Alcohol is a favourite drink for many since centuries across the globe. People drink it as a pre-dinner drink or for celebrations or as formal occasion. Many drink alcohol regularly without giving a thought as to what it is causing to their digestion and nutrition.In some moderate habitual drinkers, alcohol tends to improve appetite because of its euphoriant effect on brain. But in many others it tends to reduce the appetite, hence quantity of food consumed due to the high amount of calories present.   There are seven kilogrammes of calories present in alcohol. These are empty calories as it has no other nutrients. Because of this many people eat poorly after drinking. They feel full after drinking. Overall result is that they are deprived of essential nutrients and thus suffer from chronic malnutrition after a period of time. Because of the high calories provided to the body, alcohol tends to increase the body weight of an individual, which results in obesity. Internally, levels of fat and glucose are increased in the blood, which becomes the cause for increase in hypertension, diabetes and heart problems   in alcoholics.Alcohol has a direct irritant and inflammatory effect on the protective inner lining of the stomach. This causes pain in the upper part of stomach, burning sensation in the stomach and chest, nausea and vomiting. Chronic use of alcohol also causes inflammation of the pancreas. This leads to severe pain in upper abdomen which is relieved by bending forwards. Due to these types of pain also, a person is not able to eat adequately and the overall food intake of a person is reduced. This contributes to physical weakness and malnourishment. Regular intake of alcohol tends to drive out some essential nutrients from the body. The most damaging effect is on folic acid (a component of vitamin B.complex). Normally liver contains adequate folate to meet the entire  requirement of the body. But alcohol tends to drive out folate from the liver. Thus folate levels rise in the blood and it is   expelled from the kidneys. Resultant deficiency of folate damages the cells of the intestine and impairs the digestion of the person. Thereafter, the person is unable to eat food in sufficient quantity. This harms his overall nutritional status. Folate deficiency also causes anemia (deficiency of blood)  and impairs the body’s ability to regenerate damaged cells. This becomes a risk factor for cancer of the colon and rectum. All these factors contribute to physical weakness.Alcohol deprives the body of Pyridoxine (vitamin B6), due to the action of acetaldehyde (a metabolic product of alcohol in the body). This results in damage to the nerves causing burning sensation in the feet and palms.Malnutrition due to alcohol also occurs due to its interference with absorption and metabolism of essential nutrients of the body. Cells of the intestine fail to absorb vitamins of the B.complex group causing deficiency of vitamin B.complex in the body. This manifests as ulcers over the tongue and lips and around mouth, dryness of the skin, abnormal sensations in the limbs and muscular weakness. One can also develop photophobia, that is, headache occurring after exposure to sunlight due to deficiency of vitamin B. complex.The liver cells lose their ability to activate vitamin D due to effect of alcohol on the liver cells. The result is weakening of the bones of the body. In elderly people, this can cause pathological fractures, that is, spontaneous breaking of the bones without any trauma. Normally cells of the retina (curtain of the eye where an image is fixed) convert retinol (a component of vitamin A) into aldehyde which is needed for vision. But due to interference by alcohol, these cells start converting retinol to acetaldehyde which contributes to malnutrition. The vision of a person is damaged due to this, apart from the direct toxic effect of alcohol on the retina.Thus one can see clearly that over a period of time, regular use of alcohol greatly   impairs the nutrition of a person and results in chronic malnutrition. An alcoholic never feels as energetic and fresh as his counterparts who do not drink or just take it occasionally. It is a myth that some types of drinks are safe because alcohol content is low. But this is a false belief. Any type of alcohol taken regularly is harmful for overall nutritional status of a person.Dr Rachna Pande,Specialist Internal medicine, Ruhengeri Hospital