How is pellagra connected to long-term alcoholism?

Pellagra is a nutritional-deficiency disease caused by a lack of niacin or the amino acid tryptophan in the body. In the context of long-term alcoholism, it develops as a direct consequence of poor nutrition.12

Alcohol provides empty calories that lack essential vitamins and nutrients. During periods of heavy drinking, individuals often neglect to eat a balanced diet, or they may suffer from digestive issues that prevent the proper absorption of necessary nutrients. Because the body requires these elements to function, this chronic neglect leads to various deficiency diseases, including pellagra.2

Pellagra is characterized by the "four Ds": dermatitis, diarrhea, dementia, and death. While it is a serious medical condition, it can be treated through a well-balanced, high-protein diet and appropriate vitamin supplementation.1