Mechanisms of Malnutrition: Nutrition-related Diseases

1
Mechanisms of Malnutrition Nutrition-related
Diseases

• M. Burns, PhD, RD
• FCS 4753

2
Session Outcomes

• Identify the different causes of malnutrition in
  those with alcoholism.
• Differentiate among the four diet patterns
  frequently seen in alcoholics.
• Analyze provided meal plans on adequacy of key
  nutrients that are commonly deficient in
  alcoholics.

3
Causes of malnutrition

• Poor diet
• Alcohol can contribute 50-75 of kcalories
• Other food choices, food intolerances
• Anorexia (lack of appetite)
• Suppresses the hypothalamus
• Physiological changes

4
Causes of malnutrition

• Energy source
• Short-lived energy source
• Hypoglycemia
• Due to energy source
• Body learns to use alcohol as energy thus
  impairing proper glycolysis

5
Causes of malnutrition

• Malabsorption
• Causes diarrhea, food allergies
• Utilization
• Liver, kidney, and pancreas function altered
• Impairments in metabolism

6
Causes of malnutrition

• Excretion
• Increases excretion of many vitamins and minerals
• Ca, Mg, Zn, P
• Increased needs to detoxify and metabolize drugs
  AND to compensate for and replete systemic
  disorders

7
Diet Patterns in Substance Abusers

• Basic Four
• Weight Maintainer
• Know-it-all
• Binger
• Junk food junkie

8
Basic Four Diet Pattern

• Junk food, fast food, fuel food, and stimulants
• Excessive in sodium and potassium, and calories
• Health consequences?

9
Weight Maintainer Diet Pattern

• Liquid BF, liquid lunch, and steak and salad for
  dinner (small servings)
• Low calories and protein, and all nutrients but
  Vitamin C and niacin
• Health consequences?

10
Know-it-all Diet Pattern

• Well balanced meals, but small portions
• 100 of RDA for most nutrients, but inadequate
  zinc and folic acid
• Health consequences?

11
Binger Diet Pattern

• Coffee for BF, light lunch, fast food for dinner,
  binges of low nutrient dense snacks
• Excessive in most nutrients, with mild
  malnutrition
• Health consequences?

12
Junk Food Junkies

• Variation of Weight Maintainer
• Maintain weight, but have an irregular,
  convenience- and fast-food diet
• Feelings of guilt for not eating better and
  insecurity about food availability

13
Moment of Application

• Why can alcoholics be underweight, overweight or
  of normal weight?
• Why can some appear healthy looking?

14
Types of malnutrition

• B vitamins
• Vitamin C
• Calcium
• Protein/Protein Energy Malnutrition

15
Wernicke-Korsakoff Syndrome

• Brain damage due to thiamin deficiency
• Fairly common
• Triad of symptoms
• Vision dysfunction, ataxia, mental disturbances

16
Pellagra

• Niacin (B3) deficiency
• Caused mostly by the drink as the substitute for
  food
• Symptoms insomnia, fatigue, nervousness,
  depression
• Tx Niacin and tryptophan

17
Other B vitamins

• Pyridoxine
• Folic acid
• Most common form of hypovitaminosis

18
Scurvy

• Vitamin C deficiency
• Leads to bleeding gums and poor dental health
• Fairly common and is heightened with smoking

19
Osteoporosis

• Decreased calcium intake due to lactose
  intolerance
• Calcium deficiency due to impaired absorption
• Heightened calcium excretion
• Vitamin D normal

20
Protein

• Basis for many of the problems
• Inadequate diet and altered amino acid
  transportation