NTR 102 Chapter 19, alcohol, Gateway fall '18

% of U.S. adults report having consumed alcohol within the past 30 days

56% of U.S. adults report having consumed alcohol within the past 30 days

Colon: Effects of Heavy Drinking or Recurrent Binge Drinking

Cancer Colon: Effects of Heavy Drinking or Recurrent Binge Drinking

Female Breast: Effects of Heavy Drinking or Recurrent Binge Drinking

Cancer Female Breast: Effects of Heavy Drinking or Recurrent Binge Drinking

Oral cavity, throat, esophagus: Effects of Heavy Drinking or Recurrent Binge Drinking

Cancer Oral cavity, throat, esophagus: Effects of Heavy Drinking or Recurrent Binge Drinking

What two categories of disease seem to be most strongly affected by excess alcohol consumption?

Cancer and cardiovascular problems are the two categories of disease linked most strongly to excess alcohol consumption

Liver: Effects of Heavy Drinking or Recurrent Binge Drinking

Cirrhosis Cancer Liver: Effects of Heavy Drinking or Recurrent Binge Drinking

Alcohol and nutritional considerations

Containing 7 kcal/g, alcohol is a fairly dense energy source. Yet because it lacks overall nutrient value, alcohol is considered a source of 'empty calories' The DGAs recommend that less than 5% of total calorie intake should come from alcohol. Chronic alcohol abuse can compromise nutrition by reducing the secretion of digestive enzymes, impairing nutrient absorption and utilization, contributing to potential nutrient deficiencies. In addition, alcohol often displaced more nutrient- dense foods, resulting in dietary inadequacies

FASD (fetal alcohol spectrum disorder)

FASDs represent a group of of conditions that occur in a person whose mother drank alcohol during pregnancy. The effects range in severity and can include physical as well as behavioral and learning problems. Even moderate drinking (1-6 alcoholic drinks per week) I'm pregnant women has been shown to decrease the IQ of their child when tested at 8 yrs of age

Stomach: Effects of Heavy Drinking or Recurrent Binge Drinking

Gastritis Stomach: Effects of Heavy Drinking or Recurrent Binge Drinking

Factors that affect intoxication

Gender, body weight, food intake before or during consumption, use of drugs or prescription medications, and genes Lower body water content and higher body fat in women causes blood alcohol concentrations to increase more quickly than in men of the same body weight

Distillation

Gin, rum, vodka, and whiskey are distilled, which involves heating a fermented mixture and then cooling it to condense the alcohol content into a more concentrated liquid form

Moderate Drinking

Moderate drinking is defined by the Dietary Guidelines for Americans as one drink per day for a woman and no more than two drinks per day for a man. Associated with a reduced risk of several chronic diseases and conditions

Peripheral Nervous System: Effects of Heavy Drinking or Recurrent Binge Drinking

Numbness in arms and legs Feeling 'pins & needles' Muscle weakness Peripheral Nervous System: Effects of Heavy Drinking or Recurrent Binge Drinking

Bones: Effects of Heavy Drinking or Recurrent Binge Drinking

Osteoporosis Bones: Effects of Heavy Drinking or Recurrent Binge Drinking

Pancreas: Effects of Heavy Drinking or Recurrent Binge Drinking

Pancreatitis Pancreas: Effects of Heavy Drinking or Recurrent Binge Drinking

Immune System: Effects of Heavy Drinking or Recurrent Binge Drinking

Suppressed immune function Increased risk of infectious diseases Immune System: Effects of Heavy Drinking or Recurrent Binge Drinking

Alcohol consumption during pregnancy

There is no known safe level of alcohol use during pregnancy. Several conditions, including Fetal Alcohol Spectrum Disorders (FASDs) have been liked to alcohol use during pregnancy

Binge Drinking

A pattern of alcohol consumption that brings blood alcohol concentration to 0.08% or higher, corresponding to about 5 or more drinks on a single occasion for men or 4 or more for women, generally within about 2 hours As many as 17% of the US population reports binge drinking, but as many as 40% of college age students have engaged in binge drinking in the last month

Alcohol

A potentially intoxicating ingredient found in beer, wine and liquor; can be considered a food because it provides energy at 7 kcal/g, but also has drug-like effects via the central nervous system. It is a toxin. A central nervous system depressant. Alcohol is the common name for Ethanol

Acetaldehyde

A product of the first step of alcohol metabolism in the liver; a highly reactive and toxic compound that can damage cellular components, including the dna. Highly toxic, causes many of the ill effects of alcohol consumption.

Standard Alcoholic Drink

A standard alcoholic drink is comprised of 15 grams (0.6 fluid ounces) of pure alcohol (ethanol) which can typically be found in: 12 ounces of beer 6-7 ounces of some craft beers 5 ounces of wine 1.5 ounces (a shot) of 80-proof distilled spirits or liquor.

Heavy Drinking

Typically defined as consuming 15 or more standard alcohol drinks per week for men and 8 or more per week for womenswear

Consequences of Drinking Among College Students Between 18-24 yrs old/

Virtually all students experience the effects of drinking whether they drink or not In ascending order: Death from injuries Alcohol-related sexual assault Health problems Unsafe sex Unintentional injury Assault by other students Drunk driving

Approx. calorie content of various alcoholic beverages

*Beer: Scotch Ale, Stout: 12 oz, 10% alcohol, 300 kcal *Beer: Ale: 12 oz, 5% alcohol, 150 kcal *Light Beer, Lager: 12 oz, 5% alcohol, 100 kcal *Red and White Wines: 5 oz, 12-14% alcohol, 120-130 kcal *Distilled Spirits: 1.5 oz, 40% alcohol, 100 kcal *Mojito: 6 oz, 6% alcohol, 140 kcal * Strawberry Daiquiri: 12 oz, 10% alcohol, 225 kcal *Traditional Martini: 2.25 oz, 40%, 125 kcal *Piña Colada: 9 oz, 10% alcohol, 490 kcal *Margarita: 6 oz, 12% alcohol, 250 kcal

Signs of alcohol abuse

*Failure to fulfill responsibilities *Drinking despite dangers or consequences *Aggressive or violent behavior while intoxicated *Legal issues related to alcohol *Increasing dependency on alcohol Frequent heavy drinking can increase alcohol tolerance by ramping up the activity of an alternate pathway of alcohol metabolism in the liver (not involving alcohol dehydrogenase). Ongoing alcohol abuse can lead to alcohol use disorder

% of college report having consumed alcohol within the past 30 days

60% of college students report having consumed alcohol within the past 30 days

Hangover

A term used to describe the after effects of drinking too much alcohol. Characteristics include headache, tiredness, impaired cognitive function, thirst, dizziness, nausea, and altered mood. Research suggests that alterations in immune system function resulting from the production of a variety of hormone-like molecules (cytokines) and an increase in inflammation are the greatest contributors to a hangover's development. Blood glucose concentrations are also often observed to decrease during a hangover, which may contribute to symptoms of weakness, fatigue, and altered mood. There is also some evidence that elevated concentrations of acetaldehyde in blood may cause tissue damage that contributes to the symptoms of hangover. Current research neither supports the notion that symptoms result from dehydration, nor that dehydration can reduce the severity of the symptoms

Alcohol Use Disorder

Alcohol Use Disorder is a medical diagnosis given to individuals who have severe problems with alcohol and meet certain diagnostic criteria

Effects of Heavy Drinking or Recurrent Binge Drinking

Alcohol affects every single cell in the body, so chronic use and abuse can have widespread detrimental effects on organs and body systems including the brain, cardiovascular system, liver, digestive system, and immune system. Excessive alcohol use is the 3rd leading cause of death for people in the US each year, and it is the single strongest risk factor among males 15-59 yrs of age. Intoxication, too, can lead to impaired brain function because alcohol disrupts the production and function of neurotransmitters. This leads to impaired judgement, reduced reaction time, and loss of balance and motor skills, all of which increase the risk of motor vehicle crashes, violence, and other injuries. Alcohol also increases blood flow to skin and accelerates the loss of heat from the body, greatly increasing the risk of hypothermia. Alcohol use can lead to alcohol dependence, coma, and death, if the alcohol is consumed too rapidly and in large amounts.

Harmful effects of alcohol

Alcohol consumption is associated with an increased risk of some types of cancer, and excessive intake is associated with violent crimes, drowning, and injuries from falls and motor vehicle crashes. Recent studies conclude that there is no safe level of alcohol consumption with regard to one's risk for cancer. Even light drinking is associated with increased risk of cancers of the mouth, throat, esophagus, and breast.

Absorption of Alcohol

Alcohol is readily absorbed into the bloodstream through diffusion and then is transported to the body's cells and tissues and dispersed throughout the water-containing portions of the body. About 1/5 of all alcohol consumed is absorbed through the stomach; the rest is absorbed in the small intestine. The presence of food in the stomach will slow alcohol absorption

Brain: Specific Effects of Heavy Drinking or Recurrent Binge Drinking

Dementia Stroke Shrinkage of brain tissue Psychiatric problems including depression, anxiety, suicide Brain: Specific Effects of Heavy Drinking or Recurrent Binge Drinking

Accidental deaths attributed to alcohol

Deaths resulting from alcohol-related injuries account for about 1/4 of all deaths among 15-20 yr olds in the US Alcohol consumption causes impaired judgement, reduced reaction time, and loss of balance and motor skills. Because of these effects, alcohol consumption can lead to accidents and injuries From lowest % to highest: Suicide Poisoning Car crash Burn/fire Homicide Gunshot Drowning Fall Hypothermia

Calculating the alcohol in a beverage

Divide 60 by the percent alcohol content to determine the number of ounces that will supply 14 grams of alcohol - that of a "standard" drink Example: - a 7.5% beer, 60/7.5 = 8 ounces of beer that will contain 14 grams of alcohol - vodka 80 proof (40% alcohol) = 60/40 = 1.5 fluid ounces of vodka supply 14 grams of alcohol

Benefits of alcohol

Evidence for beneficial effects of alcohol is not as strong as the evidence for its harmful effects. The risk to benefit ratio of light to moderate drinking is more favorable in those older than 50 than those younger than 50 I'm healthy adults, moderate alcohol consumption 1 a day for women, 2 a day for men, is associated with a reduced risk of several chronic diseases and conditions, including heart disease, stroke, diabetes mellitus, abdominal obesity, and dementia, as well as a reduction in overall mortality risk. The most significant health benefits of light to moderate drinking seem to be on the cardiovascular system, with the risk of heart disease typically being reduced by 30% to 35%, with increases in high-density lipoprotein cholesterol contributing significantly to this reduction in risk. The most beneficial drinking pattern associated with a decrease in the risk of cardiovascular disease seems to be the consumption of one to two glasses of red wine immediately before or during the evening meal, as is practiced in many Mediterranean countries. However, it is not known if the benefit results from the alcohol itself, or from the social bonding or the avoidance of excess consumption that is promoted by this tradition.

Excessive alcohol consumption

Excessive alcohol consumption causes hypertension and impairs cardiac function. Binge drinking, even in those who typically drink only lightly, increases the incidence of heart attacks and death. Even just an occasional binge-drinking episode virtually eliminates the protective effects seen with otherwise light to moderate intakes.

Cardiovascular System: Effects of Heavy Drinking or Recurrent Binge Drinking

Heart attack Cardiomyopathy (weakened heart) Arrhythmia Hypertension Cardiovascular System: Effects of Heavy Drinking or Recurrent Binge Drinking

Reproductive System: Effects of Heavy Drinking or Recurrent Binge Drinking

Ovarian cancer Miscarriage and stillbirth Erectile dysfunction Reproductive System: Effects of Heavy Drinking or Recurrent Binge Drinking

Underage drinking

People ages 12-20 years old drink 11% of all alcohol consumed in the US, more than 90% of this amount is consumed in excessive amounts in relatively short periods of time Alcohol consumed during years of critical brain development can cause permanent impairment of cognitive function and increase the risk of fatal and non-fatal injuries. Plus, children who consume alcohol before the age of 15 are 5 times more likely to become alcohol dependent than are adults who begin drinking at the age of 21. Kids who drink alcohol are also more likely to engage in risky sexual behaviors, have poorer school performance and are at a higher risk for suicide as well as more likely to commit homicide than other kids

Who should never consume alcohol?

Pregnant women People under 21 yrs old Individuals who plan to drive, operate machinery, or take part in other activities that require attention, skill, or coordination, as well as individuals who have medical conditions or take certain medications, should not consume alcohol. It is also wise for people with a personal or family history of alcohol use disorder, alcohol abuse, or who are unable to limit their alcohol intake to moderate levels, to abstain from alcohol use

Fermentation

Production of alcohol (and carbon dioxide) through the action of yeast on the simple sugars in grains or fruit. Microscopic yeast obtain energy from simple sugars in grains or fruit via a metabolic pathway called fermentation, which produces alcohol and carbon dioxide. The carbon dioxide may be released into the air, or the carbon dioxide may be trapped in the beverage causing it to be carbonated, as when beer is brewed.

Symptoms of Alcohol Use Disorder

Symptoms of Alcohol Use Disorder: *drinking more or for longer than intended *wanted to but unable to cut down or stop drinking *more than once gotten into situations while or after drinking that increased chances of getting hurt (ie driving, swimming, using machinery, walking in a dangerous area, having unsafe sex) *had to drink much more than once did to get the effect wanted, or found that the usual number of drinks had much less effect than before *continued to drink even though it was causing depression or anxiety or adding to another health problem, or after having had a memory blackout *spent a lot of time drinking, or being sick or getting over other aftereffects *continuing to drink even though it was causing trouble with family or friends * finding that drinking, or being sick from drinking, often interfered with taking care of home or family, or caused job troubles, or school problems *given up or cut back on activities that were important or interesting or gave pleasure, in order to drink *more than once gotten arrested, been held at a police station, or had other legal problems because of drinking *experiencing withdrawal symptoms, such as trouble sleeping, shakiness, restlessness, nausea, sweating, racing heart, seizure, or sensing things that are not there

Alcohol content of Liquor

The alcohol content of liquor is half the proof, therefore 80% proof means 40% alcohol. In practice the alcohol content in a typical serving varies significantly

BAC Blood Alcohol Concentration

The percentage of alcohol in blood that is used as a measure of the degree of intoxication of an individual. The concentration of alcohol in breath and urine mirrors the concentration of alcohol in the blood, so the BAC blood alcohol concentration of an individual can be determined by measuring the amount of alcohol in the breath. The BAC is the standard means of assessing the extent of a person's alcohol impairment; a BAC of 0.08% is the legal limit for intoxication in the US for drivers 21 and over.

Metabolism of Alcohol

When consumed in moderate amounts, alcohol is metabolized primarily in the liver by a 2 step process to form acetate. In the first step: the enzyme alcohol dehydrogenase converts alcohol to acetaldehyde, which is a highly reactive and toxic compound that can damage cellular components, including the dna Acetaldehyde is then converted to acetate by the enzyme acetaldehyde dehydrogenase, and acetate then disperses to tissues throughout the body where it is converted to acetyl-coenzyme A, which can be used as a source of energy in the liver and elsewhere in the body. With higher levels of alcohol intake, the excessive amount of acetyl-coenzyme A that is produced in the liver results in high levels of fat synthesis that can cause a fatty liver, and eventually cause liver damage. Most alcohol is metabolized to acetate in the liver, but a small amount can also be metabolized in the stomach by the same 2 step process, while even smaller amounts are excreted through breath, sweat, and urine. A small amount of alcohol is metabolized by the brain Alcohol that is not removed by the liver circulated throughout the rest of the body *the liver can only metabolize about an ounce of alcohol per hour, regardless of how much has been consumed