Nutrition

Question 1

How does food affect alcohol metabolism etc

Answer 1

It reduces absorption and speeds up elimination of alcohol
Slows gastric emptying
Feeding = higher portal blood flow which speeds up metabolism

Question 2

How many calories are in 1g of alcohol

Answer 2

7

Question 3

How does alcohol affect weight gain - short and long term

Answer 3

Short - don’t compensate for the excess calories consumed in alcohol and drinking makes you more likely to eat more
Long - lack of evidence but potentially binge and heavy drinking are linked to weight

Question 4

How does alcohol increase your risk of deficiencies

Answer 4

Altered food intake/appetite
Decreased secretion of pancreatic enzymes and bile
Damages cells lining stomach and intestine which decreases absorption
Decreased liver stores of vitamins
Increased excretion
Alcohol metabolism uses up thiamine

Question 5

When is it common to see muscle wasting and weight loss

Answer 5

Alcoholic liver disease
95% of patients
Nutritional deficiency also common in this group

Question 6

What is the function of thiamine

Answer 6

ATP production
Nerve conduction
Maintenance of neural membranes

Question 7

Why is thiamine deficiency common in chronic alcohol use

Answer 7

Poor food intake - less thiamine 
Decreased conversion to coenzyme 
Reduced storage due to fatty liver 
Inhibited intestinal absorption 
Increased demand due to ethanol metabolism

Question 8

What 3 conditions can be caused by thiamine deficiency

Answer 8

Dry beriberi
Wet beriberi
Wernicke-Korsakoff Syndrome

Question 9

What is dry beriberi

Answer 9

Affects the nervous system

Polyneuropathy, weakness, numbness usually in lower limbs

Question 10

What is wet beriberi

Answer 10

Affects the CV system
Increased HR
SOB
high output cardiac failure

Question 11

Describe Wernicke’s encephalopathy

Answer 11

Neurological disease causing confusion, ataxia and eye abnormalities
Reversible if caught early

Question 12

Describe Korsakoff’s syndrome

Answer 12

Mental disorder
Amnesia and confabulation
Mostly irreversible

Question 13

What vitamins and minerals may alcoholics become deficient in except thiamine

Answer 13

Folate and B12 - metabolism impaired leading to anaemia
Niacin - pellagra sometimes seen
Vit A - metabolism is abnormal so plasma levels fall and may cause blindness
Calcium - increased excretion may cause osteoporosis
Zinc - lesions in mouth ,nose and eyes

Question 14

How does alcohol consumption affect CV health

Answer 14

Heavy drinking may increase risk

Little to no evidence that low amounts have any effect - no benefit

Question 15

How does alcohol affect cancer risk

Answer 15

Increases risk of several cancers:

breast, bowel, liver, mouth/throat, oesophageal and stomach

Question 16

By which mechanisms does alcohol increase cancer risk

Answer 16

Breakdown products are carcinogenic
Acts as a solvent that allows carcinogen to enter cells
Combined effect with oestrogen increases breast cancer risk
Causes deficiency in essential nutrients

Question 17

How does alcohol consumption affect blood glucose

Answer 17

Affects the foods we eat. the breakdown of glycogen and gluconeogenesis
Also interferes with insulin, reducing it’s effectiveness
Affects hypoglycaemic medication

Question 18

What is the risk of drinking during pregnancy

Answer 18

Low birth weight or preterm
foetal alcohol syndrome
spectrum of disorders that leads to abnormal appearance, behaviour and learning difficulty etc