The Nutritional Damage of Alcohol Abuse

Care for a drink before your meal?” asks the waitperson. “Yes, but hold the food” is the increasing reply. The cocktail is enjoying a renaissance in our country as a sophisticated way to drink and socialize. Meeting for cocktails rather than for a meal is a more casual way to socially interact; it takes the pressure off of performing as host and guest and provides more flexibility for busy schedules. It’s also considerably less expensive. As New York Times writer William L. Hamilton describes it, “Fewer people want to be onstage for two hours, eat three courses and pay four figures.”

There are physiological reasons people skip meals for alcoholic beverages. The body constantly endeavors to maintain fat. Drinking alcohol without eating food stimulates to the liver to make fat at a rate fifteen times faster than without the drink. Very little (less than 5 percent) of the alcohol itself is stored as fat, however, most of the alcohol becoming acetate, the chemical of hangovers. Drinking only stimulates the storage of fat from other sources.

There are also physiological reasons for drinking with a meal. Clinical studies confirm that drinking an alcohol beverage with a meal makes food taste and smell better. Having a drink with a meal eliminates aftertaste. Not surprisingly, drinking alcohol kills cravings for fatty foods (although not as much as eating a high-protein meal without alcohol).

Alcohol provides “empty” calories in the most literal sense. Different kinds of major nutrients stimulate different amounts of “waste” heat production in differing degrees. The body stores carbohydrates and fats efficiently, but it stores protein only after increasing the production of body heat. About 17 percent of the calories in protein are lost to increased thermogenesis. About 27 percent of the calories in alcohol are lost to thermogenesis, partially explaining how heavy drinkers—of more alcohol drinks—tend not to be overweight.

Since alcohol disrupts metabolism in many ways, problem drinkers tend to have nutritional problems. Some of their nutritional deficiencies are caused by an impaired ability to absorb nutrients. Others are caused by the fact that alcoholics tend not to eat. Alcohol stimulates appetite, but some of the same genetic alterations that predispose people to alcoholism also induce anorexia.

Some problem drinkers have an abnormality in the brain’s production of the enzyme tyrosine hydroxylase. This chemical allows the brain to convert the amino acid tyrosine into the mood-lifting hormone norepinephrine. Chronic use of alcohol depletes the enzyme, and sets off not one or two but three vicious cycles.

The first problem is that depletion of the enzyme by excess alcohol causes depression, and depression leads the alcoholic to drink. Since physical activity helps the remaining tyrosine hydroxylase work more effectively, alcoholics with this defect tend to be driven to remain active and alert. Their bodies burn more calories.

The second problem is that depression leads to sugar cravings. Higher sugar levels clear alcohol out of the bloodstream, and the result is a craving for both alcohol and sugar. Finally, many alcoholics consume alcohol and sugar almost to the total exclusion of other nutritious foods—and even when these alcoholics do eat healthy food, their bodies have trouble absorbing nutrients.