Nutritional Support for (Former) Alcoholics

Alcohol abuse is defined as more than three drinks in a day or seven in a week for women, and more than four drinks in a day or fourteen drinks per week for men. Over time, excessive drinking takes a toll on the body, as we all know — and its specific long-term effects help to dictate the kinds of support a former alcoholic might need while weaning off.

Here are some of the things alcohol does to the body — and therefore, what you need to do to counterbalance it.

Stay Hydrated

While you’re technically consuming liquid, alcohol acts as a diuretic, because it blocks the pituitary gland’s production of ADH (Anti-Diuretic Hormone). Most heavy drinkers are therefore poorly hydrated.

A good rule of thumb for everyone, including the newly sober: drink half your body weight in ounces daily. So if you weigh 140 lbs, you should be consuming 70 ounces of water daily — more, if you’re sweating. (And if your water is Reverse Osmosis, make sure it’s got some electrolytes added back in.)

Eat Real Food

Heavy drinkers generally have a blunted hunger response, for two main reasons: one, fluids can trick the brain into thinking it’s full (this is also why drinking water while fasting helps stave off hunger pangs, and two, alcohol is high in calories. (For context, there are 4 kilocalories per gram of carbs and protein, but 7 kilocalories per gram of alcohol.) Much like eating nothing but fast food will fill you up on calories but leave you depleted in actual nutrients, heavy alcohol consumption also leaves you undernourished for both micronutrients (vitamins and minerals) and macronutrients (protein, carbohydrates, and fat).

So it’s important to follow a basic healthy eating plan consisting of real, whole, unprocessed foods, the way God made them.

And there’s one more reason for the “unprocessed” bit: any additional chemicals you put in your mouth will eventually also have to stop off in the liver to get broken down — and you don’t want to give your poor liver more to do, after all that alcohol. Give it a break. Eat real food.

Emphasize Protein

Along the lines of feeding your body adequate macronutrients — protein is probably the most important of the three (again, the other two being carbs and fat). Think of it this way: your body is made of protein. You need enough protein as a building block to repair all the damage that has occurred over time — both from the alcohol itself, and from the normal damage of daily living that you weren’t able to adequately repair while drinking (because you weren’t consuming enough protein at the time). Now, you’re playing catch-up. For that reason, consume plenty of protein every time you eat, including snacks.

It’s even a good idea to find a clean protein supplement, to really double down on this. My favorite protein supplements consist of few to no extra ingredients — just the protein itself. Whey protein is fine if you’re not allergic to dairy; soy protein is fine if you’re not allergic to soy, and if it specifically says non-GMO or organic on the package. Other good options are pea or hemp protein (though I don’t care for the flavor of either), rice protein, or other plant-based proteins such as Raw Protein.

Balance Blood Sugar

One type of addiction can easily convert to another — largely due to the way addictions affect the brain in general. Specifically, addictions of all kinds have been shown to release dopamine in the “pleasure center” of the brain, called the nucleus accumbens. The abrupt removal of a pleasurable stimulus can lead to depression — which puts former alcoholics at risk for relapse, or for substituting one addiction for another. Sugar is a common substitute, in part because low blood sugar further depletes dopamine–and therefore in the short term, sugar helps to give the brain the dopamine boost it’s lacking. But not only is sugar bad for you for its own reasons (check out this article for more on that), but it will also set you up for a roller coaster: simple sugars lead to a blood sugar spike, a brief dopamine high, insulin release, a blood sugar crash, and then the cycle repeats.

To ward off this risk, it’s important to stabilize the blood sugar by 1) consuming complex carbs (not simple, processed ones), 2) always combining some form of protein with any carbohydrates you eat, and 3) eating frequent small meals at first (perhaps 5–6 times per day).

Minimize Caffeine

As previously mentioned, withdrawal from an addictive substance leads to a sudden drop in dopamine, one of the catecholamines (which also include norepinephrine and epinephrine). The lack of these feel-good neurotransmitters is associated with the particular kind of depression associated with withdrawal. In the short term, caffeine will help with this, as it increases the release of adrenaline from the adrenal glands. This might feel similar to the boost you’d get from sugar.

The problem is, the first effect is not the lasting effect. Caffeine 1) also has to get detoxified by the liver, as it’s a foreign substance, and 2) the burst of adrenaline consumes blood sugar, which intensifies the symptoms mentioned in the previous paragraph. (That’s one of adrenaline’s jobs: it’s the “fight-or-flight” hormone, and it therefore triggers you to consume whatever energy is available so you can do what you need to do to survive.) If your adrenals are strong enough to compensate for this, you’re fine — but considering the long-term stress of alcohol on the body, strong adrenals aren’t likely. If the adrenals aren’t able to produce adequate cortisol to buffer the adrenaline crash, you get a roller coaster of both blood sugar and catecholamines — worsening both symptoms and adrenal fatigue.

So it’s best to avoid caffeine while getting sober and stable.

Replace Lost Nutrients

In the process of eliminating alcohol, the liver consumes B vitamins — so if you’ve been a heavy drinker for any length of time, you’re probably deficient. A good B complex would be an excellent addition to a healthy diet. Due to long-term malnutrition, a high quality multivitamin is also an excellent idea — but I’d still consider adding a B complex on top of that, since the levels of B’s in a multi is more for maintenance than repletion.

Essential fatty acids are also a great idea. These are one of the four nutritional supplements I recommend for everyone anyway, but it’s especially important in a recovering alcoholic. In large part this is due to the macronutrient deficiency from a poor diet while drinking. EFAs are also necessary to help restore cell membrane integrity, particularly for neurons — and are therefore helpful in treating depression.

Heal the Gut, Support the Liver

Long-term poor nutrition can easily lead to leaky gut syndrome. Long-term stress of any kind can do this as well, as poor adrenal function is often heavily correlated with poor gut integrity. Glutamine is an amino acid you’d get in your protein supplement anyway, but it’s not a bad idea at all to add extra amounts of this amino acid in particular, as it’s specifically been shown to help restore gut integrity.

And of course — the poor liver. It’s been through a lot. B vitamins will certainly help support it, and glutamine will do double duty as support for both the gut and of the liver’s six main Phase 2 Detoxification pathways (the Amino Acid Conjugation Pathway). But there are a few other nutrients to consider in general — NAC both helps to protect the liver from damage, and assists with the Glutathione Transferase Phase 2 pathway. And I wrote here on phosphatidylcholine — this incredible nutrient has actually been shown to assist with liver regeneration! Plus it helps to heal up the gut and cell membranes in at the same time.

The Upshot

If you or someone you love is a recovering alcoholic, here’s how to give the body the best shot at recovery:

• Eat a healthy, balanced diet of whole foods.
• Eat frequent small meals, with protein at every meal and snack.
• Drink plenty of fluids: half your body weight in ounces. And make sure the water you’re drinking has electrolytes, either naturally or added back in.
• Avoid caffeine.
• Consider adding a protein supplement.
• Consider nutritional support — especially a multivitamin, essential fatty acid, and a B complex.

And also, remember that it may be necessary to get professional support in the early stages of getting sober. If you need additional support, consider looking into detoxification treatment facilities near you.

Originally published at www.drlaurendeville.com on September 21, 2018.