Table of Contents
- What is alcohol?
- How is alcohol made?
- How is alcohol metabolized?
- What are the negative effects of too much alcohol?
- What is alcohol's effect on weight?
- How does alcohol affect your blood sugar?
- Does alcohol cause nutritional deficiencies?
- Does alcohol cause nutritional deficiencies? (continued)
- Do beverages with artificial sweeteners react with alcohol?
- How much alcohol can you safely consume?
Quick GuideAlcohol Abuse: 12 Health Risks of Chronic Heavy Drinking
Does alcohol cause nutritional deficiencies?
When alcohol replaces foods in a person's diet, the decreased intake of nutrients can cause primary malnutrition. Consuming too little of any of the essential nutrients (protein, carbohydrates, fats, vitamins, and/or minerals) can lead to deficiencies and health problems. Deficiencies can also occur because alcohol and its metabolism prevent the body from properly absorbing, digesting, and using the essential nutrients in your body. Unfortunately, deficiency signs only occur in when your body is extremely depleted so by the time you find out about the deficiency, you are already suffering the health consequences.
The following are common deficiencies brought on by alcohol consumption.
Vitamin B1 (thiamine)
Vitamin B1 is found in many foods, including cereal grains, beans, nuts, yeast, and meat. In the body, high concentrations are found in skeletal muscles and in the liver, brain, kidney, and heart. In the tissues, thiamine is required for the building and functioning of several enzymes. These enzymes are important for the breakdown of sugar molecules into other types of molecules, production of certain brain chemicals (for example, neurotransmitters), the production of several other essential molecules, and maintaining the body's ability to defend against free radicals.
Alcohol rapidly reduces thiamine levels in people who chronically use it. An unbalanced diet and alcohol's impact on absorption, storage, activation, and excretion of thiamine are thought to be the reasons this occurs. Beriberi is the disease caused by vitamin B1 (thiamine) deficiency. The two major types of beriberi are wet and dry beriberi. Wet beriberi affects the cardiovascular system, and dry beriberi affects the nervous system. Early symptoms of thiamine depletion include weakness, fatigue, and emotional disturbance. As this continues, the deficiency leads to beriberi with cardiac failure, neuropathy, or peripheral edema. Wernicke syndrome and Korsakoff syndrome are related disorders that often occur with dry beriberi. Wernicke's syndrome, also known as Wernicke's encephalopathy, is a neurological disease characterized by the clinical triad of confusion, the inability to coordinate voluntary movement (ataxia), and eye (ocular) abnormalities. Korsakoff's syndrome is a mental disorder characterized by disproportionate memory loss in relation to other mental aspects. When these two disorders occur together, the term Wernicke-Korsakoff syndrome is used. Unfortunately, the symptoms are only seen in 16%-20% of patients. For this reason, it is missed in 75%-80% of cases and not detected until after death if an autopsy is done.
As long as alcohol consumption continues, it is difficult to know how much thiamine to give to correct the deficiency because the alcohol will continue to interfere with thiamine being properly absorbed and converted to its active form. The recommended dietary allowances (RDA) for thiamine are: men 14 years and older, 1.2 mg, and women over 18 years, 1.1 mg. In people who have or are at risk of thiamine deficiency, 50 milligrams of thiamine may be taken by mouth daily, and in severe cases, doses of 50-100 milligrams of thiamine may be injected into the vein three to four times daily. Consult with your physician if you're at risk and in need of treatment for a deficiency in thiamine.
Folate is a B vitamin that has received a great deal of attention for its health benefits. Most notably is the risk of birth defects and cancer with an inadequate intake. Folate helps produce and maintain new cells. It is found in a wide variety of foods, including vegetables (spinach, asparagus, and Brussels sprouts are highest), nuts, beans, peas, fruits and fruit juices, meat (liver is highest), eggs, seafood, yeast, and dairy products.
Alcohol interferes with dietary folate intake, folate absorption, transport of folate to necessary tissues, and the storage and release of folate by the liver. Research has shown that even moderate alcohol consumption (8 fluid ounces of wine per day or 2.7 fluid ounces of vodka) over 2 weeks can significantly decrease serum folate concentration in healthy men. In the Nurses' Health Study, women who consumed one alcoholic drink a day or more and had the highest levels of folate in their blood were 90% less likely to develop breast cancer than those who had the lowest levels of it.
The RDA for folate for men and women over 18 years old is 400 mcg. A well-balanced diet is typically enough to meet this. There are no clear guidelines for how much folate you need to take if you consume alcohol. One study suggested that 600 micrograms a day of folate could counteract the effect of moderate alcohol consumption on breast cancer risk. High levels can mask B12 deficiency. As long as you continue to consume alcohol, you can alter your levels regardless of how much you are taking.
Caton, S.J. "Acute Effects of an Alcoholic Drink on Food Intake: Aperitif Versus Co-ingestion." Physiol Behav. 90(2-3) Feb. 28, 2007: 368-375.
DiMeglio, D.P. "Liquid Versus Solid Carbohydrate: Effects on Food Intake and Body Weight." Int J Obes Relat Metab Disord. 24.6 June 2000: 794-800.
Goralczyk, R. "Beta-Carotene and Lung Cancer in Smokers: Review of Hypotheses and Status of Research." Nutr Cancer. 61.6 (2009): 767-774.
Halsted, C.H. "Metabolic Interactions of Alcohol and Folate." J Nutr. 132(8 Suppl) Aug. 2002: 2367S-2372S.
Latt, N. "Thiamine in the Treatment of Wernicke Encephalopathy in Patients With Alcohol Use Disorders." Intern Med J. 44.9 Sept. 2014: 911-915.
Laufer, E.M. "Effects of Moderate Alcohol Consumption on Folate and Vitamin B(12) Status in Postmenopausal Women." Eur J Clin Nutr. 58.11 Nov. 2004: 1518-1524.
Poppitt, S.D. "Beverage Consumption: Are Alcoholic and Sugary Drinks Tipping the Balance Towards Overweight and Obesity?" Nutrients. 7.8 Aug. 11, 2015: 6700-6718.
Singleton, C.K. "Molecular Mechanisms of Thiamine Utilization." Curr Mol Med. 1.2 May 2001: 197-207.
Stermer, E. "Alcohol Consumption and the Gastrointestinal Tract." Isr Med Assoc J. 4.3 Mar. 2002: 200-202.
Stickel, F. "Review Article: Nutritional Therapy in Alcoholic Liver Disease." Aliment Pharmacol Ther. 18.4 Aug. 15, 2003: 357-373.
Subramanya, S.B. "Chronic Alcohol Consumption and Intestinal Thiamin Absorption: Effects on Physiological and Molecular Parameters of the Uptake Process." Am J Physiol Gastrointest Liver Physiol. 299.1 July 2010: G23-31
Switzerland. World Health Organization. "Global Strategy to Reduce Harmful Use of Alcohol." <http://www.who.int/substance_abuse/activities/gsrhua/en/>.
Thomson, A.D. "Mechanisms of Vitamin Deficiency in Chronic Alcohol Misusers and the Development of the Wernicke-Korsakoff Syndrome." Alcohol Suppl. 35.1 May-June 2000: 2-7.
Traversy, G. "Alcohol Consumption and Obesity: An Update." Curr Obes Rep. 4.1 (2015): 122-130.
United States. National Institute on Alcohol Abuse and Alcoholism. "The Role of Thiamine Deficiency in Alcoholic Brain Disease." July 2004. <http://pubs.niaaa.nih.gov/publications/arh27-2/134-142.htm>.
United States. National Institutes of Health, Office of Dietary Supplements. "Folate." Feb. 11, 2016. <https://ods.od.nih.gov/factsheets/Folate-HealthProfessional/>.
United States. National Institutes of Health, Office of Dietary Supplements. "Vitamin A." Feb. 11, 2016. <https://ods.od.nih.gov/factsheets/Folate-HealthProfessional/>.
United States. National Institutes of Health, Office of Dietary Supplements. "Vitamin B12." Feb. 11, 2016. <https://ods.od.nih.gov/factsheets/Folate-HealthProfessional/>.
Wakabayashi, L. "Frequency of Heavy Alcohol Drinking and Risk of Metabolic Syndrome in Middle-Aged Men." Alcohol Clin Exp Res. 38.6 June 2014: 1689-1696.
Yeomans, M.R. "Alcohol and Food Intake." Curr Opin Clin Nutr Metab Care. 6.6 Nov. 2003: 639-644.
Yeomans, M.R. "Alcohol, Appetite and Energy Balance: Is Alcohol Intake a Risk Factor for Obesity?" Physiol Behav. 100.1 Apr. 26, 2010: 82-89.
Yeomans, M.R. "Effects of Alcohol on Food and Energy Intake in Human Subjects: Evidence for Passive and Active Over-consumption of Energy." Br J Nutr. 92 Suppl 1 Aug. 2004: S31-4.