In the broadest sense, the word “drug” has come to mean the same as “medicine”, that is, a substance that is used in medical treatment because it has some action on the functioning of the body or on disease. Food and drugs can interact in several ways and in some instances there is a very hazy borderline between what is a food and what is a drug. Take alcohol for example. When taken in large quantities, it has a marked effect on the higher nerve centres, so alcohol is clearly a drug. Yet being a source of energy, alcohol is also a food. One gram of alcohol supplies 29 kJ and the average adult in the U.K. takes about four per cent of his total energy intake as alcohol. (In France and other wine producing countries, alcohol supplies about 14 per cent of the total adult energy intake.) A variety of effects on nutrition can be caused by alcohol. In social drinkers the commonest is a contribution to obesity. Some wines — not only “tonic wines” — are rich in iron. This is, at first sight, a good thing because iron deficiency is common all over the world. But those who take generous amounts of wine are not necessarily those who are short of iron and a state of iron overload can sometimes occur. Severe alcoholics, whose life becomes so disorganised that they eat very poorly, can have a variety of nutritional deficiencies. The most serious is thiamin deficiency which can occur in those alcoholics who drink heavily and eat very little food over a few weeks. The result is either brain disturbance, Wernicke‐Korsakoff disease, or heart failure. These respond dramatically to large doses of thiamin, provided the condition is recognised quickly. Occasional cases have been reported from British hospitals in recent years.
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