Alcohol: What it does when consumed

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By Dr. Harold Gunatillake

Few weeks back I wrote an article on the beneficial effect of alcohol to prevent dementia. Let us delve deeper into alcohol nutrition and discuss what happens to that glass of alcohol you enjoy, in your constitution.

It is a fact there is no social event without alcohol flowing. It relaxes the participants and brings mates together for a relaxed enjoyable evening with conversations, at a party or celebration.

When, even taking two small drinks a day has its added health benefits, but the negative consequences that it brings when taken in excess has problems to self and family.

Alcohol is not an essential food like the carbs, protein fat, vitamin, minerals and water you consume daily. Alcoholic drink primarily consists of water, alcohol and sugar. The calories come from alcohol and sugar are referred to as, ’empty calories’ because of the lack of any nutrients.

Though in most countries people drink alcoholic beverages, the percentage of addiction seems to be small, as most drink only on occasions. People below the poverty line seems to drink more than the affluent.

Alcohol is made through a process of fermentation when sugar breaks down into ethanol (alcohol) and carbon dioxide. At the next stage carbon dioxide gas bubbles escapes into the air, leaving alcohol and water. Then, through a distillation process water is separated from the alcohol.

When we talk of just one drink, we mean a 12-ounce glass of beer, a 5-ounce glass of wine, and a 1.5-ounce shot of liquor and all contain a half ounce of pure alcohol. 

Metabolism of alcohol

Alcohol unlike carbs, protein and fat is not stored in the body. Hence the liver metabolises alcohol as a priority in preference to any food you consume.

20 per cent of the alcohol you consume is absorbed directly from your stomach into the blood stream and goes directly into your brain. The rest of the alcohol enters the small gut and is absorbed with the other food. Alcohol is then metabolised in the liver and is excreted through your sweat, saliva, urine and your breath.

Metabolism of alcohol solely occurs in the liver and those who indulge in excess cause liver problems. Alcoholic fatty liver is quite a good example, and with further daily indulgence makes the liver harder (cirrhosis) and lead to failure of functions.

Alcohol is made less toxic through a process of detoxification in the liver, is removed through a process called oxidation.

Excess alcohol damages your liver

One of the severe side effects of alcoholism is liver damage, may lead to death.

Alcohol is converted into acetaldehyde a toxic enzyme that can damage liver cells and cause fibrosis (scarring). It is also a carcinogen. Alcohol dehydrates the body and the liver requires water to function correctly. When the body lacks it, the liver requires to force to pull in water from other sources.

It is very important to hydrate yourself by drinking plenty of water or any sweet drinks after a heavy session of drinking alcohol.

Your liver can become fatty, or cause inflammation (alcoholic hepatitis) and end in cirrhosis with regular excessive drinking.

In a fatty liver there is infiltration or build up of fat in the liver cells when you drink too much of alcohol more than the liver can cope. Fat infiltration causes inflammation of the liver cells and results in alcoholic hepatitis.

Alcoholic hepatitis is caused by excessive drinking alcohol for a long time. Ultimately the liver cells are replaced by scar tissue (fibrosis) and the term cirrhosis is used.

When you are diagnosed with cirrhosis you need to stop alcohol totally and the liver cells may repair and attempt to function normally. If it is in the irreversible phase unfortunately stopping alcohol may not help.

Generally, it is important to eat a healthy diet to lead a healthier liver. Avoid eating processed foods, sugars and saturated fat to ease the burden on the liver.

Most people drink less as they grow older, as the hangovers they experience day after could be a misery. Some people tend to drink more as they get older due to loneliness, losing a loved one, reduced income and so on.

As you get older the ability of the liver to metabolise alcohol declines. Older people drinking the same amount of alcohol as younger people, the blood concentration of alcohol seems to remain longer among the old, as the elimination is slower.

Age related changes and alcohol

Age related changes like your eyesight, hearing and reflexes may get accelerated with chronic excessive alcohol consumption. These changes will make you feel dizzy, unsteady on your feet and alcohol related falls, automobile accidents and so on.

Your medication that you take for your age-related illnesses including heart disease, hypertension, diabetes, among others may have deleterious effects on your body. Please do not mix medication with alcohol. It is advisable not to drink alcoholic beverages when you are on any medication.

Malnourished

Those who drink excessively do not seem to eat nutritious food, because alcohol replaces foods. You may get ill-nourished or malnourished when the essential nutrients do not get into your body. It brings vitamin deficiencies like B1, folate, B12, A, and minerals like calcium.

Amino acid absorption

Proteins you eat in your food is broken down into amino acids and absorbed in the small gut. Alcohol can disturb the normal digestion of food and amino acids may not be absorbed from the proteins in your food.

In situation of a chronic failing liver this can lead to complications, like decreased albumin in your blood causing ascites (fluid in your abdominal cavity, swelling of legs called oedema.

Portal hypertension

Cirrhosis of the liver also causes obstruction to the flow of blood from the gut through the portal veins. The veins get distended and we call the condition as portal hypertension.

Veins in relation to the lower oesophagus and the stomach can get distended and varicosed. These delicate veins can rupture and cause vomiting of blood (haematemesis)

This is an irreversible stage of cirrhosis that causes the veins feeding the liver to distend and rupture.

Fluid collects in your abdominal cavity (ascites), and varicosed veins are seen on the abdominal wall. Legs start swelling and your life is in danger.

How much alcohol can you drink to avoid complications.

For healthy men up to age 60- nomore than four drinks in a day and no more than 14 drinks a week.

For healthy women and healthy men over 60-no more than three drinks ina day or seven drinks in a week.

Asians being smaller made should restrict to two drinks a day.

New research, which was presented at the American Association for the Advancement of Science’s annual conference, has found that moderate drinking is linked to a longer life. Drinking about two glasses of wine or beer a day was linked to an 18% drop in a person’s risk of early death—an even stronger effect than the life-preserving practice of exercise, according to the researchers.

A 2015 study of people with mild Alzheimer’s, found that moderate drinkers were less likely to die during the study’s follow-up period than teetotalers.A large 2017 study also found that light and moderate drinkers were less likely to die from cardiovascular disease than those who never sipped. Red wine, in particular, is often singled out for its anti-aging benefits, usually because of a compound called resveratrol — though that explanation may be a little oversimplified, and more research is needed.

A large 2017 study looking at alcohol and heart health, however, was designed to eliminate the possibility of abstainer bias. It still found that moderate drinking may protect against heart attacks, strokes, chest pain and fatal heart disease. (ref: TIME HEALTH-by Jamie Ducharme).

New findings:No healthy level of alcohol consumption, says major study

Governments should consider advising people to abstain entirely, say authors. Article appears in The Guardian-written by Sarah Bosely.

The article states, “Even the occasional drink is harmful to health, according to the largest and most detailed research carried out on the effects of alcohol, which suggests governments should think of advising people to abstain completely.

The uncompromising message comes from the authors of the Global Burden of Diseases study, a rolling project based at the University of Washington, in Seattle, which produces the most comprehensive data on the causes of illness and death in the world.”

Conclusions: If you understand the word ‘moderation’ you are qualified to have a drink or two, daily. Abstaining would be better. Then, studies show that people who drink moderately live longer. Take your pick.

Ref: Alcohol and Nutrition by Betty Kovacs Harbolic

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