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Review
. 2021 Aug;25(3):557-570.
doi: 10.1016/j.cld.2021.03.002. Epub 2021 May 26.

Malnutrition and Alcohol-Associated Hepatitis

Craig J McClain  1 , Cristian D Rios  2 , Sally Condon  2 , Luis S Marsano  3
Affiliations
Review

Malnutrition and Alcohol-Associated Hepatitis

Craig J McClain et al. Clin Liver Dis. 2021 Aug.

Abstract

Malnutrition is common in alcohol-associated hepatitis (AH); almost all patients with severe AH have some component of malnutrition. The classic phenotype of malnutrition in AH is sarcopenia, but this has become more difficult to discern clinically as patients have become more obese. Patients with AH are often drinking 10 to 15 standard drinks per day. This substantial alcohol consumption becomes a major source of calories, but these are considered "empty" calories that contain little nutritional value. Malnutrition is associated with liver complications, such as hepatic encephalopathy, and worse liver outcomes. Nutrition support can improve nutrition status and reduce complications.

Keywords: Alcohol-associated hepatitis (AH); Malnutrition; Micronutrients; Nutrition; Standard drink.

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Figures

Figure 1.
Figure 1.
Drinking levels and their consequences. In the United States, drinking levels are expressed in terms of standard drinks consumed—that is, the number of alcoholic beverages drunk, each containing about 0.6 fluid ounce or 14 grams of pure alcohol. The Dietary Guidelines for Americans 2015–2020 defined moderate drinking as consuming up to 2 drinks/day for men and up to 1 drink/day for women. The Substance Abuse and Mental Health Services Administration defines binge drinking as consuming 5 or more (for men) or 4 or more (for women) alcoholic drinks on the same occasion on at least 1 day in the past 30 days. Patients hospitalized for severe AH in the NIAAA-funded DASH study were drinking approximately 13–15 drinks/day. (Data from http://www.rethinkingdrinking.niaaa.nih.gov)
See this image and copyright information in PMC

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