Decreased Appetite for Food in Alcoholism

Long-term alcohol intake can decrease the total amount of food consumed when food is freely available and over time this can promote the development of a severely malnourished state. Alcoholic beverages are high in calories but low in nutrients and how the body uses the energy contained in alcohol is complex and not well understood. Assessment of meal composition has highlighted that the alcohol-induced alteration in food intake may be highly specific and linked to impaired appetite for carbohydrate (in particular). The aim of this chapter is to explore this very specific alcohol effect (i.e. decrease in appetite for carbohydrate). We will begin by investigating whether alcohol is a food for the human body and then briefly look at the biochemical processes associated with regulation of appetite for carbohydrate. It is well accepted that appetite for carbohydrate is largely dependent on the efficient performance of cortisol, a steroid under the control of the hypothalamic-pituitary-adrenal axis, and insulin a pancreatic peptide hormone. In the last section we will look at data from a number of studies aimed at assessing the effect of alcohol on cortisol and insulin under variable nutritional conditions in order to conclude that a decreased appetite for carbohydrate may be a physiological consequence of alcohol consumption.