[Nutrition and Chronic Alcohol Abuse]

Many patients with chronic alcohol abuse present a clinical picture of malnourishment either because of reduced usual intake of essential nutrients or because alcohol precludes an appropriate digestion and absorption of the different essential elements, vitamins, and minerals. A usual example is vitamin A deficiency in these patients. Besides, ethanol metabolic pathways themselves (through the ADH and the MEOS system) generate toxic intermediate products (acetaldehyde, free radicals) interfering with normal metabolism of essential elements, mainly lipids, leading to cellular damage through lipid peroxidation mechanisms and impairment of the membrane fluidity, fat deposits (hepatocellular steatosis), inflammation secondary to oxidative stress and proinflammatory cytokines, activation of stellate cells, fibrogenesis, etc. Nutritional supports may be effective to improve alcoholic liver disease. A balanced diet, vitamin supplements, and pharmacological therapy with antioxidants in order to recover depleted glutathione deposits are recommended. It is paramount that these patients have a multidisciplinary clinical approach to resolve the problem of alcohol dependency.