Similarly, a significant increase in craving for and consumption of chocolate was observed in alcohol-dependent patients following alcohol detoxification. Importantly, these changes were not related to alcohol craving but had a temporary protective effect on alcohol relapse 24. Whether this heightened preference for sweets/palatable foods is an attempt to restore caloric deficits, alleviate the negative consequences of alcohol withdrawal, or both is less clear.
Mechanistically, D-BHB enhances the expression of BDNF through downstream targeting of CREB and acetylation of BDNF promoters (176–178). While some clinical evidence points to serum BDNF being significantly increased following adherence to a KD (116, 179, 180), nutritional therapy for alcohol use disorder Vizuete et al. (181) found a KD decreased striatal BDNF levels and had no effect on hippocampal levels of BDNF in Wistar rats. The KD and D-BHB’s effect on BDNF expression in the context of AUD warrants investigation. Attending events or gatherings where alcohol is present can be difficult, especially when there are limited healthy food options available.
- Magnesium supplementation should be given along with thiamine supplementation, as mentioned above.
- Additionally, a lack of vitamin B6 (pyridoxine) can disrupt the formation of neurotransmitters, which are essential for proper brain function.
- Alcoholic cirrhosis results in a combination of undernutrition and overnutrition, which requires individualized management, including monitoring of nutritional status and nutritional guidance.
- It is likely that specific features of the patient sample and treatment program may influence weight changes during this period.
- Due to decreased hepatic storage, vitamin B9 and vitamin B12 deficiencies can develop quickly in chronic liver illness.
- Furthermore, deficiency of certain micronutrients (e.g.. Zinc, Magnesium, Selenium, Folate, and Omega-3) has been documented to trigger negative emotional states (i.e., depression, anxiety, and suicidal ideations) 215–219 and could mediate alcohol toxic effects 220.
Nutritional deficiencies and their impact on brain function
Imaging scans use sound waves or radiation to create images inside the body that can be looked at for indications of problems such as tumors. Physical examinations involve a doctor examining the patient and making evaluations by listening to their heart or observing changes in their skin color and texture. Biopsies involve taking small tissue samples from organs that can then be examined under a microscope for signs of disease. The first stage is Wernikes encephalopathy, which presents itself as an acute condition, characterized by memory loss and impairment of cognitive and motor functions. Other symptoms may include confusion, poor concentration and problem-solving skills, vision disturbances, mental dullness or slowed mental activity, slurred speech. All these digestive complications lead to decreased digestion efficiency, which can result in malnutrition.
Effects of Nutritional Ketosis on Alcohol Withdrawal
This can result in vitamin and mineral deficiencies, which can have detrimental effects on cognitive and neurological health. Although withdrawal symptoms measured with the Clinical Institute Withdrawal Assessment—Alcohol revised did not differ between diet groups, patients in the standard American control diet received more benzodiazepines than patients treated with the KD. In the brain, the KD elevated levels of the metabolic markers acetone, AcAc, and glutamate and decreased choline and myo-inositol, metabolites linked to neuroinflammation (8). Correlations between low plasma BHB levels and greater social impairment, depression, and brain white matter alterations in patients with AUD also support the clinical relevance of BHB (43). In this regard, enhanced consumption of sugar/sweet food in individuals recovering from AUD and its potentially protective effect could shed some light 23, 24. Eating sweets is also recommended by Alcoholics Anonymous to curb alcohol cravings 25.
The Impact of Nutrition on Addiction-Related Mental Health Disorders
While follow-up dietary assessment would be of benefit, collected data did cover the most initial phases of detoxification, during which researchers could hypothesize that usual intake may be most affected. Regarding muscle recovery, alcohol consumption, especially during the post-workout recovery window, may suppress muscle growth and repair by reducing the rate of muscle protein synthesis. This effect appears to be more pronounced in men, with studies showing significant reductions in muscle protein synthesis when alcohol is consumed after exercise. Alcohol also interferes with the body’s ability to digest carbohydrates and fats, which are important for muscle growth. Furthermore, alcohol decreases testosterone production and increases estrogen levels, which can have feminising effects in males. According to the American Athletic Institute, alcohol consumption can potentially negate up to two weeks’ worth of training progress in athletes.
Glutamate levels in the nucleus accumbens (71) and thalamus (72) have been shown to be elevated in individuals with AUD compared to non-dependent controls. However, glutamate levels in the anterior cingulate cortex have been reported to be higher (73), lower (74, 75) or unchanged (71, 72, 76) in AUD individuals during early withdrawal compared to non-dependent controls. In individuals struggling with alcoholism, stress is a common trigger for relapse, making nutrition an important factor in stress management. Consuming fewer foods rich in saturated fats, sugars, or caffeine is beneficial, as these can lead to fluctuating energy levels, resulting in fatigue and irritability that might exacerbate stress. Maintaining proper hydration by drinking sufficient water throughout the day is also key in managing stress. Additionally, supplements like magnesium, known for their relaxing properties, can be effective in soothing nerves and thereby playing a significant role in long-term stress regulation.
Peer pressure or the temptation to drink can also make it harder to stick to a nutritional therapy plan. The impact of alcohol on the elderly population is multifaceted and potentially more severe than in younger adults. By addressing both the direct effects of alcohol and its nutritional implications, interventions can be tailored to support the health and well-being of older individuals dealing with alcohol-related issues. Alcohol is a diuretic, meaning that it increases urine production and leads to dehydration.
Passing through the brain blood barrier and entering the mitochondria of cells in the brain through monocarboxylate transporters, BHB is metabolized into AcAc and then into acetyl-CoA, which feeds into the TCA cycle (Figure 1). Studies of D-BHB supplementation have shown benefits of providing ketones as an alternative to glucose as an energy source for the brain. These findings lend support to the therapeutic potential of nutritional ketosis in pathologies characterized by glucose insensitivity by providing an alternative energy substrate.
Role of Nutritional Therapy in Holistic Treatment
Ethanol-induced oxidative stress plays a critical role in AUD and related pathology. Certain micronutrients and antioxidant deficiencies commonly observed in AUD patients can further exacerbate this and could contribute to the development of alcohol dependence, alcoholic liver disease, and impaired emotional and cognitive controls 223–226. Fruits, vegetables, and medicinal plants rich in antioxidants could have beneficial effects in this regard 227–233.
Thus, neither of these studies may reflect habits of men and women in the U.S. undergoing AUD treatment in hospital-based inpatient programs. To quantify nutrient and food group intake, data were coded into Nutrition Data Systems for Research 2016–2017. Firstly, it is a central nervous system depressant, affecting the brain by acting on neurotransmitters such as GABA (gamma-aminobutyric acid) and adenosine, which slow down brain activity and create a feeling of relaxation and tiredness. While this may help some people fall asleep faster, it can lead to disrupted sleep later in the night, resulting in reduced overall sleep time and next-day fatigue. Alcohol can also worsen existing sleep disorders such as insomnia, snoring, and sleep apnea, a condition characterised by interrupted breathing during sleep.
Certain vitamins, including vitamins A, D, and K, should be administered with thiamine, folic acid, and pyridoxine to correct deficiencies 64,89. Long-term oral intake of a BCAA mixture is superior to a standard diet for improving serum albumin levels and energy metabolism 27. Plasma free amino acid imbalances lead to a decrease in BCAA, a decrease in Fischer’s ratio, or BTR due to an increase in aromatic amino acids and an increase in methionine levels. Aromatic amino acids and methionine are metabolized in the liver, and their blood levels are increased with worsening severity of cirrhosis. BCAAs are normally metabolized in peripheral tissues such as muscle and adipose tissue. However, in cirrhosis, they are used as an energy source and for ammonia metabolism, and thus, their blood levels are reduced.
We get amino acids from protein in foods like meat, dairy products, and nuts, along with some grains and beans. If loved ones are not supportive of the individual’s recovery efforts or do not understand the importance of proper nutrition, it can be challenging to maintain motivation and adhere to the nutritional therapy plan. Another barrier is the limited access to healthy food options in certain areas, known as “food deserts.” These areas often lack grocery stores or farmers’ markets that offer fresh, wholesome foods, making it challenging for individuals to maintain a balanced diet.
MeSH terms
In addition, fatty acid ethyl esters (FAEE) synthase produces FAEEs via nonoxidative metabolism 22. Additionally, vitamin E, an antioxidant, protects liver cells from alcohol-induced oxidative damage and may support liver tissue regeneration. Vitamin D plays a role in reducing inflammation in the liver, and vitamin K is essential for blood clotting, which can be compromised in individuals with liver damage.
- There have been contradictory findings on brain glutamate concentrations in AUD from proton magnetic resonance spectroscopy (1H-MRS) studies.
- This can make it difficult for some people to access or afford the necessary foods to support their recovery.
- S-adenosylhomocysteine (SAH) is a product and inhibitor of methyltransferase reaction (MTs) as well as a substrate for the bidirectional enzyme SAH hydrolase (SAHH), which creates homocysteine or SAH when SAH is in excess.
- It is also apparent that feeding peptides (e.g., ghrelin. glucagon-like peptide-1) that control metabolic status can regulate brain reward circuitry and alter alcohol intake and alcohol-reinforced behaviors 21, 22.
- Interestingly, this higher susceptibility to alcohol-related liver disease in females is not due to any macro- and micro-nutrient intake differences when compared to men 119, ruling out any sex-specific nutrition differences contributing to the pathology of AUD.
1.4. Proteins Recommended for ALD
Alcoholism can be conceptualized as a state of heightened brain stress systems and reduced reward functioning as a result of impaired central neurotransmissions (e.g., dopamine, opioids, serotonin, CRF) 240. Emotional and cognitive improvements were also registered following tryptophan-rich food supplements 242, 243. In addition, certain herbal supplements (e.g., Ashwagandha, Brahmi, St John’s Wort, Korean Red Ginseng) have also been shown to reduce ethanol withdrawal syndrome in rodents 244–246. Therefore, in addition to macro and micro-nutrients, certain herbs and dietary supplementation summarized in Table 1 could provide positive effects outside of the implied benefits to overall emotional, physiological, and nutritional status in the AUD 233, 247–264 (Fig. 2).
Additionally, chronic heavy drinking can disrupt hunger hormones, such as ghrelin, which can lead to the overeating of fatty or sugary foods. Significant strides have been made in investigating the underlying neurobiological mechanisms of addictive disorders, which has paved the way for pharmacotherapeutics development 6–9. However, a considerably higher relapse rate (40–60%) within the first year of abstinence remains a significant obstacle 10, demanding better therapeutics and effective strategies for the successful treatment of SUD 11. In this regard, compromised nutritional status and disrupted dietary habits have been documented in patients with substance use disorder 12–15. As a result, malnutrition is frequently reported in this population, which could substantially contribute to this relapsing disorder and related pathology 16, 17. Evidence exists that addressing nutrition-related issues could help in recovery from addictive disorders 18, 19, yet other than injecting B Vitamins for Wernicke’s encephalopathy 20, proper nutrition and diet are often overlooked as important treatment components of AUD.