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Nutrients 2012, 4, 356-371; doi:10.3390/nu4050356 OPEN ACCESS nutrients ISSN 2072-6643 /journal/nutrients Review The Adverse Effects of Alcohol on Vitamin A Metabolism Robin D. Clugston * and William S. Blaner Department of Medicine and Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA; E-Mail: wsb2@ * Author to whom correspondence should be addressed; E-Mail: rdc2132@; Tel.: +1-212-305-1490. Received: 29 March 2012; in revised form: 30 April 2012 / Accepted: 3 May 2012 / Published: 7 May 2012 Abstract: The objective of this review is to explore the relationship between alcohol and the metabolism of the essential micronutrient, vitamin A; as well as the impact this interaction has on alcohol-induced disease in adults. Depleted hepatic vitamin A content has been reported in human alcoholics, an observation that has been confirmed in animal models of chronic alcohol consumption. Indeed, alcohol consumption has been associated with declines in hepatic levels of retinol (vitamin A), as well as retinyl ester and retinoic acid; collectively referred to as retinoids. Through the use of animal models, the complex interplay between alcohol metabolism and vitamin A homeostasis has been studied; the reviewed research supports the notion that chronic alcohol consumption precipitates a decline in hepatic retinoid levels through increased breakdown, as well as increased export to extra-hepatic t