Alcohol and Nutrition Flashcards
What are some things that can influence the impact alcohol has on health?
Dose of alcohol, potential interactions with nutrients, duration and pattern of consumption
Where does absorption of alcohol take place?
The stomach (20%), small intestines (passive diffusion)
Where is the site of primary alcohol metabolism?
The liver
What does the liver do to alcohol?
Removes it from the blood through oxidation to prevent accumulation (limits cell death and organ damage)
When does Blood Alcohol Concentration (BAC) peak?
About 30-60 mins after consumption
What are some factors that can influence BAC?
Gender, race, chronic alcohol consumption, drinking pattern, medication, food consumption
What are the physiological processes that influence BAC?
Absorption, distribution, metabolism, excretion
Why does controlling rate of consumption limit BAC?
Gives the liver time to metabolise the alcohol
What is the only way to remove alcohol from the blood?
Time
How does food influence peak BAC?
Food reduces absorption and speeds up elimination, slows gastric emptying and may bind to alcohol
How does feeding affect portal blood flow and how does this impact alcohol metabolism?
Increases portal blood flow which causes faster metabolism of alcohol
What does a slower and prolonged absorption phase do?
Increases first pass metabolism, causing metabolising enzymes to not be fully saturated
Why does alcohol lead to weight gain?
Consistent failure to compensate for energy ingested as alcohol, and alcohol tends to increase food intake when taken around meals
What type of drinking is likely to result in weight gain?
Heavy and binge drinking
What are some tips for calorie reduction?
Have one non-alcoholic drink in between each alcoholic drink, select light versions, always have food in your stomach before you drink, learn to sip, keep water available
Why does alcohol lower food intake?
Replaces food, alters appetite
How does alcohol impact metabolism and digestion?
Decreases secretion of pancreatic enzymes and bile, ethanol metabolism requires micronutrients
How does alcohol affect nutrients?
Decreases liver stores of vitamins and increases secretion
How does alcohol impact absorption?
Damages the cells lining the stomach and small intestine
What is thiamine?
Water soluble essential nutrient phosphorylated in gut to active coenzyme form
What is the active coenzyme form of thiamine involved in?
ATP production, normal nerve conduction and maintenance of neural membranes
Why do thiamine levels decline due to chronic alcohol use?
Poor intake, decreased conversion to co-enzyme, reduced storage in fatty liver, inhibited intestinal absorption, increased metabolic demand
What are the clinical signs of thiamine deficiency?
Dry beriberi, wet beriberi, Wernicke-Korsakoff syndrome
What is dry beriberi?
Condition that affects the nervous system-polyneuropathy, weakness, numbness, paralysis, usually lower limbs
What is wet beriberi?
Condition that affects the CV system=increased HR, SOB, high output cardiac failure
Are the symptoms of thiamine deficiency common?
No-only seen in 16-20%of patients so often missed
What are some other water soluble vitamins alcoholics are often deficient in?
Folate and B12 (megaloblastic anaemia due to impaired metabolism), Niacin
Why does vitamin A deficiency occur in alcoholics?
The storage and synthesis of retinol binding protein is abnormal which reduces plasm retinol levels (causes night blindness)
What can calcium deficiency cause and how does it arise?
Increased urinary excretion-leads to osteoporosis
What are some signs of zinc deficiency?
Lesions around eyes, nose and mouth, impaired wound healing/liver regeneration/mental status/immune function
How does nutritional support help malnourished patients?
Improves nutritional parameters, liver function, reduces length of hospitalisation and complications of liver disease, improves outcomes of hospitalisation/surgery/transplantation
What type of drinking has the highest risk of CVD?
Heavy drinking
What cancers is alcohol linked to?
Breast, bowel, liver, mouth/throat, oesophageal, stomach
What are some mechanisms for alcohol leading to cancer?
Acetaldehyde is carcinogenic, it’s a solvent (makes it easier for carcinogens to enter cells), combined effect with oestrogen
Why do deficiencies in essential nutrients increase the risk of cancer?
Makes tissues more susceptible to carcinogenesis
How are tobacco and alcohol synergistic carcinogens?
Tobacco induces specific mutations in DNA that are less efficiently repaired in the presence of alcohol
What three things regulate blood glucose?
The food we eat, the breakdown of glycogen stores and gluconeogenesis
How much alcohol can cause low blood sugar on an empty stomach?
2 ounces
What is the effect of chronic alcohol consumption on insulin’s effectiveness?
Decreases insulin’s effectiveness, resulting in hypoglycaemia
What are the risks of drinking alcohol in the first trimester?
Risk of miscarriage, higher rate of premature birth
How much alcohol induces a risk to a foetus?
Above 1-2 units a day
What are some features of foetal alcohol disorders?
Abnormal appearance, stunting, low body weight and head size, poor co-ordination, low intelligence, behavioural problems, sight/hearing problems
What are some features of Foetal Alcohol syndrome (FAS)?
Physical/mental/behavioural problems, learning difficulties, most severe form of disorder
What effect can large volumes of alcohol have on a baby (>2units/day)?
Drowsiness, deep sleep, weakness, abnormal weight gain
How do the livers of babies and new-borns differ from those of adults?
New-borns have immature liver so will be more affected, up until 3 months of age infants metabolise alcohol at 50% the rate of adults
What are some considerations for a mother to have when drinking?
How much they weight (heavier people metabolise alcohol faster), the amount of alcohol, will they be eating (food decreases absorption rate of alcohol into bloodstream)
