Clinicians and researchers already know that people with alcohol use disorders (AUDs) have disrupted eating patterns, nutritional intake, and metabolism. Findings collected from clinical studies and a meta-analysis of the dietary habits of both inpatients and outpatients has compiled several consistent themes regarding diet quality, ultra-processed food (UPF) consumption, and food addiction in people with AUDs. These findings will be shared at the 49th annual scientific meeting of the Research Society on Alcohol (RSA) in San Antonio, Texas.
“Diet quality matters even when overall calorie intake appears “normal,” said Jennifer J. Barb, Acting Chief, Translational Biobehavioral and Health Promotion Branch at the National Institutes of Health Clinical Center (CC). “People with AUD may shift toward ultra-processed foods and products high in added sugars as a substitute for alcohol cravings, and these dietary patterns may increase health risks, especially in early recovery.”
Barb added that ultra-processed foods (UPFs) are common in the Standard American Diet, and are often inexpensive, heavily marketed, and widely accessible: sugar-sweetened beverages, fast foods, packaged snacks, processed meats, and ready-to-eat meals. “For some individuals with an AUD, socioeconomic challenges and food insecurity may further increase reliance on these types of foods because they are affordable, convenient, and readily available compared with fresh, nutrient-dense options,” she hypothesized.
“Addiction-like eating is common,” said Barb. “Based on a currently in progress retrospective study, about one in three people with AUD show food addiction-like symptoms, which are tied to psychological distress, higher body weight, and alcohol severity.” She added that her current research suggests that people with AUD may present with any one of the following compulsive food behaviors such as: eating larger amounts of food over longer periods than intended; a persistent desire or unsuccessful efforts to cut down or control eating; a great deal of time spent obtaining, eating, or recovering from eating; cravings or strong urges to eat certain foods; continued eating despite awareness that it causes problems; and withdrawal-like symptoms when certain foods are reduced or removed.
Barb believes that integrating nutrition and behavioral care into AUD treatment could improve recovery and long-term health; she is currently working with a CC dietician investigating the feasibility of an inpatient study that will explore how offering whole-food, nutrient-dense meal options with reduced or eliminated UPFs could help to support recovery during early abstinence while inpatient.
“Our research suggests that an AUD is not only about alcohol use,” said Barb. “It can also affect how people regulate their appetite and food choices, which may influence eating habits and metabolism. As a result, nutrition – including intake of UPFs and patterns of compulsive or “addiction-like” eating – may be an important but often overlooked part of comprehensive AUD care. Paying attention to diet quality early on may help reduce medical complications, support recovery, and improve overall quality of life.”
Barb hopes that treatment providers can benefit from these findings, as well as physicians, nurses, dietitians, psychologists, counselors, and program administrators who treat people with AUD. “Our findings are also valuable for researchers, public health professionals, and policy makers interested in learning about how nutrition and dietary intake behaviors intersect with addiction,” she added.
References:
1. https://pubmed.ncbi.nlm.nih.gov/41605905/
2. https://pubmed.ncbi.nlm.nih.gov/40801437/