vitamins
Alcohol consumption that causes oily diarrhea may cause imbalances and deficiencies with fat soluble vitamins. The oily consistency of the stools is indicative of poor fat absorption and excretion of fat in larger than normal quantities. To further cause problems, bile production needed for fat soluble vitamin absorption is inadequate in patients with liver damage.
All of the fat-soluble vitamins are affected; however, vitamins D and K are the main deficiencies seen in alcoholics. Vitamin D deficiency can result in bone pain, osteoporosis and increased risk of fractures. Vitamin K deficiency decreases blood clotting time and can cause excess bleeding and hemorrhaging. Alcohol also interferes with the body's use of antioxidants including vitamin E. Vitamin A is tricky when treating alcoholism as excess amounts can also be toxic to the liver. A physician should be consulted prior to starting a multivitamin to avoid excess consumption of certain nutrients.
Minerals
Excessive alcohol drinking can cause deficiencies in potassium, magnesium, calcium, zinc and phosphorus. Both zinc and magnesium are excreted in large amounts during periods of heavy drinking. Individuals should be encouraged to consume dietary sources of these minerals, but supplementation may be needed. Zinc sources are shellfish, eggs, pot roast; nuts, whole grains, vegetables and tofu are good sources of magesium.
Macronutrients: Protein, Carbs and Fat
In addition to all the micronutrient problems associated with excessive alcohol consumption, individuals also have problems with protein, carbohydrates and fats. Individuals with alcoholism have decreased ability to build protein and are unable to breakdown protein into amino acids needed for cell survival. Carbohydrates are poorly digested and are quickly utilized resulting in hypoglycemia (low blood sugar) after a binge drinking episode. If left untreated, low blood sugar can be dangerous and result in coma. To counteract weight loss and protein deficiency, individuals with alcoholism should consume between 2,000 and 3,000 calories a day. According to the Institute of Medicine and health care professional consensus, most of these calories (about 60 percent) should be in the form of carbohydrates, 15 percent should come from protein and the remaining 25 percent should come from fat.
Other Treatment Concerns
Many alcohol withdrawal symptoms such as nausea, vomiting, tremors, depression, agitation and neurological conditions will further affect nutritional intake. Some symptoms only last a few weeks but neurological conditions may be permanent. Recovering alcoholics tend to crave sweets and drink large amounts of liquid. Excessive consumption of sweets is problematic due to poor nutritional profiles of these high sugar foods. Individuals may drink excess water due to dehydration or simply the habit of drinking large amounts of fluids; either way, it will cut down on the amount of food consumed. Overall, excessive alcohol intake is a multi-faceted condition that can cause major nutritional problems. While alcoholics should receive nutritional therapy during treatment, the most important goal is to treat the underlying reason or cause for the drinking behavior.
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