PREVALENCE OF MALNUTRITION IN ALCOHOLIC AND NONALCOHOLIC MEDICAL INPATIENTS - A COMPARATIVE ANTHROPOMETRIC STUDY

Available data on the nutritional status of alcoholics is controversial. The present study was conducted to assess the frequency of malnutrition in alcoholic inpatients. The objectives were to (1) compare anthropometric data of hospitalized alcoholic and nonalcoholic patients and (2) evaluate the association between alcoholism and protein-energy malnutrition. It was a cross-sectional comparative study including a stratified analysis to control for potential confounding factors. Alcoholics were identified as patients with a score from the Michigan Alcoholism Screening Test greater-than-or-equal-to 8 among patients admitted consecutively to the general wards of a department of internal medicine; they were matched for sex, age, and time of admission with nonalcoholic patients (Michigan Alcoholism Screening Test score less-than-or-equal-to 4). Nutritional status was assessed using weight, height, midarm circumference, and tricipital skinfold thickness values, which were then used to determine the Quetelet body mass index and the mid-arm muscle circumference. The study took place in general wards of internal medicine in a 1000-bed city and teaching hospital in Lausanne, Switzerland. The participants were 93 alcoholic patients and 93 controls aged 20 to 75 years, admitted from September 1, 1988, to March 18, 1989. Alcoholics were characterized by a low rate of severe protein-energy malnutrition (<5%); their average body weight was normal, similar to the weight of nonalcoholic inpatients, and not greatly influenced by the presence or severity of concomitant liver disease. However, tricipital skinfold thickness was lower in alcoholics than in nonalcoholics (8 mm vs 10 mm, p < .05, and 13 mm vs 20 mm, p < .01, in men and women, respectively). The association between alcoholism and protein-energy malnutrition (odds ratio 3.0, 95% confidence interval 1.6-5.7) remained positive when adjusted for smoking, liver disease, or occupational status. In conclusion, alcoholism was associated with poor nutritional status in hospitalized patients, although severe protein-energy malnutrition was infrequent. The results suggest that alcoholism-related malnutrition exists irrespective of the social and medical situation of the patient and is mostly related to caloric undernutrition.