ALCOHOL
CHAPTER 8
LEARNING OUTCOMES
• Describes the sources of alcohol and the
calories it provides
• Define standard serving sizes of alcoholic
beverages and the term moderate drinking
• Summarize how alcoholic beverages are
produced
• Outline the process of alcohol absorption,
transport and metabolism
2
LEARNING OUTCOMES
• Define binge drinking and explain how it
increases the risk of alcohol poisoning
• Explain how alcohol consumption affects
blood alcohol concentration
• Describe guidelines for using alcohol safely
• Discuss potential benefits of using alcohol
• Summarize the risks of alcohol consumption
3
LEARNING OUTCOMES
• Describe the effects of chronic alcohol use on
the body and nutritional status
• List the signs of alcohol dependency and
abuse
• Outline the methods used to diagnose alcohol
abuse
• List the strategies and resources available for
the treatment of alcoholism
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ALCOHOL CAN BE MADE FROM MANY
SOURCES
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SOURCES OF ALCOHOL
• Contains 7 kcal/gm
• Beer, wine, distilled spirits, liqueurs, cordials and
hard cider
• Vary in alcohol and caloric content
• Standard drink provides 15 g of alcohol
• 12 oz beer, 10 oz wine cooler, 5 oz wine or 1.5 oz of hard liquor
• Moderate intake
• 1 drink a day for women
• 1-2 drinks a day for men
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HOW THOSE CALORIES ADD UP…
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•
•
•
•
•
•
•
•
•
•
5 oz wine
120
5 oz champagne 95
Wine cooler
210
Guiness
210
Lite beer
140
1 shot hard liquor 50
1 shot Bailey’s
160
Rum and coke
180
Martini
220
Margarita (restaurant) 540
Pina colada (restaurant) 650
• 4 pints of beer = 4 x 180 = 720 kcal
• 1 bottle of wine = 5-6 glasses x 120 =650 kcal
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PRODUCTION OF ALCOHOLIC BEVERAGES
• Fermentation
• Must get carbohydrate to monosaccharide form
• Keep sugar + yeast + water at room temp
• Yeast uses sugar for energy to make more yeast
• Oxygen depletes and yeast ferments sugar to ETOH and carbon dioxide
• If a starch must be malted: grains sprouts and makes enzymes that break
sugars to simple sugars
• Distillation
• Separating the alcohol out of the product
• Boil off alcohol, save vapors and condense to make hard alcohol
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WE DRINK ETHANOL
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ALCOHOL ABSORPTION AND METABOLISM
• Alcohol is absorbed throughout the GI
tract by simple diffusion
• Metabolism
• Low to moderate intakes
• Alcohol dehydrogenase pathway
• ETOH
Acetaldehydate
Acetyl- CoA
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ALCOHOL ABSORPTION AND METABOLISM
• Moderate to excessive intakes
• Microsomal ethanol oxidizing system (MEOS)
• Liver treats alcohol as foreign substance
• Similar to ADH pathway but requires energy
• Pathway becomes more efficient with increasing alcohol intakeallows “tolerance”
• Same pathway used to metabolize drugs, but alcohol metabolism
takes precedence
• Catalase pathway
• Plays minor role
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ALCOHOL ABSORPTION AND METABOLISM
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ALCOHOL METABOLISM
• Factors affecting alcohol metabolism
• Ethnicity, gender and age
• Alcoholic content, amount consumed, individual’s usual
intake
• Rate of alcohol metabolism
•
•
•
•
Average ½ drink an hour
Blood alcohol levels rise
Intoxication and alcohol poisoning
Binge Drinking (4+ drinks females, 5+ for males in single
sitting)
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HOW MUCH IS TOO MUCH?
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ESTIMATED ALCOHOL CONCENTRATION BY
NUMBER OF DRINKS FOR AVERAGE 130#
FEMALE
AC Level
1 drink
2 drinks
3 drinks
4 drinks
Peak
.038
.077
.116
.144
After 1 hr .023
.062
.101
.139
After 2
hrs
.047
.086
.124
After 3
hrs
.032
.071
.109
After 4
hrs
.017
.056
.094
After 5
hrs
.002
.041
.079
.026
.064
After 6
hrs
.008
Peak
usually
30-90 min
after
drinking
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ESTIMATED ALCOHOL CONCENTRATION BY
NUMBER OF DRINKS FOR AVERAGE 175#
MALE
AC
Level
1 drink
2
drinks
3
drinks
4
drinks
5
drinks
Peak
.023
.047
.071
.094
.118
After 1
hr
.008
.032
.056
.079
.103
After 2
hrs
.017
.041
.064
.088
After 3
hrs
.002
.026
.049
.073
.011
.019
.053
.004
.043
After 4
hrs
After 5
hrs
After 6
hrs
.028
Peak
usually
30-90 min
after
drinking
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ALCOHOL CONSUMPTION IN NORTH AMERICAN
• 62% adults consume alcohol
• 70% of college students who drink, at least
45% engage in binge drinking
• 4% of US population is alcohol dependent
• 9% of young adults are alcohol dependent
• By age 14/15 almost half have consumed
alcohol
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HEALTH EFFECTS
• Guidelines for Using Alcohol Safely
• Drink in moderation
• Should not be consumed by some
individuals
• Should not be consumed during some
activities
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HEALTH EFFECTS
• Potential Benefits
• Appetite stimulant
• Cardiovascular benefits
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RISKS OF EXCESSIVE ALCOHOL INTAKE
• A hangover describes the sum of unpleasant physiological
effects following heavy consumption of alcohol.
• Headaches, dry mouth, and lethargy: Ethanol increases
urine production (dehydration) which leads to decreased
fluids in brain
• Nausea: Alcohol's irritates the stomach lining
• Fatigue, weakness, mood disturbances and decreased
attention and concentration: three enzymes of the Citric
Acid Cycle are inhibited leads to low blood sugar and
prevents gluconeogenesis
• Acetaldehyde (ethanal) is between 10 and 30 times more
toxic than alcohol itself
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RISKS OF EXCESSIVE ALCOHOL INTAKE
• TRUE OR FALSE: some drinks are more likely to cause
hangovers?
• TRUE OR FALSE: Drinking coffee or taking cold showers will
help bring your blood alcohol content down
• TRUE OR FALSE: eating and drinking water will help bring
your blood alcohol content down
• TRUE OR FALSE: some people are more or less prone to
hangovers, even if age, gender, and size are equal
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RISKS OF EXCESSIVE ALCOHOL INTAKE
• Alcohol affects many organs and systems
• Brain, heart damage, high blood pressure
• Cancers: oral cavity, esophagus, trachea,
larynx and throat
• Cirrhosis of the liver
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HEALTH EFFECTS OF EXCESSIVE ETOH
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CIRRHOSIS
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ALCOHOL POSIONING
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BEER BELLY
• The average adult drinker
gets around 10 percent of
his/her total daily calories
from an alcoholic
beverage
• When you drink alcohol,
the liver burns alcohol
instead of fat
• Gender, age, smoking,
genetics
• Treatment options
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EFFECTS OF ALCOHOL ABUSE ON
NUTRITIONAL STATUS
• Water soluble vitamin deficiency common
(why?)
• Thiamin
• Wernicke-Korsakoff Syndrome
• Niacin
• B-12 and B6
• Folate
• Fat soluble vitamins
• A, D, E and K
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EFFECTS OF ALCOHOL ABUSE ON NUTRITIONAL
STATUS
• Minerals
• Calcium, magnesium, zinc and iron
• Protein-energy malnutrition
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ALCOHOL CONSUMPTION DURING PREGNANCY
AND BREASTFEEDING
• Most severe damage occurs in the first 12-16
weeks of pregnancy
• Fetal alcohol syndrome
• Fetal alcohol effects
• Breastfeeding
• Alcohol does pass through breast milk
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FAS
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ALCOHOL ABUSE AND ALCOHOLISM
• Alcohol Abuse
• Alcohol Dependency (Alcoholism)
• Genetic influences
• Effect of gender
• Age of onset of drinking
• Ethnicity
• Mental health
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HOW DRUGS WORK
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DIAGNOSIS AND TREATMENT OF ALCOHOLISM
• Determining whether a problem exists
• 75% of people with alcohol problems do not seek
treatment
• Recovery from alcoholism
• Medications
• Alcoholics Anonymous (AA)
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