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Karaagac Y, Özçelik AÖ. Nutritional status changes in the treatment of substance use disorder: Relationship with substance craving. Nutr Res 2024; 123:120-129. [PMID: 38335923 DOI: 10.1016/j.nutres.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 01/14/2024] [Accepted: 01/14/2024] [Indexed: 02/12/2024]
Abstract
Tailored nutrition counseling enhances the efficacy of routine treatment for substance (alcohol/drugs) use disorders (SUDs). For this purpose, it is important to understand the current nutritional status of addicts and the changes in their nutritional status during the treatment process. Furthermore, the consumption of sweets to manage substance cravings is common among people with SUDs, but the evidence for the effectiveness of this practice is limited and conflicting. We therefore hypothesized SUD treatment would be associated with increases in appetite, nutrient intake, and anthropometric measurements in addicts, and that these changes, including changes in sweet consumption, would not be associated with decreased substance craving. Data for this prospective observational study were collected from 38 adult male patients who completed 21 days of inpatient SUD treatment. During the treatment, the participants' levels of appetite (P < 1.0 × 10-4), the frequency of main meals (P < 1.0 × 10-4), intake of macro- and micronutrients (P < .05 for each), and anthropometric measurements (P ≤ 5.9 × 10-4), significantly increased. Furthermore, it was found that the patients had a significant increase in sweets craving (P < 1.0 × 10-4) and sweets consumption (P = 1.2 × 10-3) during treatment. However, there was no significant difference between the individuals whose craving decreased and those whose craving did not decrease at the end of the treatment (P > .05 for both). The findings suggest the need to offer dietary counseling to individuals undergoing inpatient SUD treatment, given the substantial changes in nutritional status, and that increased consumption of sweets is not an effective strategy to reduce substance craving.
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Affiliation(s)
- Yasemin Karaagac
- Izmir Katip Çelebi University, Faculty of Health Sciences, Department of Nutrition and Dietetic, Izmir, Turkey.
| | - Ayşe Özfer Özçelik
- Ankara University, Faculty of Health Sciences, Department of Nutrition and Dietetic, Ankara, Turkey
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White B, Sirohi S. A Complex Interplay between Nutrition and Alcohol use Disorder: Implications for Breaking the Vicious Cycle. Curr Pharm Des 2024; 30:1822-1837. [PMID: 38797900 DOI: 10.2174/0113816128292367240510111746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 04/24/2024] [Accepted: 04/25/2024] [Indexed: 05/29/2024]
Abstract
Approximately 16.5% of the United States population met the diagnostic criteria for substance use disorder (SUD) in 2021, including 29.5 million individuals with alcohol use disorder (AUD). Individuals with AUD are at increased risk for malnutrition, and impairments in nutritional status in chronic alcohol users can be detrimental to physical and emotional well-being. Furthermore, these nutritional deficiencies could contribute to the never-ending cycle of alcoholism and related pathologies, thereby jeopardizing the prospects of recovery and treatment outcomes. Improving nutritional status in AUD patients may not only compensate for general malnutrition but could also reduce adverse symptoms during recovery, thereby promoting abstinence and successful treatment of AUD. In this review, we briefly summarize alterations in the nutritional status of people with addictive disorders, in addition to the underlying neurobiological mechanisms and clinical implications regarding the role of nutritional intervention in recovery from alcohol use disorder.
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Affiliation(s)
- Brooke White
- Laboratory of Endocrine and Neuropsychiatric Disorders, Division of Basic Pharmaceutical Sciences, College of Pharmacy, Xavier University of Louisiana, New Orleans, LA 70125, USA
| | - Sunil Sirohi
- Laboratory of Endocrine and Neuropsychiatric Disorders, Division of Basic Pharmaceutical Sciences, College of Pharmacy, Xavier University of Louisiana, New Orleans, LA 70125, USA
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Alessi J, Dzemidzic M, Benson K, Chittum G, Kosobud A, Harezlak J, Plawecki MH, O'Connor SJ, Kareken DA. High-intensity sweet taste as a predictor of subjective alcohol responses to the ascending limb of an intravenous alcohol prime: an fMRI study. Neuropsychopharmacology 2024; 49:396-404. [PMID: 37550441 PMCID: PMC10724194 DOI: 10.1038/s41386-023-01684-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 07/11/2023] [Accepted: 07/19/2023] [Indexed: 08/09/2023]
Abstract
High-intensity sweet-liking has been linked to alcohol use disorder (AUD) risk. However, the neural underpinning of this association is poorly understood. To find a biomarker predictive of AUD, 140 participants (social and heavy drinkers, ages 21-26) underwent functional magnetic resonance imaging (fMRI) during a monetary incentive delay (MID) task and stimulation with high (SucroseHigh)- and low-concentration sucrose, as well as viscosity-matched water. On another day after imaging, and just before free-access intravenous alcohol self-administration, participants experienced a 30 mg% alcohol prime (10 min ascent) using the Computerized Alcohol Infusion System. Principal component analysis (PCA) of subjective responses (SR) to the prime's ascending limb generated enjoyable (SRenjoy) and sedative (SRsed) intoxication components. Another PCA created one component reflective of self-administered alcohol exposure (AE) over 90 min. Component loadings were entered as regressors in a voxel-wise general linear fMRI model, with reward type as a fixed factor. By design, peak prime breath alcohol concentration was similar across participants (29 ± 3.4 mg%). SRenjoy on the prime's ascending limb correlated positively with [SucroseHigh > Water] in the supplementary motor area and right dorsal anterior insula, implicating the salience network. Neither SR component correlated with the brain's response to MID. AE was unrelated to brain reward activation. While these findings do not support a relationship between alcohol self-administration and (1) subjective liking of or (2) regional brain response to an intensely sweet taste, they show that alcohol's enjoyable intoxicating effects on the rising limb correspond with anterior insular and supplementary motor area responses to high-concentration sucrose taste. No such associations were observed with MID despite robust activation in those regions. Insula and supplementary motor area responses to intense sensations relate to a known risk factor for AUD in a way that is not apparent with a secondary (monetary) reward.
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Affiliation(s)
- Jonathan Alessi
- Medical Neuroscience Graduate Program, Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Mario Dzemidzic
- Indiana Alcohol Research Center, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Radiology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Katherine Benson
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
- Clinical Psychology Graduate Program, Department of Psychology and Neuroscience, University of North Carolina- Chapel Hill, Chapel Hill, NC, USA
| | - George Chittum
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Pharmacology & Toxicology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Ann Kosobud
- Indiana Alcohol Research Center, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Jaroslaw Harezlak
- Indiana Alcohol Research Center, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health, Bloomington, IN, USA
| | - Martin H Plawecki
- Indiana Alcohol Research Center, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Sean J O'Connor
- Indiana Alcohol Research Center, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - David A Kareken
- Indiana Alcohol Research Center, Indiana University School of Medicine, Indianapolis, IN, USA.
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA.
- Department of Radiology, Indiana University School of Medicine, Indianapolis, IN, USA.
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA.
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