Calories and impact of alcohol Flashcards
How is alcohol produced?
1) Fermentation of fruits and vegetables converts CHO to ethanol
2) Distillation process can produce spirits
Calories in beer, sweet wine, whiskey
150 kcal in 12oz beer
105 kcal in 1.5oz whiskey
180 kcal in 4oz dessert wine
When may alcohol consumption be appropriate and not?
- there has been SOME evidence that moderate consumption may prevent ischaemic heart disease and type II diabetes by lowering Hb1Ac- but later analysis suggests this may only be in women over the age of 65 years
- whereas excess is associated with 60+ different pathologies- and alcohol during pregnancy may lead to spontaneous abortions especially in the first trimester
Key statistics on alcohol use in 2012
- In 2012 there were 6490 deaths related to alcohol (this is an increase of 19% from 2001 but a decrease of 4% since 2011)
- 9% of adults in 2013 could be classified as having an alcohol use problem
- in 2012/13 there were 325,870 admissions relating to alcohol misuse
Alcohol use disorders
- one of the most common untreated mental health illness: <15% actually get help
- important to distinguish the symptoms from primary anxiety disorder
- pointing this out as a problem may help people with alcohol-related disorders understand the vicious cycle they have themselves in
Cancer burden and alcohol
- increases risk of: mouth, larynx, pharynx, oesophageal, stomach, colorectal, liver, breast, lung cancer
- tih every 10g increase in alcohol consumption per day, there is a 10% increased risk of breast cancer
- acetaldehyde is the key genotoxic compound. In East Asian populations where they are heterozygous for one form of ALDH2*2 (acetoaldehyde dehydrogenase- the inactive form), they can only metabolise 10% of alcohol and have much higher rates of oesophageal, head and neck cancers
Alcoholic liver disease
- potentially modifiable disease: occurs in excessive drinkers with genetic and environmental susceptibility
- liver steatosis in all drinkers- but only 1/3 develop significant neuroinflammation and fibrosis. Only 10% progress to cirrhosis, and of these only 1-2% develop HCC every year
- seems to be related to CYP2E1 which can be induced 10-20 fold by chronic alcohol consumption and causes oxidative stress leading to DNA lesions
Metabolism of alcohol
1) Alcohol dehydrogenase (cyotsolic) in the stomach converts ethanol to acetoaldehyde. This can also occur in peroxisomes via catalase and also by microsomes with CYP2E1
2) In the liver, acetoaldehyde is converted to acetate via aldehyde dehydrogenase, acetate then goes into te circulation to be further broken down by the TCA cycle
Effects of alcohol in the body: blood, digestive system, liver, cancer, nervous system, nutrients, CVD, hormonal changes
- Blood: interferes with production of blood cells causing macrocytosis, lack of platelets, clotting factors and white cells
- digestive system: increased gastric acid increases ulcers and also makes a perfect environment for the growth of H. pylori. Can also cause inflammation and blockage of the pancreatic ducts which leads to pancreatitis
- liver: uses ethanol as preferable source of energy, causing fats to accumulate and formation of fatty liver -> cirrhosis
- increases cancer risk
- nervous system: causes confusion and intoxication. Also binds and enhances GABA receptors meaning there is more inhibition of neurons firing which causes the ‘numbing’ effect. Also been shown to cause peripheral neuropathy which may lead to cerebellar degeneration
- nutrients: as it inhibits CHO oxidation can lead to insulin resistance. Also interferes with storage and distribution of: vitamin D, B12, B2, thiamine, A, E, K
- CVD: can cause hypertension and dyslipidemia leading to 6-fold increase in CVD
- hormonal changes: changes in cortisol, PTH, causes lower bone density and increased risk of osteoporosis and osteopenia
