Academic journal article Alcohol Research: Current Reviews

Development, Prevention, and Treatment of Alcohol-Induced Organ Injury: The Role of Nutrition

Academic journal article Alcohol Research: Current Reviews

Development, Prevention, and Treatment of Alcohol-Induced Organ Injury: The Role of Nutrition

Article excerpt

Alcohol and nutrition have the potential to interact at multiple levels. For example, heavy alcohol consumption can interfere with normal nutrition, resulting in overall malnutrition or in deficiencies of important micronutrients, such as zinc, by reducing their absorption or increasing their loss. Interactions between alcohol consumption and nutrition also can affect epigenetic regulation of gene expression by influencing multiple regulatory mechanisms, including methylation and acetylation of histone proteins and DNA. These effects may contribute to alcohol-related organ or tissue injury. The impact of alcohol-nutrition interactions has been assessed for several organs and tissues, including the intestine, where heavy alcohol use can increase intestinal permeability, and the liver, where the degree of malnutrition can be associated with the severity of liver injury and liver disease. Alcohol--nutrition interactions also play a role in alcohol-related lung injury, brain injury, and immune dysfunction. Therefore, treatment involving nutrient supplementation (e.g., with zinc or S-adenosylmethionine) may help prevent or attenuate some types of alcohol-induced organ damage.

Key words: Alcohol consumption; alcohol use, abuse, and disorder; heavy alcohol consumption; alcohol-nutrition interactions; organ injury; tissue injury; intestine; nutrition; nutrients

The effect of alcohol on organ health and injury is complex and influenced by a host of different factors, such as dose of alcohol consumed; duration and pattern of drinking (e.g., binge drinking); and, as reviewed in this article, potential interactions with nutrition. The 2015-2020 Dietary Guidelines for Americans (U.S. Department of Health and Human Services and U.S. Department of Agriculture 2015) highlight the concept of the standard drink and the fact that if alcohol is consumed, it should be in moderation (i.e., up to 1 drink per day for women and 2 drinks per day for men in adults of legal drinking age). It is becoming increasingly accepted that this moderate form of drinking may have health benefits that seem to lessen many types of organ injury. This concept was popularized in 1991, when Morley Safer presented information on the television show 60 Minutes related to the "French paradox"--that is, the observation that the French seemed to have lower rates of heart attacks despite higher fat consumption. This outcome was postulated as possibly resulting from the beneficial effects of wine consumption by the French. Subsequent studies have shown that all forms of alcohol, when consumed in moderation, seem to lower the risk of coronary artery disease (Yang et al. 2016). The beneficial effect can be represented by a J-shaped curve, in which low alcohol consumption has protective effects compared with abstention, whereas excessive alcohol consumption is harmful. Moderate drinking also may have beneficial effects on several other organs and organ systems, including the following:

* Decreased risk of ischemic stroke (Sacco et al. 1999);

* Protection against type 2 diabetes (Conigrave et al. 2001);

* Decrease in rheumatoid arthritis (Di Giuseppe et al. 2012);

* Improved cognition (Anstey et al. 2009);

* Decreased progression of liver disease to fibrosis in obese individuals (Thomson et al. 2012); and

* Improved renal function (Koning et al. 2015).

Indeed, moderate alcohol consumption may be associated with an overall modest survival benefit (Ford et al. 2011).

Moderate alcohol consumption also has been shown to decrease biomarkers of inflammation, such as C-reactive protein, and reduced inflammation could be one unifying mechanism underlying alcohol's protective effects (Imhof et al. 2004). On the other hand, long-term heavy alcohol abuse can cause organ injury, which may, at least in part, result from alcohol-nutrient interactions and alcohol-related nutrient deficiencies. As described in this article, people who abuse alcohol frequendy consume large amounts of alcohol, which may contribute to the displacement of needed nutrients (see figure 1). …

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