Nutritionists Perspective

Question 1

where is alcohol absorbed?

Answer 1

20% in stomach

rest in small intestine

Question 2

where is alcohol excreted?

Answer 2

1-5% in lungs

0. 5% in sweat
1. 5 - 2% in urine

Question 3

where is alcohol metabolised?

Answer 3

primarily in the liver

removed from blood via oxidation process

Question 4

how does food influence blood alcohol conc. (BAC)?

Answer 4

slows gastric emptying
increases portal blood flow so faster metabolism of ethanol
slower and prolonged absorption increases first pass metabolism in the liver (before it reaches systemic circulation) so metabolising enzymes aren’t saturated with ethanol and excess doesn’t go into blood

Question 5

how many calories per 1g of alcohol?

Answer 5

7

Question 6

how is alcohol associated with weight?

Answer 6

people don’t compensate for the calories in drinks so just add to normal dietary calories
no epidemiological evidence that alcohol increases weight but binge drinkers are likely to gain weight

Question 7

how does alcohol increase risk of deficiencies?

Answer 7

altered food intake (food replaced by drinks)
decreased secretion of pancreatic enzymes and bile so digestion affected
stomach and intestinal lining damaged, disabling transport of nutrients into blood
ethanol metabolism uses up ntrients (e.g thiamine)
decreased liver stores of vitamins and increased excretion (fat)

Question 8

why might deficiencies go unnoticed?

Answer 8

symptoms only occur once very depleted

Question 9

can alcohol cause weight loss?

Answer 9

sometimes
vague evidence that it might suppress ghrelin
alcohol hepatitis and liver disease can cause decreased appetite and weight loss/muscle wasting

Question 10

why is thiamine important?

Answer 10

needed for ATP production, normal nerve function and maintenance of neural membranes

Question 11

why do thiamine levels decrease in alcoholism?

Answer 11

poor intake
decreased conversion to active coenzyme
reduced storage in fatty liver
increased metabolic demand
inhibited absorption

Question 12

what are the 3 stages of thiamine deficiency?

Answer 12

dry beriberi(limbs)
wet beriberi (CV problems)
Wernicke-koraskoff syndrome(neurological problems)

Question 13

what other deficiencies are common in alcoholism?

Answer 13

folate, B12 and niacin (water soluble)
vit A (fat sol.)
Calcium

Question 14

name 4 likely mechanisms for alcohol causing cancer

Answer 14

carcinogenic breakdown products (acetaldehyde)
alcohol is a solvent making it easier for carcinogens to enter cells
combined effect with oestrogen
nutrient deficiencies

Question 15

how is alcohol related to diabetes?

Answer 15

alcohol interferes with all 3 glucose regulation mechanisms (food, glycolysis and gluconeogenesis)
and can decrease insulins effectiveness over time