Class 11 lecture: Health Implications of Tobacco and Alcohol

in the US, a standard drink contains ___oz (___g) of pure alcohol

0.6; 14.0

blood alcohol concentration (BAC)

% of alcohol in a person’s bloodstream

a person is legally intoxicated with a BAC of ____%

0.08

alcohol (ethanol) is metabolized in what organ

liver

alcohol (ethanol) is metabolized by what 2 key enzymes 

alcohol dehydrogenase and aldehyde dehydrogenase 

factors that affect how alcohol is absorbed and metabolized

1) quantity of alcohol dehydrogenase and aldehyde dehydrogenase

2) body weight

3) body composition (inc muscle —> lower BAC) 

4) sex

5) race/ethnicity

6) medications

7) hormones 

alcohol is metabolized at different rates in men and women of the same weight due to differences in what 2 factors?

1) body composition (women have higher proportion of body fat)

2) production of alcohol dehydrogenase and aldehyde dehydrogenase (women’s liver prooduces lower conce

essential body fat % in men

3

essential body fat % in women 

12 (b/c of capacity for reproduction)

total body fat % for women

20-25

total body fat % for men

15-20

people of this race/ethnicity tend to have very low alcohol tolerance?

East Asians (think Asian flush) → produce less enzymes to metabolize alcohol

people of this race/ethnicity tend to have higher alcohol tolerance?

blacks/African Americans

premenstrual hormonal changes cause intoxication to set in _________(faster/slower) during the days before a woman gets her period

faster

heightened levels of what hormones during luteal phase?

estrogen and progesterone

estrogen _______(slows/speeds up) alcohol metabolism 

slows 

birth control methods containing estrogen ______(speed up/slow) the rate at which alcohol is metabolized and eliminated from the body

slow

majority of alcohol metabolized in the liver by what enzyme?

alcohol dehydrogenase 

• converts ethanol → acetaldehyde 

acetaldehyde is _____ ______ to the body

highly toxic (even in low concentrations)

what enzyme rapidly oxidizes acetaldehyde to acetate

aldehyde dehydrogenase

____ is the limiting factor for the rate at which we can metabolize alcohol

liver

liver can only produce enough alcohol dehydrogenase and aldehyde dehydrogenase to metabolize ~______ drinks/hr

1-2

fatty liver

• accumulation of fat on liver

• alcohol disrupts the liver’s ability to metabolize fats, leading to fat deposits

• REVERSIBLE with abstinence

alcoholic hepatitis

• widespread inflamm and destruction of liver tissue

• fibrosis → scar tissue replaces healthy liver tissue

• may be REVERSIBLE with abstinence

alcoholic cirrhosis 

• extensive fibrosis → stiffens blood vessels and distorts internal structure 

• severe function impairment → malfunction of OTHER ORGANS 

• often fatal, but can stabilize with abstinence 

why does alcohol provide a “feel good effect”

alcohol consumption inc secretion of endorphins (“pleasure” hormones) → bind to opiate receptors on the brain → enhances mood

neurotoxicity

condition in which neurons overreact to neurotransmitters for too long

• too much exposure to neurotransmitter can cause neurons to eventually “burn out” → delayed response and activation of these pathways → impaired cognitive and motor functioning (short-term and long-term)

alcohol acts as a _____ (inc urine output)

diuretic 

• inhibits vasopressin (aka ADH; regulates fluid balance)

alcohol can inc urine output as quickly as _____ min after intake

20

excessive urination can lead to

• excessive thirst

• dehydration (electrolyte imbalances → potentially fatal)

in the short-term, alcohol has what effect on blood vessels?

vasodilation → temporary feelings of warm, dec HR/BP

heavy drinking has been associated with what negative cardiovascular health effects

• HTN → inc production of renin (hormone causing vasoconstriction)

• cardiac arrhythmias and cardiomyopathy (dec heard muscle activity)

• HF

in the pituitary gland, alcohol can decrease production of what 2 hormones

LH and FSH

Luteinizing hormone (LH) 

stimulates Leydig cells of the testes to produce testosterone 

• spermatogenesis and sperm maturation 

• secondary sex characteristics (inc muscle mass, body hair, deeper voice)

follicle stimulating hormone (FSH)

spermatogenesis

outcomes of alcohol on reproductive system (testes) in males

impotence, infertility, erectile dysfunction, low libido

LH and FSH in women 

• both responsible for maturing / developing a follicle each cycle 

• secrete estrogen and progesterone to thicken endometrium 

• LH causes ovulation 

which hormone causes ovulation

luteinizing hormone (LH)

effect of alcohol on secretion of LH and FSH

alcohol impairs secretion

excessive drinking includes 

any drinking by pregnant women and people <21 y/o 

binge drinking quantity in men and women

• women: at least 4 drinks in a single occasion

• men: at least 5 drinks in a single occasion

heavy drinking quantity in men and women 

• women: at least 8 drinks per week

• men: at least 15 drinks per week

binge drinking most common in who

young adults (18-34 y/o) and males

binge drinkers with lower incomes and educational levels consume _______ drinks/binge

more

high aldehyde levels side effects 

inc skin temp, facial flushing, inc HR, dec BP, dry mouth, N, and headache 

headaches of a hangover caused by

shrinking of our brain dura (membrane encasing the brain) due to dehydration

• b/c alcohol is a diuretic

gastrointestinal complications from hangover

inc in production of stomach acid and delay of stomach emptying → heart burn, abdominal pain, N&V

hangover causes _____glycemia which causes 

hypo(glycemia) → fatigue, weakness, shakiness, and mood disturbances 

hangovers cause poor quality sleep which causes

prevents deep sleep (dec time in stage 3) → results in grogginess

congeners 

natural by-products of alcohol fermentation (e.g. ketones, esters, acids) → provide taste and aroma 

• higher content in darker colored alcoholic beverages 

• body must metabolize alcohol + congeners → more severe hangover sx 

hangovers cause a reduction in vitamin ___? 

B

• processing alcohol places strain on body → inc requirements for energy and vitamins crucial in metabolism 

  • SE is reduction in B vitamins → fatigued, tired

caffeine can ___ the depressant effects of alcohol 

mask → makes drinkers feel more alert than they would otherwise → ppl may drink more alcohol and become more impaired than they realize 

should you mix alcohol and caffeine?

NO

alcohol use disorder (AUD)

chronic disease characterized by uncontrolled alcohol intake and preoccupation with alcohol

• encompasses: alcoholism, alcohol abuse, alcohol dependence, alcohol addiction

• both physical AND emotional dependence

• mild, moderate, severe