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Charles S. Lieber, MD

JAMA. 1975;233(10):1077-1082.

Abstract
Malnutrition is common among alcoholics because alcohol displaces protein-, vitamin-, and mineral-containing foods in the diet, and chronic alcohol consumption results in maldigestion and malabsorption of essential nutrients. In addition, alcohol exerts direct toxic effects on both the liver and gut, resulting in structural alterations in the intestine and the development of fatty liver, alcoholic hepatitis, and cirrhosis. Liver injury is preceded by an adaptive phase characterized by accelerated metabolism of drugs (including ethanol), and hyperlipemia, secondary to hypertrophy and hyperactivity of the smooth endoplasmic reticulum. Side effects include enhanced hepatotoxicity of CCI₄ and possibly energy wastage. Alcoholics should not be led to believe that correction or prevention of nutritional deficiency will prevent liver damage in the face of continued alcohol abuse.

(JAMA 233:1077-1082, 1975)

Author Affiliations
From the Section and Laboratory of Liver Disease and Nutrition, Veterans Administration Hospital, and the Department of Medicine, Mt. Sinai School of Medicine of the City University of New York, Bronx, NY.

Footnotes
Authorized for publication by the AMA Council on Foods and Nutrition, Philip L. White, ScD, Secretary.

Reprint requests to AMA Department of Foods and Nutrition, 535 N Dearborn St, Chicago, IL 60610.

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