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

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.