Alcohol and Nutrition

Question 1

Calories (kcal) in the following alcohol:

1. White wine (11%)
2. Red wine (11%)
3. Pint of cider (5%)
4. Pint of lager (4%)
5. 25ml Spirits (37.5)
6. 330ml Alcopop (5%)

Answer 1

1. 130 (chips)
2. 120 (sponge cake)
3. 200 (baked beans)
4. 170 (sausage roll)
5. 50 (cream)
6. 200 (medium cheddar)

Question 2

How many units do you think a large glass of wine is (250ml)?

Answer 2

3.2 units

Question 3

How many units do you think a bottle of Alcopop is (275ml)?

Answer 3

1.1 units

Question 4

How many units do you think 2 rum and cokes are (50ml total)?

Answer 4

2 units

Question 5

How many units do you think 2 bottles of beer are (660ml total)?

Answer 5

3.4 units

Question 6

How many units do you think a glass of champagne is (125ml)?

Answer 6

1 unit

Question 7

How many units do you think a pint of cider is?

Answer 7

2.5 units

Question 8

How many calories are there in 1g of carbs/protein/fat/alcohol?

Answer 8

Carbs = 4
Protein = 4
Fat = 9
Alcohol = 7

Question 9

What are the definitions of safe alcohol intakes in:

UK

Answer 9

8g

Question 10

What are the definitions of safe alcohol intakes in: Austria, France, Ireland, Italy, Poland, Spain

Answer 10

10g

Question 11

What are the definitions of safe alcohol intakes in: Denmark and Italy

Answer 11

12g

Question 12

What are the definitions of safe alcohol intakes in: Portugal

Answer 12

14g

Question 13

Which country has the highest drinking prevalence rate?

Answer 13

Belgium

Question 14

The liver has 2 blood supplies, state them:

Answer 14

• heart, brings oxygenated blod

- gut, carries absorbed foot and nutrients

Question 15

What is the function of the liver in layman terms?

Answer 15

cleans and nourishes the blood, returns it it full of vitamins and proteins through the venous system to the heart, to send to the rest of the body

Question 16

Liver specific symptoms and sign are apparent at late stages. What are some non-specific liver disease symptoms?

Answer 16

• tiredness
• repeated infections
• irritability
• lack of concentration
• impotence, menstrual disturbance

Question 17

What are the risk factors of liver disease?

Answer 17

• excessive alcohol consumption
• viral hepatitis
• obesity, diabetes
• high cholesterol
• heart disease
• family history of liver disease
• multiple drugs

Question 18

How many estimate admission were related to alcohol consumption for England?

Answer 18

1.1 million

Question 19

44% of the patients admitted for alcohol consumption were between what ages?

Answer 19

55-74yo

Question 20

What is the recommended upper limit for alcohol intake in UK?

Answer 20

• not more than 14 units

- spread the drinking over 3 or more days, have drink-free days

Question 21

How to calculate the alcohol units?

Answer 21

multiply total volume of drin by its ABV, then divide the result by 1000

e.g. (strength (ABV) x volume)/1000 = ? units

Question 22

Define binge drinking:

Answer 22

it is the consumption, twice the daily alcohol limit. Attained simply by sharing a bottle of wine with someone

Question 23

What can acute binge drinking do?

Answer 23

increase serum endotoxin and bacterial DNA levels in healthy individuals

Question 24

What is the % of heavy drinkers who admit they underplay their consumption habits?

Answer 24

40%

Question 25

What does alcohol do to hepatocytes?

Answer 25

- increase CYP2E1/ROS/Fe stores | - decrease antioxidants/mitochondria

Question 26

What can affect Kupffer cells and cause an increase in both ROS and TNF-alpha?

Answer 26

Bacterial endotoxin and alcohol

Question 27

What generally happens in liver injury in terms of structure and activated features?

Answer 27

- loss of hepatocyte microvilli - loss of fenestrae - Activate HSC - deposition of scar ECM - activated Kupffer cells

Question 28

What contributes to oxidative metabolism of ethanol?

Answer 28

- ADH - cytochrome P450 2E1 (CYP2E1) - catalase

Question 29

What happens as a result of oxidative metabolism of alcohol?

Answer 29

1. Acetaldehyde adducts formation 2. Increase ROS formation 3. Increase NADH:NAD ratio

Question 30

Explain the metabolisation process of ethanol (alcohol):

Answer 30

1. Ethanol metabolised to acetaldehyde by ADH, CYP2E1, catalase 2. Further oxidation to actetate by ALDH 3. Results in generation of NADH, acetaldehyde, ROS 4. Inherited mutations of ADH1B/ADH1C/ALDH2, cause amount of production of acetaldehyde to vary in individuals

Question 31

Does acetaldehyde metabolise rapidly at high or low concentrations?

Answer 31

low concentrations

Question 32

Why is it NOT a good thing to have circulating acetaldehyde?

Answer 32

generates oxidative stress, associated with tissue damage

Question 33

What is associated with the 'hangover' sensation?

Answer 33

acetaldehyde

Question 34

What is associated with the "flushing" response following alcohol consumption?

Answer 34

mutations in ALDH gene

Question 35

What is the increased risk in individuals with mutations in ALDH?

Answer 35

cancer (particularly oesophageal)

Question 36

What are the results of increased CYP2E1 activity?

Answer 36

- increased ROS generation | - increased activation of pro-carcinogens in tobacco smoke/polycyclic hydrocarbon, hydrazines, nitrosamines

Question 37

What levels do CYP2E1 decrease?

Answer 37

retinol and retinoic acid (important functions in cell growth regulation and transdifferentiation + DNA transcription)

Question 38

What are the effects of chronic alcohol exposure?

Answer 38

- oxidative stress - reduction in anti-oxidant levels (mito. glutathione) - dysregulation of iron transport, increased hepatic iron stores - depletion of hepatic mito. - Lipid deposition - DNA damage - release proinflammatory mediators (cytokines) - necrotic death of hepatocytes - stellate cell activation - white cell infiltration