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Questions and Answers
What is the most common vitamin deficiency among alcoholics?
What is the most common vitamin deficiency among alcoholics?
Which factor contributes to folate deficiency in chronic alcoholics?
Which factor contributes to folate deficiency in chronic alcoholics?
What are the potential effects of pyridoxine deficiency in chronic alcoholics?
What are the potential effects of pyridoxine deficiency in chronic alcoholics?
What condition poses a danger due to chronic alcoholism?
What condition poses a danger due to chronic alcoholism?
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What is the approximate daily protein intake for chronic alcoholics compared to non-drinkers?
What is the approximate daily protein intake for chronic alcoholics compared to non-drinkers?
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Which nutrient is suggested to be administered to reduce withdrawal symptoms in chronic alcoholics?
Which nutrient is suggested to be administered to reduce withdrawal symptoms in chronic alcoholics?
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What vitamin is administered at a dose of 50 mg to address neurological disorders in alcoholics?
What vitamin is administered at a dose of 50 mg to address neurological disorders in alcoholics?
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What is one of the common consequences of a poor diet among alcoholics?
What is one of the common consequences of a poor diet among alcoholics?
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What is the primary form of alcohol consumed by humans?
What is the primary form of alcohol consumed by humans?
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What is the primary organ responsible for the metabolism of alcohol?
What is the primary organ responsible for the metabolism of alcohol?
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Which vitamin's absorption is reduced due to chronic alcohol consumption?
Which vitamin's absorption is reduced due to chronic alcohol consumption?
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What is the effect of alcohol on gastric motility?
What is the effect of alcohol on gastric motility?
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What condition is characterized by inflammation of the liver and may result from excessive alcohol consumption?
What condition is characterized by inflammation of the liver and may result from excessive alcohol consumption?
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What happens to thiamin levels in chronic alcoholics?
What happens to thiamin levels in chronic alcoholics?
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What nutrient is particularly lost due to increased urinary excretion among alcoholics?
What nutrient is particularly lost due to increased urinary excretion among alcoholics?
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Which of the following effects is associated with a deficiency in zinc due to alcohol consumption?
Which of the following effects is associated with a deficiency in zinc due to alcohol consumption?
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At what rate does alcohol absorption occur in the human body?
At what rate does alcohol absorption occur in the human body?
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Which of the following is a potential consequence of persistent alcohol metabolism?
Which of the following is a potential consequence of persistent alcohol metabolism?
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What is the maximum effect of alcohol on appetite stimulation?
What is the maximum effect of alcohol on appetite stimulation?
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What is a common symptom of Wernicke-Korsakoff syndrome related to thiamin deficiency?
What is a common symptom of Wernicke-Korsakoff syndrome related to thiamin deficiency?
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Which enzyme pathway is primarily involved in the breakdown of alcohol?
Which enzyme pathway is primarily involved in the breakdown of alcohol?
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What is a significant effect of alcohol on the absorption of amino acids?
What is a significant effect of alcohol on the absorption of amino acids?
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Study Notes
Alcohol and Nutrients
- Alcohol is a general term for organic chemicals with a –OH group, with common properties. Ethanol is the most commonly consumed type. This course will use "alcohol" to refer specifically to ethanol.
- Alcohol is absorbed 100% in the small intestines (80%) and stomach (20%).
- Alcohol is mostly metabolized in the liver.
- Alcohol spreads throughout the body, impacting the brain and other tissues, until metabolized.
- Alcohol acts as a toxin, sedative, and CNS depressant, in addition to being a psychoactive drug, and a source of energy.
Introduction
- Alcohol is a broad term.
- It's commonly consumed in the form of ethanol.
- An alcoholic has an overwhelming desire for alcohol beyond their ability to control it. This is regardless of common sense.
Upper GIT/Food Intake
- Alcoholics/Binge drinkers: Reduced gastric motility (movement) and emptying, nausea, and loss of appetite lead to decreased food intake.
- Short-term appetite stimulation occurs, peaking within one hour.
- Increased energy intake through alcohol may create a positive energy balance.
Upper GIT
- Acute alcohol ingestion inflames the stomach.
- This may cause hidden bleeding and iron loss.
- Alcohol can cause upper gastrointestinal bleeding due to damage to the esophageal lining.
Pancreas
- Alcoholism is a major cause of recurring pancreatitis (inflammation of the pancreas).
- Pancreatic insufficiency results from pancreatitis.
- Pancreatic lipase decreases, leading to steatorrhea (undigested fat in feces) and weight loss.
- Absorption and utilization of fat-soluble vitamins are reduced.
Small Intestines
- Alcohol (0.5-3%) in small intestines reduces amino acid and glucose absorption.
- Thiamin, Vitamin B12, and folate absorption are also reduced for chronic alcoholics.
Liver
- The liver is the largest organ in the body, responsible for numerous roles.
- Alcohol breakdown occurs primarily in the liver, accounting for 80% in the process.
- Alcohol-related liver diseases account for a significant amount of liver problems in Western countries.
Liver: Suggested Mechanisms
- Steatosis (fatty liver) is the first step that leads to alcoholic hepatitis to ultimately lead to cirrhosis.
- Oxidative stress from alcohol breakdown causes cell inflammation and scarring.
- Toxins from the gastrointestinal tract are transported to the liver leading to inflammation and scarring.
Alcohol Metabolism
- Alcohol can be metabolized by the Alcohol dehydrogenase pathway (ADH) and the Microsomal ethanol oxidizing system (MEOS).
- A byproduct of alcohol metabolism is acetaldehyde and the liver further breaks this down into acetic acid.
Steatosis
- Steatosis, or fatty liver, occurs briefly after moderate drinking and is usually reversible.
- Acetaldehyde is converted into acetic acid, leading to fatty acid synthesis and triglyceride accumulation in the liver.
Alcoholic Hepatitis
- Alcoholic hepatitis is inflammation of the liver cells (hepatocytes).
- Cytokines induce cell death.
- Genetic predisposition influences susceptibility.
Liver Cirrhosis
- Inflammation (swelling) and hardening (scarring) of liver cells occur in cirrhosis.
- Liver architecture is lost.
- Acetaldehyde stimulates collagen deposition, leading to scarring.
- Symptoms include jaundice, enlarged liver, pain and can lead to liver failure.
Effect of Alcohol on Nutrients
- Alcohol-related changes in the liver affect nutrient utilization.
- Most significant effects result from heavy alcohol consumption.
- Small amounts of acetaldehyde can cause nausea, headache, palpitation, and decreased blood pressure.
Magnesium
- Increased magnesium excretion in urine in alcoholics.
- Alcohol decreases the response to parathyroid hormone.
- A sudden decrease in blood pressure, and potentially cardiac arrest, could result.
Zinc
- Insufficient zinc intake in alcoholics.
- Reduced intestinal absorption and increased excretion occurs due to low albumin levels.
- Alcohol affects zinc excretion.
- This leads to taste and smell changes.
- Impaired cell-mediated immunity and wound healing occur.
Vitamin A
- Alcohol affects zinc, which partially impacts retinol (Vitamin A) metabolism.
- Alcohol, and zinc deficiency impacts vitamin A metabolism.
- Zinc deficiency affects retinol-binding protein synthesis and the conversion of retinol to retinal.
Thiamin
- Thiamin deficiency is common among alcoholics due to insufficient intake, decreased absorption and increased calorie-to-thiamin ratios.
- Significant cognitive issues and Wernicke-Korsakoff syndrome occur.
- Psychosis, altered consciousness, and ataxia (muscular coordination problems) particularly in the eyes.
- Severe, or untreated cases, may result in permanent amnesia and ataxia.
Folate
- Folate deficiency is prevalent among alcoholics due to poor diet, malabsorption, and increased urinary loss.
- Oxidative catabolism caused by acetaldehyde contributes to the folate loss.
- Deficiency results in anemia and problems with cell division.
Pyridoxine
- Pyridoxine deficiency is common among chronic alcoholics.
- Related to the suppression of pyridoxal phosphatase and the displacement of pyridoxal-5-phosphate (active vitamin form) from its protein binder.
- Excretion of pyridoxine increases due to alcohol-related issues.
- Symptoms include anemia, withdrawal symptoms, and convulsions.
Nutrition Therapy of Chronic Alcoholics
- Treat with intravenous and oral fluids, high protein, minerals, and vitamins.
- Specific supplements to address deficiencies in B vitamins, along with nutritional counselling, is recommended.
Prevailing Conditions
- Danger of significant protein deficiency.
- Deficiencies of other minerals.
- Deficiencies of B vitamins in these individuals.
Nutrient Depletion
- Depletion depends on length of alcohol consumption, and the amount of food consumed during and between drinking periods.
Treatment
- Includes intravenous and oral fluids, along with a high protein, mineral and vitamin mix.
- High Vitamin B6 (pyridoxine, 100mg/day) and 50mg thiamin (for neurological issues and ataxia).
- Regular consultation with a dietician/nutritionist is crucial.
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Description
This quiz covers essential information about alcohol, focusing on its definition, absorption, metabolism, and effects on the body. It discusses the implications of alcohol consumption, particularly in relation to nutrition and appetite. Test your knowledge on the role of ethanol as a psychoactive substance and its impact on the gastrointestinal system.
