Explain how chronic alcohol abuse can lead to malnutrition.

Question

What will be an ideal response?

Answer 1

Heavy drinkers usually consumer alcohol as a substitution—instead of their normal food intake. Diet quality declines as alcohol consumption increases. Consequently, many heavy drinkers suffer malnutrition. Alcohol is rich in energy (7 kcal per gram), but the calories are empty of nutrients. The more alcohol people drink, the less likely they are to eat enough food to obtain adequate nutrients. The more kcalories used for alcohol, the fewer kcalories available to use from nutritious foods.
Chronic alcohol abuse not only displaces nutrients from the diet, but it also interferes with the body’s metabolism of nutrients. Most dramatic is alcohol’s effect on the B vitamin folate. The liver loses its ability to retain folate, and the kidneys increase their excretion of it. Alcohol abuse creates a folate deficiency that devastates digestive system function. The small intestine normally releases and retrieves folate continuously, but it becomes damaged by folate deficiency and alcohol toxicity, so it fails to retrieve its own folate and misses any that may trickle in from food as well.
The inadequate intake and impaired nutrient absorption that accompany chronic alcohol abuse often lead to a deficiency in thiamin. Acetaldehyde, an intermediate in alcohol metabolism, interferes with nutrient use, too. For example, acetaldehyde dislodges vitamin B6 from its protective binding protein so that it is destroyed, causing a vitamin B6 deficiency.
Malnutrition occurs not only because of lack of intake and altered metabolism but also because of direct toxic effects, as well. Alcohol causes stomach cells to oversecrete both gastric acid and histamine, an immune system agent that produces inflammation.