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A little overhung??

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Sunday, October 17, 2010

A little overhung??

Why do we get hungover? I think people don't really understand the metabolism of alcohol, because there are ways to prevent hangovers, and make that fun night that you may have imbibed too much, into a much softer morning wake up!

So, the not so fun part, alcohol metabolism:
Its how our bodies convert substances into other compounds that we can either use  or excrete . Oxidation is the process by which alcohol is metabolized in the blood. Obviously the alcohol is distributed throughout the body, including the brain, organs, and tissues after ingestion and during metabolization, and small amounts are excreted through your breath and urine in unmetabolized forms.
You have your favorite adult beverage, it goes into your intestines, then is absorbed into your blood stream, it is metabolized by various enzymes.  In the liver the enzyme that breaks down alcohol is called alcohol dehydrogenase (ADH) which turns alcohol into acetaldehyde, which is then broken down to carbon dioxide and water.  Alcohol is also broken down by an enzyme in the liver called P450IIE1, which can increase in number with chronic drinking (hence how people build up a "tolerance" for drinking....increase P450IIE1) and this is where most alcohol is metabolized.

The liver can only metabolize a certain amount of alcohol per hour, no matter if you are a virgin drinker or if you have your sea legs.  That being said, the ability to metabolize alcohol is dependent upon the number of metabolizing enzymes, which varies in each individual and can be genetic (i.e. over half of all east Asians have low numbers of ADH enzymes so they tend to get drunk easily, have wicked hangovers, and get flushed with drinking which is due to a fast heart rate which is how their bodies respond to metabolism of alcohol.) Usually, once you have a drink, your blood alcohol level peaks within 30-45 minutes.

Wilkinson et al., Journal of Pharmacokinetics and Biopharmaceutics5(3):207-224, 197

What other factors influence alcohol Metabolism?
Food: The higher the dietary fat content in the stomach/GI tract increases the amount of time it takes for the alcohol to get absorbed into the blood stream.  One study showed that people who ate a meal of fat, carbs, and protein absorbed alcohol 3 times more quickly than those who drank on an empty stomach.
Gender: Unfortunately, women absorb alcohol differently than men.  Us ladies will have a higher Blood Alcohol Content (BAC) than men drinking the same amounts, and we are more susceptible to alcoholic liver disease, heart muscle damage, and brain damage.  It is presumed that the difference is due to women having a smaller amount of body water and we may have a lower amount of ADH (never been proven but highly likely based on numerous studies). 

Effects of Alcohol:
Body Weight: interestingly, Women who drink (moderately) tend to have significantly lower body weights than those who don't drink at all.  Men, there is no weight difference, but if non drinkers add alcohol to their diet, they don't tend to gain any weight.  Chronic alcoholics tend to lose weight because they substitute alcohol for food....
Sex Hormones: Chronic alcohol intake causes significant hormonal imbalances; the liver metabolizes estrogen into testosterone, but when damaged, it is unable to do that, so you can have decreased sperm production.  In men who consume 220 grams of alcohol daily for 4 weeks, testosterone levels decreased after 5 days and kept dropping throughout the study period.  Also, chronic alcohol intake in men can lead to testicular atrophy (getting smaller) and the growth of male breast tissue. In women, we can create estradiol, which increases bone density and decreases the risk of cardiac disease (whoo hoo!!)
Medications: Tylenol (paracetamol, acetaminophen) can be toxic in the liver in large doses by itself, but add alcohol and it is a HUGE problem that can lead to immediate liver failure.  Like 4-5 extra strength pills in the course of the day with someone who is drinking can cause death. Other drugs such as pepcid (famotidine), ranitidine (zantac), and cimentidine (tagamet) can cause alcohol to be metabolized slower for reasons truly unknown at this point.

What can also cause increased rate of metabolism?  
The only thing known to increase the rate of metabolism of alcohol is fructose!! Consuming 100 grams of fructose has been shown to increase alcohol metabolism by 80%!  Sooooo not helpful for people like me that drink vodka sodas, but great for the rum and coke (not diet coke) drinkers of the world!!  I guess I need to go back to my gin and Q Tonic beverages OR maybe a handful of skittles after every drink???  

So, the best way to prevent a hangover is to eat a meal with fat, protein and carbs (cheeseburger anyone?), increase your water (before bed chug a coconut water if you have one, or just regular water) because we all know the the metabolism process dehydrates our bodies (because of the effects of alcohol), and increase your sugar intake....high fructose corn syrup does count!!  So seriously, a great idea for a bar is to hand each patron a bag of candy with each drink!!  Actually, one of the reasons why "fruity" drinks tend to make you less drunk :) hmmmm.....  BUT I must say, carbonation supposedly increases your alcohol absorption, so maybe a Harvey Wallbanger is the way to go...and try to stick with the same kind of alcohol.  Really, I think we all knew these tips except for the sugar.

So, ladies apparently drinking is good for you?!?!  And men, if you are looking to be more manly, you may want to lay off the booze for a bit....

Yours in Good Health


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