Dietary intake, quality, and assessment tools in individuals with problematic alcohol use: a scoping review and meta-analysis

TL;DR

People with alcohol use disorder often have nutrient deficiencies despite normal calorie intake, highlighting the need for better dietary guidelines and assessment tools.

Contribution

This study systematically reviews dietary patterns and assessment methods in individuals with AUD, revealing gaps in diet quality evaluation.

Findings

Individuals with AUD typically have normal BMI and adequate caloric intake.

Nutrient deficiencies are common due to alcohol's impact on absorption and metabolism.

Only a few studies assessed diet quality or adherence to nutrient recommendations.

Abstract

Alcohol Use Disorder (AUD) is commonly associated with malnutrition, yet the relative contributions of inadequate intake versus alcohol-related metabolic disruption remain unclear. This scoping review summarizes existing literature on dietary intake patterns and diet quality among individuals with AUD, following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines. A comprehensive, systematic search was conducted without date restrictions, and dietary intake was categorized by drinking status (active vs. abstinent). Across 41 included studies, only four reported on diet quality or assessed adherence to recommended nutrient intake. There was considerable variability in both the reporting of dietary variables and the assessment tools utilized across studies. Weighted averages showed that individuals with AUD generally had Body Mass Index (BMI) values in the normal range and reported adequate total caloric intake and macronutrient distribution during both active drinking and abstinence. However, despite seemingly sufficient intake, nutrient deficiencies are common in this population, likely due to alcohol-related interference with nutrient absorption, metabolism, and utilization. These findings underscore the need for AUD-specific nutritional guidelines, standardized dietary assessment methods, and more robust evaluations of diet quality. Integrating nutrition science into AUD research and clinical care may provide an opportunity to improve both treatment outcomes and long-term recovery.

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