1

What is alcohol?
Alcohol is a part of everything, from family dinners to parties, to sporting events and nightcaps. The problems associated with alcoholism are well known, but what about the impact of social drinking or a moderate intake of alcohol? Does alcohol belong in ourdiet, or does the risk that it presents outweigh any benefits that may be derived from consuming it? Good nutrition can help to improve your health and prevent diseases. The nutrients that your body needs are carbohydrates, protein, fat, vitamins, minerals, and water. Some people feel that alcohol is another necessity in their diet, while others feel that any amount is toxic and needs to be avoided. The key to determining whether you need alcohol is to understand what alcohol is and how it is processed in your body. Calories provide energy for our bodies to function. We get calories from carbohydrates, protein, fat, and alcohol. For each gram, you get a set number of calories. The vitamin, mineral, and water content add to the nutritional value for each of these energy sources but do not provide any calories. A food is considered to be a source of "empty calories" when there are no other nutrients present besides the nutrient that provide the calories. Alcohol is considered to be a source of empty calories because it provides only negligible amounts of vitamins and minerals. Due to the fact that alcohol often replaces nutrient-rich food and directly interferes with the body's absorption, storage, and use of nutrients, it has also been called the "antinutrient nutrient." Alcohol can also be classified as a drug. Under this category, it is the most widely used drug in the world. Approximately 10 to 15 million Americans are alcoholics or problem drinkers, and more than 100,000 deaths each year are attributed to alcohol consumption. The majority of the population consumes alcohol moderately or occasionally. The potential to become addicted to alcohol is a serious problem that warrants limitations on its consumption.

How is alcohol made?

Alcohol, also known as ethanol, is made through a process called fermentation. During fermentation, yeast breaks sugar down into ethanol and carbon dioxide. This process is done without any air present, and once complete, the carbon dioxide gas bubbles out into the air leaving ethanol and water behind. Distilled spirits, such as vodka, rum, gin, and whiskey, are fermented and then distilled to separate the ethanol from the water. Various sources of sugar are used in these processes resulting in different forms of alcohol. The sugar from crushed grapes is used to make wine; malted barley is used to make beer; sugar cane or molasses makes rum; grain, potatoes, beets, molasses, and a variety of other plants are used to make vodka. The technique used to make the beverage will determine the alcohol content. You will see the percentage of alcohol per volume listed on the bottle, as well as the proof of the drink. The proof of a beverage is twice the alcohol content, so a drink with 12% alcohol per volume is 24 proof. Generally, a 12-ounce glass of beer, a 5-ounce glass of wine, and a 1.5-ounce shot of liquor all contain a ounce of pure alcohol and are considered one drink. The nutrients protein, carbohydrates, and fat can be stored in our bodies, but alcohol cannot. For this reason, it takes priority over everything else in order to be metabolized; doing so means that all of the other processes that should be taking place are being interrupted. Other nutrients need to be broken up prior to being absorbed, whereas alcohol is absorbed as is. The enzyme alcohol dehydrogenase begins some of the metabolism of alcohol in the stomach. Women have less of this enzyme, so alcohol passes through their stomachs and into their bloodstream quicker than in men. Once alcohol is absorbed, it spreads rapidly into the body water spaces, so the smaller size and higher body fat content of women increase its levels. Women metabolize about 10% of the alcohol ingested, while men metabolize about 30%. The liver is the primary site for alcohol metabolism. Alcohol is detoxified and removed from the blood through a process called oxidation. Oxidation prevents the alcohol from accumulating and destroying cells and organs. A healthy liver oxidizes pure ethanol at the rate of about to of an ounce per hour, which is less than 1 ounce of hard liquor. A small percent of the alcohol is excreted through the lungs and urine, which can be detected in breathalyzers. While being metabolized, alcohol is distributed throughout the body, affecting the brain and other tissues. Within minutes of being ingested, alcohol reaches the brain and initially gives the temporary impression of being a stimulant. Alcohol goes on to act as a depressant and a sedative, producing a sense of calm. It will also act as an anesthetic and hypnotic. When you drink alcohol, your blood alcohol concentration (BAC) will rise rapidly. Within five minutes of having a drink, there's enough alcohol in your blood to measure. The BAC is determined by how quickly alcohol is absorbed, distributed, metabolized, and excreted. The following factors can influence the BAC: gender, race, food consumed, chronic alcohol consumption, drinking pattern, and medications. The consumption of one standard drink will result in a peak in BAC within 35 to 45 minutes. A 150-pound person with normal liver function metabolizes about 7 to 14 grams of alcohol per hour, which is approximately 100 to 200 mg/kg of body weight per hour. This is comparable to 8 to 12 ounces of beer or half of an alcoholic drink. Controlling the rate of consumption will give your liver time to metabolize the alcohol and limit your BAC. Once you stop drinking, your blood alcohol level decreases by about 0.01% per hour. You are legally intoxicated with a blood alcohol concentration of 0.8. Time is the only way to eliminate alcohol from your system, so cold showers and coffee will not sober you up. Trying to get someone who is drunk to feel and appear more alert can cause a false sense of sobriety and result in many problems.

How is alcohol metabolized?

Are there health benefits to consuming alcohol?

Many people have heard that there are health benefits to alcohol and claim to consume it for that reason. All reported benefits are limited to an intake at or below the U.S. Dietary Guidelines for Americans recommendations of one drink per day or less for women and two or fewer drinks per day for men. There has been an association described between alcohol and reduced risk of coronary heart disease (CHD). The reason for this is that alcohol helps raise the levels of high density lipoprotein (HDL) cholesterol and lowers plasma fibrinogen levels, which contribute to blood clotting. A Danish study of 27,178 men and 29,875 women who were free of CHD monitored their intake of alcohol over 5.7 years. The men who drank the most alcohol had a lower risk of CHD. One drink a week lowered the risk by about 7%, two to four drinks by 22%, and five or six drinks a week by 29%. Those who drank every day had a 41% lower risk of heart disease than those who did not drink at all. The women also experienced a decrease in risk, but the frequency of drinking did not have the same impact as with the men. One drink a week lowered the risk by 36%, but daily drinking lowered it by 35%. The limitation to this study was that binge drinking and the number of drinks at each occasion were not studied. The pattern of drinking seems important for the possible cardioprotective effect of alcohol, and the risk of CHD is generally lower for steady versus binge drinking. Higher drinking levels increase the risk of death from cancer, liver cirrhosis, trauma, and other types of heart disease.

Which alcohol is the best to consume?

Your drink of choice may be due to the perceived health benefits of the individual beverages. The debate over which beverage is more beneficial continues. Beer drinkers claim that there are more vitamins in beer, while wine drinkers point to the "French paradox" for the health benefits of consuming wine. Is it the alcohol, or are there other factors that make a drink beneficial to your health? The French paradox refers to the observation that the French have a lower mortality rate from heart disease than Americans, even though they eat similar amounts of high-fat foods, exercise less, and smoke more. Studies suggest that one of the reasons for this may be their regular consumption of red wine. Danish studies show that wine drinkers, compared with beer and distilled spirit drinkers, have lower risks of cancer,stroke, and total mortality. Other studies have shown that the frequency of wine drinking was independently related to a lower incidence of deaths due to coronary heart disease and respiratory diseases. While there is some evidence that wine may have more beneficial effects than beer and distilled spirits, these results are still controversial and may be confounded by personal characteristics and other lifestyle factors such as diet. Beer contains more B vitamins than wine and comparable levels of different antioxidants. The antioxidants in beer come from the barley and hops used to make the beer, while the antioxidants in wine come from the grapes. A German study of over 300 patients with known heart disease found that those who reported consuming mainly or exclusively beer had a lower risk of heart disease than others. Animal studies have shown that beer may prevent carcinogenesis and osteoporosis, and the hops may prevent and improve type 2 diabetes and suppress atherosclerosis. The studies need to be done on humans before any recommendations can be made. You may also be able to achieve these same benefits without the alcohol. One short-term study of 12 men showed that nonalcoholic beer could provide cardiovascular benefits superior to the alcoholic version. Regardless of the kind of alcohol consumed, moderation remains the key. Excessive intakes of wine, beer, or distilled sprits will detrimentally affect your health.

Brief Description:

Ethyl alcohol, or ethanol, is an intoxicating ingredient found in beer, wine, and liquor. Alcohol is produced by the fermentation of yeast, sugars, and starches. It is a central nervous system depressant that is rapidly absorbed from the stomach and small intestine into the bloodstream. A standard drink equals 0.6 ounces of pure ethanol, or 12 ounces of beer; 8 ounces of malt liquor; 5 ounces of wine; or 1.5 ounces (a "shot") of 80-proof distilled spirits or liquor (e.g., gin, rum, vodka, or whiskey). NIDA does not conduct research on alcohol; for more information, please visit theNational Institute on Alcohol Abuse and Alcoholism (NIAAA)and the Centers for Disease Control (CDC). Alcohol affects every organ in the drinker's body and can damage a developing fetus. Intoxication can impair brain function and motor skills; heavy use can increase risk of certain cancers, stroke, and liver disease. Alcoholism or alcohol dependence is a diagnosable disease characterized by a strong craving for alcohol, and/or continued use despite harm or personal injury. Alcohol abuse, which can lead to alcoholism, is a pattern of drinking that results in harm to one's health, interpersonal relationships, or ability to work. In 2008, 51.6% of Americans age 12 and older had used alcohol at least once in the 30 days prior to being surveyed; 23.3% had binged (5+ drinks within 2 hours); and 23.3% drank heavily (5+ drinks on 5+ occasions). In the 12-17 age range, 14.6% had consumed at least one drink in the 30 days prior to being surveyed; 8.8% had binged; and 2.0% drank heavily. Source: National Survey on Drug Use and Health(Substance Abuse and Mental Health Administration Web Site). The NIDA-funded 2008 Monitoring the Future Study showed that 15.9% of 8th graders, 28.8% of 10th graders, and 43.1% of 12th graders had consumed at least one drink in the 30 days prior to being surveyed, and 5.4% of 8th graders, 14.4% of 10th graders, and 27.6% of 12th graders had been drunk. Source: Monitoring the Future (University of Michigan Web Site)

Effects:

Statistics and Trends:

2 Effects of alcohol on health

Data from The Lancet shows ethanol in comparison to other psychoactive drugs.[23]

See also: Alcohol and sex, Blood alcohol content, Long-term effects of alcohol, and Short-term effects of alcohol Short-term effects of alcohol consumption include intoxication and dehydration. Long-term effects of alcohol include changes in the metabolism of the liver and brain and alcoholism (addiction to alcohol). Alcohol intoxication affects the brain, causing slurred speech, clumsiness, and delayed reflexes. Alcohol stimulates insulin production, which speeds upglucose metabolism and can result in low blood sugar, causing irritability and (for diabetics) possible death. Severe alcohol poisoning can be fatal. A blood alcohol content of .45% in test animals results in a median lethal dose of LD50. This means that .45% is the concentration of blood alcohol that is fatal in 50% of the test subjects. That is about six times the level of ordinary intoxication (0.08%), but vomiting or unconsciousness may occur much sooner in people who have a low tolerance for alcohol.[24] The high tolerance of chronic heavy drinkers may allow some of them to remain conscious at levels above .40%, although serious health dangers are incurred at this level. Alcohol also limits the production of vasopressin (ADH) from the hypothalamus and the secretion of this hormone from the posterior pituitary gland. This is what causes severe dehydration when large amounts of alcohol are drunk. It also causes a high concentration of water in the urine and vomit and the intense thirst that goes along with a hangover. [edit]Alcoholism Main articles: Alcoholism and Long-term effects of alcohol Proclivity to alcoholism may be partially genetic. Persons who have this proclivity may have an atypical biochemical response to alcohol, although this is disputed. Alcoholism can lead to malnutrition because it can alter digestion and the metabolism of most nutrients. Severe thiamine deficiency is common in alcoholism due to deficiency of folate, riboflavin,vitamin B6, and selenium ; this can lead to Korsakoff's syndrome. Alcoholism is also associated with a type of dementia called Wernicke-Korsakoff syndrome, which is caused by a deficiency inthiamine (vitamin B1).[25] Muscle cramps, nausea, loss of appetite, nerve disorders, and depression are common symptoms of alcoholism. Osteoporosis and bone fractures may occur due to deficiency of vitamin D. [edit]Heart

disease

Main article: Alcohol and cardiovascular disease One study found that men who drank moderate amounts of alcohol three or more times a week were up to 35% less likely to have a heart attack than non-drinkers, and men who increased their alcohol consumption by one drink per day over the 12 years of the study had a 22% lower risk of heart attack.[26] Daily intake of one or two units of alcohol (a half or full standard glass of wine) is associated with a lower risk of coronary heart disease in men over 40, and in women who have been through menopause.[27] However, getting drunk one or more times per month put women at a significantly increased risk of heart attack, negating alcohol's potential protective effect.[28] Increased longevity due to alcohol consumption is almost entirely the result of a reduced rate of coronary heart disease.[29] [edit]Dementia Main article: Alcohol dementia Long-term moderate or short-term excessive (binge) drinking has been linked to dementia; it is estimated that 10% to 24% of dementia cases are caused by alcohol consumption, with women being at greater risk than men.[30][31] Alcoholism is associated with a type of dementia called Wernicke-Korsakoff syndrome, which is caused by a deficiency in thiamine (vitamin B1).[25] The neurotoxic effects of alcohol on the brain are caused by alcohol's interaction with nutritional deficiencies and by the neurotoxicity of withdrawal from alcohol.[32] In rats, extended consumption of alcohol "did not produce anatomic deficits", but withdrawal from alcohol was associated with neuronal loss.[32] Alcohol interferes with the neurotransmitter glutamate, increasing (upregulating) the number of glutamate receptors in the brain. When alcohol intake is reduced, the glutamate receptors become overactive and neurotoxic.[25] Other effects that could contribute to the toxicity of withdrawal from alcohol include the facilitation of GABA, upregulation of certain voltage sensitive calcium channels, and dopamine release.[32] In people aged 55 or older, daily light-to-moderate drinking (one to three drinks) was associated with a 42% reduction in the probability of developing dementia and a 70% reduction in risk ofvascular dementia.[33] The researchers suggest that alcohol may stimulate the release of acetylcholine in the hippocampus area of the brain.[33] [edit]Cancer Main article: Alcohol and cancer Alcohol consumption has been linked with seven types of cancer: mouth cancer, pharyngeal cancer, oesophageal cancer, laryngeal cancer, breast cancer, bowel cancer and liver cancer.[34] Heavy drinkers are more likely to develop liver cancer due to cirrhosis of the liver.[34] The risk of developing cancer increases even with consumption of as little as three units of alcohol (one pint of lager or a large glass of wine) a day.[34] A global study found that 3.6% of all cancer cases worldwide are caused by drinking alcohol, resulting in 3.5% of all global cancer deaths.[35] A study in the United Kingdom found that alcohol causes about 6% of cancer deaths in the UK (9,000 deaths per year).[34] A study in China found that alcohol causes about 4.40% of all cancer deaths and 3.63% of all cancer incidences.[36] For both men and women, the consumption of two or more drinks daily increases the risk of pancreatic cancer by 22%.[37] Women who regularly consume low to moderate amounts of alcohol have an increased risk of cancer of the upper digestive tract, rectum, liver, and breast.[38][39] Red wine contains resveratrol, which has some anti-cancer effect. However, based on studies done so far, there is no strong evidence that red wine protects against cancer in humans.[40] [edit]Diabetes Daily consumption of a small amount of pure alcohol by older women may slow or prevent the onset of diabetes by lowering the level of blood glucose.[41] However, the researchers caution that the study used pure alcohol and that alcoholic beverages contain additives, including sugar, which would negate this effect. [41] People with diabetes should avoid sugary drinks such as dessert wines and liqueurs.[42] [edit]Stroke A study found that lifelong abstainers were 2.36 times more likely to suffer a stroke than those who regularly drank a moderate amount of alcohol beverages. Heavy drinkers were 2.88 times more likely to suffer a stroke than moderate drinkers.[43] [edit]Longevity Alcohol consumption by the elderly results in increased longevity, which is almost entirely a result of lowered coronary heart disease.[29] A British study found that consumption of two units of alcohol (one regular glass of wine) daily by doctors aged 48+ years increased longevity by reducing the risk of death by ischaemic heart disease and respiratory disease.[44] Deaths for which alcohol consumption is known to increase risk accounted for only 5% of the total deaths, but this figure increased among those who drank more than two units of alcohol per day.[44] In a 2010 long-term study of an older population, the beneficial effects of moderate drinking were confirmed, but abstainers and heavy drinkers showed an increase of about 50% in mortality (even after controlling for confounding factors).[45] [edit]Mortality

rate

Main article: Long-term effects of alcohol#Alcohol-related deaths A report of the United States Centers for Disease Control estimated that medium and high consumption of alcohol led to 75,754 deaths in the U.S. in 2001. Low consumption of alcohol had some beneficial effects, so a net 59,180 deaths were attributed to alcohol.[46] In the United Kingdom, heavy drinking is blamed for about 33,000 deaths a year.[47] A study in Sweden found that 29% to 44% of "unnatural" deaths (those not caused by illness) were related to alcohol. The causes of death included murder, suicide, falls, traffic accidents,asphyxia, and intoxication.[48] A global study found that 3.6% of all cancer cases worldwide are caused by alcohol drinking, resulting in 3.5% of all global cancer deaths.[35] A study in the United Kingdom found that alcohol causes about 6% of cancer deaths in the UK (9,000 deaths per year).[34]

3
[edit]Alcohol

expectations

Alcohol expectations are beliefs and attitudes that people have about the effects they will experience when drinking alcoholic beverages. They are largely beliefs about alcohol's effects on a persons behaviors, abilities, and emotions. Some people believe that if alcohol expectations can be changed, then alcohol abuse might be reduced.[49] The phenomenon of alcohol expectations recognizes that intoxication has real physiological consequences that alter a drinker's perception of space and time, reduce psychomotor skills, and disrupt equilibrium.[50] The manner and degree to which alcohol expectations interact with the physiological effects of intoxication, resulting in specific behaviors, is unclear. If a society believes that intoxication leads to sexual behavior, rowdy behavior, or aggression, then people tend to act that way when intoxicated. But if a society believes that intoxication leads to relaxation and tranquil behavior, then it usually leads to those outcomes. Alcohol expectations vary within a society, so these outcomes are not certain.[51] People tend to conform to social expectations, and some societies expect that drinking alcohol will cause disinhibition. However, in societies in which the people do not expect that alcohol will disinhibit, intoxication seldom leads to disinhibition and bad behavior.[50] Alcohol expectations can operate in the absence of actual consumption of alcohol. Research in the United States over a period of decades has shown that men tend to become more sexually aroused when they think they have been drinking alcohol, even when they have not been drinking it. Women report feeling more sexually aroused when they falsely believe the beverages they have been drinking contained alcohol (although one measure of their physiological arousal shows that they became less aroused). Men tend to become more aggressive in laboratory studies in which they are drinking only tonic water but believe that it contains alcohol. They also become less aggressive when they believe they are drinking only tonic water, but are actually drinking tonic water that contains alcohol.[49]

Cardiovascular system

Main article: Alcohol and cardiovascular disease A meta-analysis of 34 studies found a reduced risk of mortality from coronary heart disease in men who drank 2 - 4 drinks per day and women who drank 1 - 2 drinks per day.[30] A meta-analysis of randomized trials found that alcohol consumption in moderation decreases serum levels of fibrinogen, a protein that promotes clot formation and increases levels of tissue type plasminogen activator, an enzyme that helps dissolve clots.[31] The serum levels of C-reactive protein (CRP), a marker of inflammation and predictor of CHD risk, are lower in people who drink moderately than those who abstain from alcohol suggesting that alcohol consumption in moderation might have anti-inflammatory effects.[32][33][34] In addition to its psychotropic properties, alcohol hasanticoagulation properties similar to warfarin.[35][36] Additionally, thrombosis is lower among moderate drinkers than teetotalers.[37] Despite epidemiological evidence, some criticize the idea of recommending alcohol for health benefits. A doctor at the World Health Organisation stated that recommending moderate alcohol consumption for health benefits is "ridiculous and dangerous".[38][39] There have been no randomised controlled trials to demonstrate the cardio benefits of alcohol. Due to the risks of abuse, dependence, adverse effects, alcohol should never be recommended for cardio benefits. Instead, a good diet, exercise, and if necessary pharmacotherapy are the recommended treatments for cardio-protection.[40] It has been argued that the health benefits from alcohol are at best debatable and may have been exaggerated by the alcohol industry. Alcohol should be regarded as a recreational drug with potentially serious adverse effects on health and should not be promoted for cardioprotection.[6] [edit]Peripheral Arterial Disease "Moderate alcohol consumption appears to decrease the risk of PAD in apparently healthy men."[41] "In this large population-based study, moderate alcohol consumption was inversely associated with peripheral arterial disease in women but not in men. Residual confounding by smoking may have influenced the results. Among nonsmokers an inverse association was found between alcohol consumption and peripheral arterial disease in both men and women."[42][43] [edit]Intermittent claudication (IC) A study found that moderate consumption of alcohol had a protective effect against intermittent claudication. The lowest risk was seen in men who drank 1 to 2 drinks per day and in women who drank half to 1 drink per day.[44] [edit]Heart attack and stroke Drinking in moderation has been found to help those who have suffered a heart attack survive it.[45][46] However, excessive alcohol consumption leads to an increased risk of heart failure.[47] A review of the literature found that half a drink of alcohol offered the best level of protection. However, they noted that at present there have been no randomised trials to confirm the evidence which suggests a protective role of low doses of alcohol against heart attacks.[48] However, moderate alcohol consumption is associated with hypertension. [8] There is an increased risk ofhypertriglyceridemia, cardiomyopathy, hypertension, and stroke if 3 or more standard drinks of alcohol are taken per day.[49] Compared to abstaining, drinking in moderation is associated with an increased risk of stroke. Light drinking offers no benefits in prevention of stroke.[50] [edit]Cardiomyopathy Large amount of alcohol can lead to alcoholic cardiomyopathy, commonly known as "holiday heart syndrome." Alcoholic cardiomyopathy presents in a manner clinically identical to idiopathicdilated cardiomyopathy, involving hypertrophy of the musculature of the heart that can lead to a form of cardiac arrythmia. These electrical anomalies, represented on an EKG, often vary in nature, but range from nominal changes of the PR, QRS, or QT intervals to paroxsysmal episodes of ventricular tachycardia. The pathophysiology of alcoholic cardiomyopathy has not been firmly identified, but certain hypotheses cite an increased secretion of epinephrine and norepinephrine, increased sympathetic output, or a rise in the level of plasma free fatty acids as possible mechanisms.[51] [edit]Hematologic diseases Alcoholics may have anemia from several causes;[52] they may also develop thrombocytopenia from direct toxic effect on megakaryocytes, or from hypersplenism. [edit]Nervous

system

Chronic heavy alcohol consumption impairs brain development, causes brain shrinkage, dementia, physical dependence, increases neuropsychiatric and cognitive disorders and causes distortion of the brain chemistry. Some studies however have shown that moderate alcohol consumption may decrease risk of dementia, including Alzheimer disease, although there are studies which find the opposite. At present due to poor study design and methodology the literature is inconclusive on whether moderate alcohol consumptions increases the risk of dementia or decreases it.[53]Evidence for a protective effect of low to moderate alcohol consumption on age related cognitive decline and dementia has been suggested by some research, however, other research has not found a protective effect of low to moderate alcohol consumption.[54] Some evidence suggests that low to moderate alcohol consumption may speed up brain volume loss.[55] [edit]Strokes A 2003 Johns Hopkins study has linked moderate alcohol use to brain shrinkage and did not find any reduced risk of stroke among moderate drinkers.[56] [edit]Brain Alcohol abuse is associated with wide spread and significant brain lesions. Alcohol related brain damage is due not only to the direct toxic effects of alcohol; alcohol withdrawal, nutritional deficiency, electrolyte disturbances, and liver damage are also believed to contribute to alcohol related brain damage.[57] [edit]Brain development Consuming large amounts of alcohol over a period of time can impair normal brain development in humans.[58][59] Deficits in retrieval of verbal and nonverbal information and in visuospatial functioning were evident in youths with histories of heavy drinking during early and middle adolescence.[60][61] During adolescence critical stages of neurodevelopment occur. Binge drinking, which is common among adolescents, interferes with this important stage of development.[62] Heavy alcohol consumption inhibits new brain cell development.[63] Nearly half of chronic alcoholics may have myopathy.[64] Proximal muscle groups are especially affected. Twenty-five percent of alcoholics may have peripheral neuropathy, including autonomic.[65] [edit]Cognition and dementia Excessive alcohol intake is associated with impaired prospective memory. This impaired cognitive ability leads to increased failure to carry out an intended task at a later date, for example, forgetting to lock the door or to post a letter on time. The higher the volume of alcohol consumed and the longer consumed, the more severe the impairments. [66] One of the organs most sensitive to the toxic effects of chronic alcohol consumption is the brain. In France approximately 20% of admissions to mental health facilities are related to alcohol related cognitive impairment, most notably alcohol related dementia. Chronic excessive alcohol intake is also associated with serious cognitive decline and a range of neuropsychiatric complications. The elderly are the most sensitive to the toxic effects of alcohol on the brain.[67] There is some inconclusive evidence that small amounts of alcohol taken in earlier adult life is protective in later life against cognitive decline and dementia.[68] However, a study concluded, "Our findings suggest that, despite previous suggestions, moderate alcohol consumption does not protect older people from cognitive decline."[69] Acetaldehyde is produced by the liver during breakdown of ethanol. People who have a genetic deficiency for the subsequent conversion of acetaldehyde into acetic acid (a trait more prevalent in those of East Asian descent) may have a greater risk of Alzheimer's disease. "These results indicate that the ALDH2 deficiency is a risk factor for LOAD [lateonset Alzheimer's disease] "[70] Wernicke-Korsakoff syndrome is a manifestation of thiamine deficiency, usually as a secondary effect of alcohol abuse.[71] The syndrome is a combined manifestation of two eponymous disorders,Korsakoff's Psychosis and Wernicke's encephalopathy, named after Drs. Sergei Korsakoff and Carl Wernicke. Wernicke's encephalopathy is the acute presentation of the syndrome and is characterised by a confusional state while Korsakoff's psychosis main symptoms are amnesia and executive dysfunction.[72] [edit]Essential tremor Essential tremors can be temporarily relieved in up to two-thirds of patients by drinking small amounts of alcohol.[73]

4
[edit]Sleep Chronic use of alcohol used to induce sleep can lead to insomnia. Frequent moving between sleep stages occurs, with awakenings due to headaches and diaphoresis. Stopping chronic alcohol abuse can also lead to profound disturbances of sleep with vivid dreams. Chronic alcohol abuse is associated with NREM stage 3 and 4 sleep as well as suppression of REM sleep and REM sleep fragmentation. During withdrawal REM sleep is typically exaggerated as part of a rebound effect.[74] [edit]Mental health effects High rates of major depressive disorder occur in heavy drinkers and those who abuse alcohol. Controversy has previously surrounded whether those who abused alcohol who developed major depressive disorder were self medicating (which may be true in some cases) but recent research has now concluded that chronic excessive alcohol intake itself directly causes the development ofmajor depressive disorder in a significant number of alcohol abusers.[75] Alcohol misuse is associated with a number of mental health disorders and alcoholics have a very high suicide rate.[76] A study of people hospitalised for suicide attempts found that those who were alcoholics were 75 times more likely to go on to successfully commit suicide than non-alcoholic suicide attempters.[77]In the general alcoholic population the increased risk of suicide compared to the general public is 5 - 20 times greater. About 15 percent of alcoholics commit suicide. Abuse of other drugs is also associated with an increased risk of suicide. About 33 percent of suicides in the under 35s are due to alcohol or other substance misuse.[78] Studies have shown that alcohol dependence relates directly to cravings and irritability.[79] Another study has shown that alcohol use is a significant predisposing factor towards antisocial behaviorin children.[80] Depression, anxiety and panic disorder are disorders commonly reported by alcohol dependent people. Alcoholism is associated with dampened activation in brain networks responsible for emotional processing (e.g. the amygdala and hippocampus).[81] Evidence that the mental health disorders are often induced by alcohol misuse via distortion of brain neurochemistry is indicated by the improvement or disappearance of symptoms that occurs after prolonged abstinence, although problems may worsen in early withdrawal and recovery periods.[82][83][84]Psychosis is secondary to several alcohol-related conditions including acute intoxication and withdrawal after significant exposure.[85] Chronic alcohol misuse can cause psychotic type symptoms to develop, more so than with other drugs of abuse. Alcohol abuse has been shown to cause an 800% increased risk of psychotic disorders in men and a 300% increased risk of psychotic disorders in women which are not related to pre-existing psychiatric disorders. This is significantly higher than the increased risk of psychotic disorders seen from cannabis use making alcohol abuse a very significant cause of psychotic disorders. [86] Prominent hallucinations and/or delusions are usually present when a patient is intoxicated or recently withdrawn from alcohol.[85] Whilst alcohol initially helps social phobia or panic symptoms, with longer term alcohol misuse can often worsen social phobia symptoms and can cause panic disorder to develop or worsen, during alcohol intoxication and especially during the alcohol withdrawal syndrome. This effect is not unique to alcohol but can also occur with long term use of drugs which have a similar mechanism of action to alcohol such as the benzodiazepines which are sometimes prescribed as tranquillisers to people with alcohol problems. [87] Approximately half of patients attending mental health services for conditions including anxiety disorders such as panic disorder or social phobia are the result of alcohol or benzodiazepine dependence. It was noted that every individual has an individual sensitivity level to alcohol or sedative hypnotic drugs and what one person can tolerate without ill health another will suffer very ill health and that even moderate drinking can causerebound anxiety syndromes and sleep disorders. A person who is suffering the toxic effects of alcohol will not benefit from other therapies or medications as they do not address the root cause of the symptoms.[88] [edit]Digestive

system and weight gain

See also: Alcohol and weight, Alcoholic liver disease, Alcoholic hepatitis, Fatty liver, and Cirrhosis The impact of alcohol on weight-gain is contentious: some studies find no effect,[89] others find decreased[90] or increased effect on weight gain. Alcohol use increases the risk of chronic gastritis (stomach inflammation);[91][92] it is one cause of cirrhosis, hepatitis, and pancreatitis in both its chronic and acute forms. [edit]Metabolic syndrome A study concluded, "Mild to moderate alcohol consumption is associated with a lower prevalence of the metabolic syndrome, with a favorable influence on lipids, waist circumference, and fasting insulin. This association was strongest among whites and among beer and wine drinkers."[93] "Odds ratios for the metabolic syndrome and its components tended to increase with increasing alcohol consumption."[94] [edit]Gallbladder effects Research has found that drinking reduces the risk of developing gallstones. Compared with alcohol abstainers, the relative risk of gallstone disease, controlling for age, sex, education, smoking, and body mass index, is 0.83 for occasional and regular moderate drinkers (< 25 ml of ethanol per day), 0.67 for intermediate drinkers (25-50 ml per day), and 0.58 for heavy drinkers. This inverse association was consistent across strata of age, sex, and body mass index."[95] Frequency of drinking also appears to be a factor. "An increase in frequency of alcohol consumption also was related to decreased risk. Combining the reports of quantity and frequency of alcohol intake, a consumption pattern that reflected frequent intake (5-7 days/week) of any given amount of alcohol was associated with a decreased risk, as compared with nondrinkers. In contrast, infrequent alcohol intake (1-2 days/week) showed no significant association with risk.[96] Consumption of alcohol is unrelated to gallbladder disease.[97] However one study suggested that drinkers who take vitamin C (ascorbic acid) might reduce their risk of gallbladder disease.[98] [edit]Liver disease Alcoholic liver disease is a major public health problem. For example in the United States up to two million people have alcohol related liver disorders. Chronic alcohol abuse can cause fatty liver,cirrhosis and alcoholic hepatitis. Treatment options are limited and consist of most importantly discontinuing alcohol consumption. In cases of severe liver disease, the only treatment option may be a liver transplant in alcohol abstinent patients. Research is being conducted into the effectiveness of anti-TNF's. Certain complimentary medications, e.g., milk thistle and silymarin, appear to offer some benefit.[99][100] Alcohol is a leading cause of liver cancer in the Western world, accounting for 32-45% of hepatic cancers. Up to half a million people in the United States develop alcohol related liver cancer.[101][102] Moderate alcohol consumption also increases the risk of liver disease.[8] [edit]Pancreatitis Alcohol misuse is a leading cause of both acute pancreatitis and chronic pancreatitis.[103][104] Chronic excessive intake of alcohol can cause destruction of the pancreas resulting in severe chronic pain, which may progress to pancreatic cancer.[105] Chronic pancreatitis often results in malabsorption problems and diabetes.[106] [edit]Other

systems

[edit]Alcoholic Lung disease Chronic alcohol ingestion impairs multiple critical cellular functions in the lung. These cellular impairments lead to increased susceptibility to serious complications from lung disease. Recent research cites alcoholic lung disease as comparable to liver disease in alcohol related mortality. Alcoholics have a higher risk of developing acute respiratory distress syndrome (ARDS) and experience higher rates of mortality from ARDS when compared to non-alcoholics. [edit]Kidney stones Research indicates that drinking alcohol is associated with a lower risk of developing kidney stones. One study concludes, "Since beer seemed to be protective against kidney stones, the physiologic effects of other substances besides ethanol, especially those of hops, should also be examined."[107] "...consumption of coffee, alcohol, and vitamin C supplements were negatively associated with stones."[108] "After mutually adjusting for the intake of other beverages, the risk of stone formation decreased by the following amount for each 240-ml (8-oz) serving consumed daily: caffeinated coffee, 10%; decaffeinated coffee, 10%; tea, 14%; beer, 21%; and wine, 39%."[109] "...stone formation decreased by the following amount for each 240-mL (8-oz) serving consumed daily: 10% for caffeinated coffee, 9% for decaffeinated coffee, 8% for tea, and 59% for wine." (CI data excised from last two quotes.).[110] [edit]Sexual dysfunction Long term excessive intake of alcohol can lead to damage to the central nervous system and the peripheral nervous system resulting in loss of sexual desire and impotence in men.[111] [edit]Hormonal Imbalance Excessive alcohol intake can result in hyperoestrogenisation.[112] It has been speculated that alcohol beverages may contain estrogen like compounds. In men, high levels of estrogen can lead totesticular failure and the development of feminine traits including development of male breasts, called gynecomastia.[113][114] In women, increased levels of estrogen due to excessive alcohol intake have been related to an increased risk of breast cancer.[114][115] [edit]Diabetes mellitus Moderate drinkers may have a lower risk of diabetes than non-drinkers. On the other hand, binge drinking and high alcohol consumption may increase the risk of type 2 diabetes in women."[116]Alcohol consumption promotes insulin sensitivity.[117] [edit]Rheumatoid arthritis Regular consumption of alcohol is associated with an increased risk of gouty arthritis[118][119] and a decreased risk of rheumatoid arthritis.[120][121][122][123][124] Two recent studies report that the more alcohol consumed, the lower the risk of developing rheumatoid arthritis. Among those who drank regularly, the one-quarter who drank the most were up to 50% less likely to develop the disease compared to the half who drank the least.[125] The researchers noted that moderate alcohol consumption also reduces the risk of other inflammatory processes such as cardiovascualar disease. Some of the biological mechanisms by which ethanol reduces the risk of destructive arthritis and prevents the loss of bone mineral density (BMD), which is part of the disease process.[126] A study concluded, "Alcohol either protects from RA or, subjects with RA curtail their drinking after the manifestation of RA".[127] Another study found, "Postmenopausal women who averaged more than 14 alcoholic drinks per week had a reduced risk of rheumatoid arthritis..." [128]

5
[edit]Osteoporosis Moderate alcohol consumption is associated with higher bone mineral density in postmenopausal women. "...Alcohol consumption significantly decreased the likelihood [of osteoporosis]."[129]"Moderate alcohol intake was associated with higher BMD in postmenopausal elderly women."[130] "Social drinking is associated with higher bone mineral density in men and women [over 45]."[131] However, alcohol abuse is associated with bone loss.[132][133] [edit]Skin Chronic excessive alcohol abuse is associated with a wide range of skin disorders including urticaria, porphyria cutanea tarda, flushing, cutaneous stigmata of cirrhosis, psoriasis, pruritus,seborrheic dermatitis and rosacea.[134] A 2010 study concluded, "Nonlight beer intake is associated with an increased risk of developing psoriasis among women. Other alcoholic beverages did not increase the risk of psoriasis in this study."[135] [edit]Immune

system, bacterial contamination, viral infections, and cancer

[edit]Bacterial infection There is a protective effect of alcohol consumption against active infection with H. pylori[136] In contrast, alcohol intake (comparing those who drink > 30 gm of alcohol per day to nondrinkers) is not associated with higher risk of duodenal ulcer.[137] Excessive alcohol consumption seen in alcoholics is a known risk factor for pneumonia. [edit]Common cold A study on the common cold found that "Greater numbers of alcoholic drinks (up to three or four per day) were associated with decreased risk for developing colds because drinking was associated with decreased illness following infection. However, the benefits of drinking occurred only among nonsmokers. [...] Although alcohol consumption did not influence risk of clinical illness for smokers, moderate alcohol consumption was associated with decreased risk for nonsmokers."[138] Another study concluded, "Findings suggest that wine intake, especially red wine, may have a protective effect against common cold. Beer, spirits, and total alcohol intakes do not seem to affect the incidence of common cold."[139] [edit]Cancer Main article: Alcohol and cancer The International Agency for Research on Cancer (Centre International de Recherche sur le Cancer) of the World Health Organization has classified alcohol as a Group 1 carcinogen. Its evaluation states, "There is sufficient evidence for the carcinogenicity of alcoholic beverages in humans.... Alcoholic beverages are carcinogenic to humans (Group 1)."[140] The U.S. Department of Health & Human Services National Toxicology Program listed alcohol as a known carcinogen in 2000.[141] One study determined that "3.6% of all cancer cases worldwide are related to alcohol drinking, resulting in 3.5% of all cancer deaths."[142] The World Cancer Research Fund panel report Food, Nutrition, Physical Activity and the Prevention of Cancer: a Global Perspective finds the evidence "convincing" that alcoholic drinks increase the risk of the following cancers: mouth, pharynx and larynx, oesophagus, colorectum (men), breast (pre- and postmenopause).[143] High concentrations of acetaldehyde, which is produced as the body breaks down ethanol, may damage DNA in healthy cells. The National Institute on Alcohol Abuse and Alcoholism have shown that acetaldehyde reacts with polyamines which are naturally occurring compounds essential for cell growthto create a particularly dangerous type of mutagenic DNA base called a Cr-Pdg adduct.[144] Even moderate levels of alcohol consumption are associated with an increased risk of certain forms of cancer.[8]

Signs and symptoms

Alcohol is an addictive drug that can greatly exacerbate sleep problems. During abstinence, residual disruptions in sleep regularity and sleep patterns[clarification needed] are the greatest predictors of relapse.[5] [edit]Moderate alcohol consumption and sleep disruptions Moderate alcohol consumption 3060 minutes before sleep, although decreasing sleep onset latency, disrupts sleep architecture.[6] Rebound effects occur once the alcohol has been largely metabolized, causing late night disruptions in sleep maintenance. Under conditions of moderate alcohol consumption where blood alcohol levels average 0.060.08 percent and decrease 0.010.02 percent per hour, an alcohol clearance rate of 45 hours would coincide with disruptions in sleep maintenance in the second half of an 8 hr sleep episode.[6] In terms of sleep architecture, moderate doses of alcohol facilitate "rebounds" in rapid eye movement (REM) and stage 1 sleep; following suppression in REM and stage 1 sleep in the first half of an 8 hr sleep episode, REM and stage 1 sleep increase well beyond baseline in the second half. Moderate doses of alcohol also very quickly increase slow wave sleep (SWS) in the first half of an 8 hr sleep episode.[6] Enhancements in REM sleep and SWS following moderate alcohol consumption are mediated by reductions in glutamatergic activity by adenosine in the central nervous system.[6] In addition, tolerance to changes in sleep maintenance and sleep architecture develops within 3 days of alcohol consumption before bedtime.[6] [edit]Alcohol consumption and sleep improvements Low doses of alcohol (one 360 ml (13 imp fl oz; 12 US fl oz) beer) increase total sleep time and reduce awakening during the night. The sleep-promoting benefits of alcohol dissipate at moderate and higher doses of alcohol.[7] Previous experience with alcohol also influences the extent to which alcohol positively or negatively affects sleep. Under free-choice conditions, in which subjects chose between drinking alcohol or water, inexperienced drinkers were sedated while experienced drinkers were stimulated following alcohol consumption.[8] In insomniacs, moderate doses of alcohol improve sleep maintenance.[9]

French wines

[edit]Alcohol consumption and fatigue Conditions of sleep deprivation correlate positively with increased alcohol consumption.[6] In Northern climates, increased alcohol consumption during the winter months is attributed to escalations in fatigue.[10] [edit]Alcohol abstinence and sleep disruptions Hormonal imbalance and sleep disruption following withdrawal from chronic alcohol consumption are strong predictors of relapse.[5] During abstinence, recovering alcoholics have attenuated melatonin secretion at onset of a sleep episode, resulting in prolonged sleep onset latencies.[11] Escalations incortisol and core body temperatures during the sleep period contribute to poor sleep maintenance.[11][12] [edit]Effects by dosage Different concentrations of alcohol in the human body have different effects on the subject. The following lists the common effects of alcohol on the body, depending on the blood alcohol concentration (BAC). However, tolerance varies considerably between individuals, as does individual response to a given dosage; the effects of alcohol differ widely between people. Hence, BAC percentages are just estimates used for illustrative purposes. Euphoria (BAC = 0.03 to 0.12%) Overall improvement in mood and possible euphoria Increased self-confidence Increased sociability Shortened attention span Flushed appearance Inhibited judgment Impaired fine muscle coordination Stupor (BAC = 0.25 to 0.40%) Severe ataxia Lapses in and out of consciousness Unconsciousness Anterograde amnesia

Vomiting (death may occur due to inhalation of vomit (pulmonary aspiration) while unconscious) Respiratory depression (potentially life-threatening) Decreased heart rate

Lethargy (BAC = 0.09 to 0.25%) Urinary incontinence Sedation Impaired memory and comprehension Coma (BAC = 0.35 to 0.50%) Delayed reactions Unconsciousness (coma) Ataxia; balance difficulty; unbalanced walk Depressed reflexes (i.e., pupils do not respond appropriately to changes Blurred vision; other senses may be in light) impaired Marked and life-threatening respiratory depression Markedly decreased heart rate

6
Confusion (BAC = 0.18 to 0.30%) Most deaths from alcohol poisoning are caused by dosage levels in this Profound confusion range. Emotional lability Impaired senses Analgesia Increased ataxia; impaired speech; staggering Dizziness often associated with nausea ("the spins") Vomiting (emesis) [edit]Moderate doses Ethanol inhibits the ability of glutamate to open the cation channel associated with the N-methyl-D-aspartate (NMDA) subtype of glutamate receptors. Stimulated areas include the cortex,hippocampus and nucleus accumbens, which are responsible for thinking and pleasure seeking. Another one of alcohol's agreeable effects is body relaxation, possibly caused by neuronstransmitting electrical signals in an alpha waves-pattern; such waves are observed (with the aid of EEGs) when the body is relaxed.[citation needed] Short-term effects of alcohol include the risk of injuries, violence and fetal damage.[13] Alcohol has also been linked with lowered inhibitions, though it is unclear to what degree this is chemical versus psychological as studies with placebos can often duplicate the social effects of alcohol at low to moderate doses. Some studies have suggested that intoxicated people have much greater control over their behavior than is generally recognized, though they have a reduced ability to evaluate the consequences of their behavior. [14] Behavioral changes associated with drunkenness are, to some degree, contextual.[15][16] A scientific study[weasel words] found that people drinking in a social setting significantly and dramatically altered their behavior immediately after the first sip of alcohol,[citation needed] well before the chemical itself could have filtered through to the nervous system. Areas of the brain responsible for planning and motor learning are dulled. A related effect, caused by even low levels of alcohol, is the tendency for people to become more animated in speech and movement. This is due to increased metabolism in areas of the brain associated with movement, such as the nigrostriatal pathway. This causes reward systems in the brain to become more active, which may induce certain individuals to behave in an uncharacteristically loud and cheerful manner. Alcohol has been known to mitigate the production of antidiuretic hormone (ADH), which is a hormone that acts on the kidney, favoring water reabsorption in the kidneys during filtration. This occurs because alcohol confuses osmoreceptors in the hypothalamus, which relay osmotic pressure information to the posterior pituitary, the site of ADH release. Alcohol causes the osmoreceptors to signal that there is low osmotic pressure in the blood, which triggers an inhibition of ADH. Consequently, one's kidneys are no longer able to reabsorb as much water as they should be absorbing, leading to creation of excessive volumes of urine and subsequently overall dehydration. [edit]Excessive doses Acute alcohol intoxication via excessive doses generally causes short- or long-term health effects. NMDA receptors start to become unresponsive, slowing areas of the brain they are responsible for. Contributing to this effect is the activity which alcohol induces in the gamma-aminobutyric acid (GABA) system. The GABA system is known to inhibit activity in the brain. GABA could also be responsible for the memory impairment that many people experience. It has been asserted that GABA signals interfere with the registration and consolidation stages of memory formation. As the GABA system is found in the hippocampus (among other areas in the CNS) which is thought to play a large role in memory formation, this is thought to be possible. Anterograde amnesia, colloquially referred to as "blacking out", is another symptom of heavy drinking. This is the loss of memory during and after an episode of drinking. Another classic finding of alcohol intoxication is ataxia, in its appendicular, gait, and truncal forms. Appendicular ataxia results in jerky, uncoordinated movements of the limbs, as though each muscle were working independently from the others. Truncal ataxia results in postural instability; gait instability is manifested as a disorderly, wide-based gait with inconsistent foot positioning. Ataxia is responsible for the observation that drunk people are clumsy, sway back and forth, and often fall down. It is probably due to alcohol's effect on the cerebellum.
Alcohol, or ethyl alcohol (ethanol), refers to the intoxicating ingredient found in wine, beer and hard liquor. Alcohol arises naturally from carbohydrates when certain micro-organisms metabolize them in the absence of oxygen, called fermentation. Beer, wine and other liquor contain different amounts of alcohol. The amount of alcohol in distilled liquor is known as ?proof?. Proof refers to the amount of alcohol in the liquor; for example, 100 proof liquor contains 50% alcohol, 40 proof liquor contains 20% alcohol, and so on. Traditional wine has approximately 8-14% alcohol, while regular beer has 4-6% alcohol. Recent studies show that moderate use of alcohol may have a beneficial effect on the coronary system. In general, for healthy people, one drink per day for women and no more than two drinks per day for men would be considered the maximum amount of alcohol consumption to be considered moderate use. (By ?healthy? people, we are referring to non-pregnant women, individuals not addicted to alcohol, and people without pre-existing medical conditions, among others). However, the amount of alcohol that a person can drink safely is highly individual, depending on genetics, age, sex, weight and family history, etc. A ?drink? is considered to be: 4-5 ounces of wine 10 ounces of wine cooler 12 ounces of beer 1-1/4 ounces of distilled liquor (80 proof whiskey, vodka, scotch, or rum)

How Alcohol Travels Through the Body

Alcohol is metabolized extremely quickly by the body. Unlike foods, which require time for digestion, alcohol needs no digestion and is quickly absorbed. Alcohol gets ?VIP? treatment in the body ? absorbing and metabolizing before most other nutrients. About 20 percent is absorbed directly across the walls of an empty stomach and can reach the brain within one minute. Once alcohol reaches the stomach, it begins to break down with the alcohol dehydrogenase enzyme. This process reduces the amount of alcohol entering the blood by approximately 20%. (Women produce less of this enzyme, which may help to partially explain why women become more intoxicated on less alcohol than men.). In addition, about 10% of the alcohol is expelled in the breath and urine. Alcohol is rapidly absorbed in the upper portion of the small intestine. The alcohol-laden blood then travels to the liver via the veins and capillaries of the digestive tract, which affects nearly every liver cell. The liver cells are the only cells in our body that can produce enough of the enzyme alcohol dehydrogenase to oxidize alcohol at an appreciable rate. Though alcohol affects every organ of the body, it?s most dramatic impact is upon the liver. The liver cells normally prefer fatty acids as fuel, and package excess fatty acids as triglycerides, which they then route to other tissues of the body. However, when alcohol is present, the liver cells are forced to first metabolize the alcohol, letting the fatty acids accumulate, sometimes in huge amounts. Alcohol metabolism permanently changes liver cell structure, which impairs the liver?s ability to metabolize fats. This explains why heavy drinkers tend to develop fatty livers. The liver is able to metabolize about ounce of ethanol per hour (approximately one drink, depending on a person?s body size, food intake, etc.). If more alcohol arrives in the liver than the enzymes can handle, the excess alcohol travels to all parts of the body, circulating until the liver enzymes are finally able to process it. (Which is another good reason not to consume more than one drink per hour.).

How the Liver Breaks Down Alcohol

The alcohol dehydrogenase enzyme breaks down alcohol by removing hydrogen in two steps: 1. Alcohol dehydrogenase oxidizes alcohol to acetaldehyde 2. Acetaldehyde dehydrogenase oxidizes the acetaldehyde to acetyl CoA. These reactions produce hydrogen ions (acid). The B vitamin niacin (in its role as the coenzyme NAD) picks up these hydrogen ions (becoming NADH). Thus when alcohol is metabolized, NAD diminishes and NADH increases. During alcohol metabolism, NAD becomes unavailable for the many other vital body processes for which it is needed, including glycolysis, the TCA cycle and the electron transport chain. Without NAD, the energy pathway is blocked, and alternative routes are taken, with serious physical consequences: The accumulation of hydrogen atoms shifts the body?s balance toward acid. The accumulation of NADH slows the TCA cycle, resulting in a build up of pyruvate and acetyl CoA. Excess acetyl CoA results in fatty acid synthesis and fat begins to clog the liver. (An accumulation of fat in the liver can be observed after only a single night of heavy drinking).

Fatty Liver and Liver Disease

With moderate drinking, the liver can process alcohol fairly safely. However, heavy drinking overtaxes the liver resulting in serious consequences. A liver clogged with fat causes liver cells to become less efficient at performing their necessary tasks, resulting in impairment of a person?s nutritional health. Fatty liver is the first stage of liver deterioration in heavy drinkers, and interferes with the distribution of oxygen and nutrients to the liver?s cells. If the condition persists long enough, the liver cells will die, forming fibrous scar tissue (the second stage of liver deterioration, or fibrosis). Some liver cells can regenerate with good nutrition and abstinence, however in the last stage of deterioration, or cirrhosis, the damage to the liver cells is the least reversible.

Alcohol and Malnutrition

For moderate drinkers, alcohol does not suppress food intake, and may actually increase appetite. Chronic alcohol consumption appears to have the opposite effect. Alcohol causes euphoria, which depresses appetite, so that heavy drinkers tend to eat poorly and become malnourished. Alcohol is very rich in energy, packing 7 calories per gram. But like pure sugar or fat, the calories are void of nutrients. The more calories an individual consumes in alcohol, the less likely it is that they will eat enough food to obtain adequate nutrients. To make matters worse, chronic alcohol abuse not only displaces calories from needed nutrients, but also interferes with the body?s metabolism of nutrients, leading to damage of the liver, digestive system, and nearly every bodily organ.

Health Effects of Alcohol Consumption

Arthritis Cancer Fetal Alcohol Syndrome Heart Disease Hyperglycermia

Increases risk of gouty arthritis Increases the risk of cancer in the liver, pancreas, rectum, breast, mouth, pharynx, larynx and esophagus Causes physical and behavioral abnormalities in the fetus Raises blood pressure, blood lipids and the risk of stroke and heart disease in heavy drinkers. Heart disease is generally lower in light to moderate drinkers. Raises blood glucose

7
Hypoglycemia Kidney Disease Liver Disease Malnutrition Nervous Disorders Obesity Psychological disturbances Lowers blood glucose, especially for people with diabetes Enlarges the kidneys, alters hormone functions, and increases the risk of kidney failure Causes fatty liver, alcoholic hepatitis and cirrhosis Increases the risk of protein-energy malnutrition,; low intakes of protein, calcium, iron, vitamin A, vitamin C, thiamine, vitamin B6 and riboflavin, and impaired absorption of calcium, phosphorus, vitamin D and zinc. Causes neuropathy and dementia; impairs balance and memory Increases energy intake, but not a primary cause of obesity Causes depression, anxiety and insomnia