Alcohol Drinking Patterns and Nutrition in Alcoholic Liver Disease

In most Western countries alcoholic beverages contribute markedly to the overall caloric intake. Indeed, alcohol contributes to approximately 5% of the daily caloric intake in the American diet (Halsted, 2004). Alcohol, besides nicotine, is also the most widely used drug in our society, bearing a large potential for addiction but also organ damage and herein particularly liver damage. Chronic alcohol abuse is frequently accompanied with malnutrition with the degree of malnutrition varying not only between the type of alcohol abuse (e.g. binge drinker vs. chronic drinker) but also the degree of liver damage. For practitioners it is important to recognize the various factors contributing to the evolvement of malnutrition in alcoholic patients, as the correction of deficiencies or other strategies to improve nutritional status may have a beneficial effect in the prevention and treatment of alcoholic liver disease. The effects of alcohol ingestion on dietary pattern, nutrient intake and the intermediary metabolism have been investigated in numerous human but also animal studies. In this chapter the role of alcohol as energy source but also the effects of alcohol ingestion on energy metabolism, dietary pattern and micronutrient bioavailability as well as metabolism with special emphasize on the liver and the development of alcoholic liver disease are reviewed. Furthermore, current recommendations for treatment of malnutrition in patients with alcoholic liver disease are summarized.