Alcohol

alcohol

made from carbs

fermentation

carbs must under ? to produce alcohol

yeast

will eat the carb to get fermentation going

alcohol

byproduct of fermentation

12 ounces

ounces of beer that provides 14 g of alcohol

10 ounces

ounces of win cooler/malt liquor that provides 14 grams of alcohol

5 ounces

ounces of wine that provide 14 grams of alcohol

1.5 ounces

ounces of hard liquor that provide 14 grams of alcohol

720

4 pints of beer = ? kcal

650

1 bottle of wine = 5-6 glasses x 120 = ? kcal

1 standard-size drink for women per day

2 standard-size drinks for men per day

moderate alcohol intake is:

digestion

specific transport mechanisms

receptors (rapidly absorbed through GI tract by simple diffusion

alcohol requires no:

20%

stomach absorbs ?% of alcohol, remainder is absorbed in the SI

slowed

if food is ingested with alcohol, especially high-fat foods, absorption is ?

water

alcohol is found wherever ? is distributed in the body

proteins

alcohol easily moves through cell membranes, damaging the ? in membranes

alcohol dehydrogenase (ADH) pathway

microsomal ethanol oxidizing system (MEOS)

pathways of alcohol metabolism

alcohol dehydrogenase (AHD) pathway

low to moderate intake

alcohol —> acetaldehyde —> acetyl-CoA —> fatty acid + CO2 + H2O + energy

enzymes: alcohol dehydrogenase + aldehyde dehydrogenase

acetyl-CoA can be used for fatty acids synthesis

liver is the chief site for alcohol metabolism

alcohol dehydrogenase

aldehyde dehydrogenase

2 enzymes in alcohol dehydrogenase pathway

alcohol dehydrogenase

converts alcohol to acetaldehyde

aldehyde dehydrogenase

converts acetaldehyde to acetyl-CoA

acetyl-CoA

can be used for fatty acids synthesis

intermediate of ADH pathway

liver

chief site for alcohol metabolism

microsomal ethanol oxidizing system (MEOS)

during moderate to excessive alcohol intake, ADH pathway cannot keep up:

liver activates ? to help metabolize alcohol

microsomal ethanol oxidizing system (MEOS)

as intake of alcohol increases overtime, ? is active:

allows for efficient metabolism and greater alcohol tolerance

more alcohol is required to produce the same effect

MEOS

metabolizes drugs and other foreign substances

MEOS

decreased

when activating the ? pathway with excessive alcohol, the liver’s capacity to metabolize drugs is ?

alcohol metabolism

the ability to produce enzymes is key to ?

Asian

aldehyde dehydrogenase

some individuals of ? decent have low activity of ? —> results in build up of toxic acetaldehyde

women

alcohol dehydrogenase

? produce less ? in the cells that line the stomach so they can absorb 30-35% more unmetabolized etOH

also are smaller and have more body fat (less total water means EtOH will be more concentrated)

age

? allows for less water in the cells and more concentrated EtOH is present

ethnicity

gender

age

factors that affect alcohol metabolism

blood alcohol levels rise

symptoms of alcohol intoxication appear (brain and nervous system are exposed to alcohol)

when alcohol consumption exceeds the liver’s metabolic capacity: ? and ?

blood alcohol concentration (BAC)

amount of alcohol excreted in the lungs

measured alcohol content of exhaled air and blood are directly related

acute alcohol toxicity

alcohol poisoning

requires immediate medical treatment

respiratory failure and death

if alcohol toxicity is untreated, it results in ? and ? (greater risk if consuming distilled spirits)

binge drinking

4 or more drinks for women

5 or more drinks for male

health-related

low to moderate use of alcohol has ? benefits

health and nutritional status

excessive intake of alcohol has serious ? and ? effects

J-shaped curve

the relationship between the amount of alcohol consumed and its health effects

benefits of moderate alcohol intake

stimulates appetite and increase dietary intake in elderly

lower the risk of cardiovascular disease:

• lower bad cholesterol

• increase good cholesterol

• decrease platelet aggregation

• associated with red wine’s phytochemical, resveratrol

heart failure: arrhythmias

some cancers: oral cavity, pharynx, larynx, esophagus, liver, breast, colon, rectum

cirrhosis of liver

motor vehicle and other accidents

suicide

contributes to 5 of the 10 leading causes of death in North America

moderate alcohol consumption

not discouraged, drink sensibly and in moderation

cannot restrict your intake to moderate levels

pregnant

younger than legal drinking age

take medications that interact with alcohol

medical condition

engaging in activities that require attention, skill, or coordination

avoid alcohol if you:

hangover

describes the sum of unpleasant physiological effects following heavy consumption of alcohol

headaches, dry mouth, and lethargy

nausea

fatigue, weakness, mood disturbances, and decreased attention and concentration

lethargy during hangover

ethanol increases urine production (dehydration) which leads to decreased fluids in brain

nausea

alcohol irritates the stomach lining

three enzymes of the citric acid cycle

these are inhibited after heavy consumption of alcohol —> leads to low blood sugar and prevents gluconeogenesis

early stage cirrhosis

long-term alcohol abuse —> causes liver damage

fatty liver

liver

main organ for alcohol metabolism

fatty liver

first change seen is the response of increased fat synthesis and trapping of fat in liver

reversible at this if EtOH is decreased

alcoholic hepatitis follows

alcoholic hepatitis

inflammation of the liver

occurs if alcohol consumption persists

frequently progresses to cirrhosis, but is reversible

nausea

poor appetite

vomiting

fever

pain

jaundice in the whites of the eyes

symptoms of alcoholic hepatitis

final stage cirrhosis

loss of function hepatocytes

ascites is a common complication, resulting in fluid retention in the abdomen

not reversible and liver failure develops

50% chance of death in 5 years

associated with a 10-year or longer consumption of 80 g of alcohol per day

ascites

common complication, resulting in fluid retention in the abdomen

loss of functioning hepatocytes

final stage of cirrhosis is caused from the ?

alcohol abuse

can lead to poor nutritional status and development of nutrient deficiences

alcohol

may replace food in the diet

deficiencies of vitamins and minerals

can also occur due to loss in urine and increased need for certain vitamins and minerals to help metabolize alcohol

vitamin B, zinc, and magnesium

most common vitamin and mineral deficiencies due to alcohol abuse

slows nutrient and oxygen delivery to fetus, slows growth and development

replaces nutrient dense food

causes of drinking during pregnancy (most severe damage at 12 to 16 weeks)

small size of fetus

prolonged exposure time

effects of alcohol from fetal alcohol syndrome are intensified by ? and ?

unknown

amount of alcohol needed to cause FAS is ?

reduces milk production

causes babies to drink less and have disturbed sleeping patterns

effects of alcohol consumption during breastfeeding

2 hours

infants cannot efficiently break down alcohol in breast milk —> avoid alcohol intake or limit to 1 to 2 drinks and wait for ? before breastfeeding

failure to fulfill major responsibilities

drinking when physically dangerous

reoccurring alcohol-related drinking problems

social or relationship problems

alcohol abuse is characterized by:

cravings

loss of control

withdrawal symptoms such as nausea, sweating, anxiety, shakiness

tolerance

unsuccessful attempts to cut down use

alcoholism is characterized by:

alcoholism

chronic disease

CAGE questionnaire

used to determine if a problem towards alcohol exists:

C: have you felt you need to cut down on drinking?

A: have people annoyed you by critcizing your drinking?

G: have you ever felt guilty about drinking?

E: have you ever had a drink first thing in the morning?

CAGE questionnaire questions (more than one positive suggests problem)

behavioral therapy and medication

treatment for alcohol abuse

psychologist

social worker

counselor

behavioral therapy is facilitated by:

identify ways to compensate for loss of pleasure from drinking

total abstinence is ultimate goal

goal of treatment for alcoholism

naltrexone

acamprosate

disulfiram

medications provided for alcohol treatment

naltrexone

blocks craving for alcohol and pleasure of intoxication

acamprosate

decreases desire to drink

disulfiram

causes physical reactions when drinking and blocks the complete breakdown of alcohol

alcoholics anonymous (AA)

Al-Anon

mutual-help programs that help facilitate recovery

alcoholics anonymous (AA)

12-step program

only requirement is the desire to quit

Al-Anon

helps family members and friends recover from effects of living with an alcohol-dependent person