Role of nutrition in alcoholism

Although the relationship of chronic alcoholism and liver disease is firmly established, the importance of nutritional factors in its etiology remains controversial. The prevalence and nature of nutritional deficiencies detected in chronic alcoholics varies considerably but is more common during clinical liver disease. In addition to protein-calorie malnutrition, deficiencies in minerals and vitamins including thiamine, pyridoxine, ascorbic acid, folate, vitamins A, D and E, potassium, zinc and selenium are commonly observed in alcoholics. Nutrient deficiencies arise from impaired nutrient metabolism, inadequate dietary intake, maldigestion and malabsorption, and increased excretion induced by chronic alcohol use. Nutritional support involving adequate dietary supplements of macronutrients, vitamins, minerals and other food factors in the treatment of alcohol abuse with or without liver disease is imperative. It seems critical because of the high frequency of malnutrition observed in these patients as well as due to evidence of a link between malnutrition, immunocompetence, morbidity and mortality. While nutritional support of a cirrhotic patient is important, it is unlikely to have a significant effect on the irreversible hepatic lesions. However acute alcoholic hepatitis is potentially reversible, and nutritional support in these patients may have a considerate impact, particularly in retarding alcohol diseases prior to clinical organ damage. A new understanding of the roles of nutritional deficiencies in alcohol hepatotoxicity and the need for adequate or supplemental dietary therapy with macro(-) and micronutrients may lead to a more successful recovery and maintenance of health during recovery from alcohol abuse.