Alcohol and health.pdf

Alcohol consumption and health effects Pr. Roberta FORESTI Professor of Biochemistry, Faculty of Health, UPEC [email protected]  Alcohol Alcohol is interchangeably used with ethanol and the term drinkin...

Alcohol consumption and health effects Pr. Roberta FORESTI Professor of Biochemistry, Faculty of Health, UPEC [email protected]  Alcohol Alcohol is interchangeably used with ethanol and the term drinking is associated with consumption of beverages containing alcohol. Alcohol consumption permeates all societies- big business! Alcohol consumption has psycho-pharmacological effects. Some people react badly to alcohol consumption with redness, flushing, nausea, palpitations. Most people consume a moderate amounts of alcohol. However, a proportion of people will practise binge drinking, the practise of drinking huge amounts of alcohol in a single drinking session. Heavy drinking episodes at least once a month higher in Denmark, Romania and Luxembourg Heavy episodic drinking is defined as ingesting the equivalent of more than 60g of pure ethanol on a single occasion. Among the EU Member States, between 4% (Cyprus and Italy) and 38% (Denmark) of adults reported taking part in heavy drinking episodes at least once a month. Among these, the majority did so every month, while a smaller proportion (between 3 to 19 times smaller) engaged in the behaviour at least once a week.  Alcohol Alcohol limits (maximum): 10 g alcohol corresponds to ca. 250 ml beer 10 g/d women 125 ml wine 20 g/d men 30 ml liquor  Figure 1 Alcohol consumption increases during the weekend The Lancet Public Health 2019 4e41-e48DOI: (10.1016/S2468-2667(18)30230-5) The Lancet Public Health 2019 4e41-e48DOI: (10.1016/S2468-2667(18)30230-5)  Alcohol and its chemical nature Metabolism People have different abilities to metabolize acetaldehyde Alcohol dehydrogenase metabolizes alcohol to acetaldehyde, a highly toxic substance and known carcinogen. In a second step, acetaldehyde is further metabolized down to another, less active byproduct called acetate, which then is broken down into water and carbon dioxide for easy elimination. The liver is the major organ for alcohol metabolism.  Systems affected by alcohol misuse Hepatobiliary and pancreatic Central, peripheral and autonomic nervous Musculoskeletal Genitourinary Cardiovascular Dermatological Respiratory Gastrointestinal Hematological ~ 60-120 different pathologies and disordes are due to alcohol Alcohol consumption and mortality - a J-shaped curve Alcohol use and cancer The consumption of alcoholic beverages is causally linked to cancers of the upper aerodigestive tract (oral cavity, pharynx, larynx, and oesophagus) and cancers of the colon, rectum, liver, and female breast  Alcohol and liver disease Heavy drinking has detrimental consequences on the liver, and can lead to a variety of problems and liver inflammations including: Steatosis, or fatty liver Alcoholic hepatitis Fibrosis Cirrhosis  Alcohol and pregnancy: Fetal Alcohol Spectrum Disorders (FASD) https://www.niaaa.nih.gov/sites/default/files/publications/Fetal-Alcohol-Exposure.pdf  Alcohol and malnutrition Interaction of alcohol’s direct toxic effects with malnutrition Primary malnutrition Secondary malnutrition In alcoholics, alcohol often replaces Alcohol has direct toxic effects on the other nutrients (e.g., carbohydrates gastrointestinal tract and liver, leading or proteins), resulting in insufficient to impaired digestion, reduced intake of those nutrients, absorption of nutrients into the particularly because, under certain blood, and impaired utilization or conditions, the calories provided by increased degradation of those alcohol cannot be used effectively nutrients. These effects can by the body—that is, they are contribute to the progression of liver “empty” calories. damage and significant reduction in muscle mass. Alcohol interferes with the absorption of: Essential aminoacids Vitamins (thiamin, riboflavin, pyridoxine, vitamin C, folic acid, vitamin A)  Some mechanisms in alcohol pathology Malnutrition Increased gut permeability and ingress of bacterial Free radicals/ROS production endotoxins Protein synthesis and degradation Membrane damage Cytokines production DNA damage Altered immunology Acetaldehyde reactivity Protein adducts Altered gene expression All of these mechanisms will be affected by 1) Pattern and frequency of alcohol intake 2) Total cumulative alcohol intake 3) Genetic susceptibility in alcohol dehydrogenase isoforms