Body composition changes induced by chronic ethanol abuse: Evaluation by dual energy X-ray absorptiometry

OBJECTIVE: Nutritional disorders in alcoholics remain one of the most relev ant medical problems in Western societies. As ethanol can supply >50% of th e dietary energy in alcoholics, body composition alterations may easily occ ur. The aim of the present study was to evaluate the influence of chronic a lcohol consumption on body composition in alcoholics compared to healthy so cial drinkers. METHODS: A total of 34 alcoholics defined according to DSM III R criteria, aged 41.6 +/- 9.3 yr and with a body mass index (BMI) 23.8 +/- 3.2 kg/m(2), were consecutively enrolled in the study. In addition, 43 healthy male soc ial drinkers were used as controls. Body composition was assessed using dua l energy x-ray absorptiometry (DXA), and dietary habits were determined by a 3-day food diary. RESULTS: Mean daily alcohol intake was 194 +/- 62.4 g/day in alcoholics and 35.7 +/- 5.2 in healthy subjects (p < 0.0001). Body weight did not differ between alcoholics and controls (70.1 +/- 9.9 vs 71.8 +/- 6.4 kg). Alcoholi cs had a lower percent body fat (PBF) than control subjects (18.7 +/- 3.7 v s 23.9 +/- 3.9%; p < 0.01), as well as a lower fat mass content (13.4 +/- 3 .8 vs 17.0 +/- 3.7 kg; p < 0.01). BMI was highly correlated with PBF in the patient population studied (R = 0.79; p < 0.0001). Significantly higher wa ist-to-hip ratios were found in alcoholics than in healthy subjects (p < 0. 01). No correlation was found between dose of ethanol or duration of alcoho l abuse and any of the variables examined. CONCLUSIONS: Alcoholics showed a reduced fat mass and a good preservation o f lean body mass with respect to control subjects, and duration of alcohol use and alcohol dose did not seem to influence body composition. These data suggest that, unlike control subjects, alcoholics cannot store the calorie s provided by ethanol as fat deposits. (Am J Gastroenterol 2000;95:2323-232 7. (C) 2000 by Am. Coll. of Gastroenterology).