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Alcohol

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... spirits such as whiskey, vodka, or gin are made by distilling the alcohol after fermentation ... 4 drinks a day or binge drinking while pregnant ... – PowerPoint PPT presentation

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Title: Alcohol


1
Alcohol
2
Alcohol
  • Chemically known as ethanol
  • Has played many roles throughout history
  • Considered a food, because it contributes energy
    to the diet (7 kcals/gram)
  • Not considered a nutrient, because is not needed
  • Social stimulant removes inhibitions
  • Has been a thirst quencher where water is unsafe,
    and an analgesic to treat aches and pains

3
History of Alcohol
  • Beer recipes found on Babylonian clay tablets
    6000 years old
  • Probably known as early as the Stone Age, 10,000
    years ago
  • Probably first wine was produced by accident,
    fermentation caused by wild yeast
  • Beer had to wait until establishment of
    agriculture

4
Alcohol as Alternative to Water
  • Alcoholic beverages provided a safe alternative
    to contaminated drinking water
  • Early alcoholic beverages had relatively low
    alcohol content, focused more on taste, thirst
    quenching
  • In the Old and New Testament, drinking water
    seldom mentioned wine and beer is
  • All ages, even children, drank wine and ale

5
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6
Production of Alcoholic Beverages
  • Fermentation the breakdown of carbohydrates
    without the use of oxygen
  • Alcohol, carbon dioxide, and various acids are
    byproducts
  • High carbohydrate foods especially encourage the
    growth of yeast, the micro-organism that is
    responsible for alcohol production

7
Production of Alcohol
  • Anaerobic condition CO2
  • Glucose
    Ethanol
  • Fermentation of yeast
  • Maltose
  • Amylase
  • CHO

8
Production of Beer
  • CHO must be simple sugar, such as maltose or
    glucose in order for the yeast to use it as food
  • If the CHO is a starch, such as that found in
    cereal grains (barley) it must be broken down to
    simpler forms, or malted
  • Beer is made from malted cereal grains, such as
    barley, flavored with hops and brewed by slow
    fermentation
  • Resulting CO2 is used to carbonate the beer

9
Production of Distilled Spirits
  • Distilled spirits such as whiskey, vodka, or gin
    are made by distilling the alcohol after
    fermentation
  • Distilling separates the alcohol from water and
    the alcohol is recovered
  • Vodka and gin are unaged
  • Whiskey, rum and brandies are aged

10
Alcohol Absorption
  • Depends on rate of stomach emptying
  • Absorbed readily by simple diffusion (no
    digestion needed)
  • Higher proof ? faster absorption
  • Wine is faster absorbed than liquor which is
    faster than beer
  • Food slows absorption from the stomach

11
Alcohol Absorption
  • Easily moves through the cell membrane (damaging
    it)? gastritis
  • Alcohol is found wherever water is found in the
    body

12
Alcohol (Ethanol) Metabolism
  • Depends on gender, race, size, food, physical
    condition, alcohol content
  • Metabolism depends on alcohol dehydrogenase (ADH)
  • Alcoholics and women have less ADH
  • Majority of the ethanol is metabolized by the
    liver

13
Metabolism of Moderate Alcohol Intake

alcohol dehydrogenase Alcohol
Acetaldehyde CO2 H2O small
amount excreted through
lungs,
urine, sweat
14
Alcohol in the Body
  • Ethanol
  • 7 calories/gram
  • Denaturing agent
  • Drug depresses/sedates CNS

15
Alcohol and Drugs
  • Alcohol cannot be stored and has priority in
    metabolism
  • If taken with sedatives, alcohol and sedatives
    compete for the same metabolic pathways
  • Liver cannot metabolize the sedatives fast enough
    ? coma or death

16
Alcohol (Ethanol) Metabolism
  • Social drinker who weighs 150 pounds with normal
    liver function metabolizes about 5-7 grams of
    alcohol her hour, about half a beer of ¼ of
    another drink
  • When intake of alcohol exceeds livers ability to
    metabolize it, builds up in the bloodstream
  • Small percentage excreted in urine, sweat,
    expired air (levels in expired air correspond
    with blood alcohol content ? Breathalyzer test)

17
Fig. 7.1
18
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19
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20
Women and Alcohol
  • Women absorb and metabolize alcohol differently
    than men
  • Have less activity of ADH metabolize only 10 of
    alcohol in stomach lining vs 30 by men
  • Have less body water in which to dilute the
    alcohol than men do
  • When men and women of equal size drink equal
    amounts of liquor, more alcohol reaches the
    bloodstream in women

21
Women and Alcohol
  • Women develop alcohol-related ailments such as
    cirrhosis more quickly than men with the same
    drinking habits

22
Drinking in America
  • 50 of adults
  • 17 of 12-17 year-olds
  • Highest prevalence in 18-25 year-olds
  • gt35 of adults with alcohol problems develop
    symptoms by age 19

23
Binge Drinking
  • gt5 drinks in a few hours
  • 20 of all Americans binge drink
  • 38 of 18-25 year-olds report bingeing
  • 48 of 21 year olds
  • 12 of 12-17 year-olds

24
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25
Benefits of Alcohol
  • Consumed in moderation
  • Decrease risk for cardiovascular disease
  • Socialization

26
Moderate Alcohol Use
  • Men 1 or 2 drinks daily
  • Women 1 drink daily
  • Difference due to
  • Body size/blood volume
  • Differences in body composition and water content
  • Differences in metabolism

27
One Drink
  • 12-ounce beer
  • 5-ounce glass of wine
  • 1 ounce of alcohol

28
Alcohol Abuse
  • Contributes to the leading causes of death
  • Combined with tobacco, increases the risk for
    esophageal and oral cancer
  • Risk for heart disease, heart arrhythmia, HTN,
    stroke, osteoporosis, brain damage, colorectal
    cancer, breast cancer, nutritional deficiencies,
    fetal damage, obesity, cancer

29
Health Effects of Alcohol
  • Pancreas inflammation (pancreatitis)
  • Small intestine rapid absorption with/without
    food
  • Liver major site of metabolism
  • 80 via ADH
  • 10 MEOS (microsomal ethanol oxidizing system)
  • 10 excreted

30
Effect of Alcohol in the Body
  • Heart
  • Sedates muscle
  • Slows rate
  • Lungs
  • Exhaled in small amounts
  • Smell on breath

31
Effect of Alcohol on the Body
  • Brain
  • Depresses and sedates brain
  • Order brain affected
  • Inhibitory nerves
  • Judgement/reasoning
  • Speech/vision
  • Voluntary muscle control
  • Respiration/heart activity

32
Effects of Alcohol
33
Hangovers
  • Dehydration
  • Antidiuretic hormone depressed
  • Increased urine output
  • Brain cells dehydrate
  • Rehydration ? severe headache

34
Hangovers
  • Formaldehyde
  • Metabolism ? methanol
  • Liver metabolizes methanol ? formaldehyde ? C02,
    H20
  • Same enzymes metabolize alcohol
  • Ethanol ? acetaldehyde ? C02, H20
  • Acealdehyde processed
  • Formaldehyde builds up ? hangover symptoms

35
Cure for Hangover
  • TIME
  • Fluids for rehydration

36
Limited Metabolic Enzymes Increase Risk
  • Normally metabolize ½ oz/hour
  • Fewer enzymes
  • Women
  • Native Americans
  • Asians
  • Poor nutritional status (enzymes are proteins)

37
Some People Are at Greater Risk
38
Increased Enzymes
  • Previous drinking experience (develop tolerance)
  • MEOS increases

39
Alcoholic Hepatitis
  • Inflammation of the liver
  • Scar tissue
  • Reversible with
  • Abstinence
  • Good nutrition

40
Cirrhosis
  • Fatty infiltration of the liver
  • Response to the increased synthesis of fat
  • Enlarged fat cells choke off nutrient and O2
    supply to liver cells
  • Engorged fat cells burst and die
  • Scar tissue

41
Cirrhosis
  • 15-20 of alcoholics after gt10 years of alcohol
    abuse
  • 2 million people in the U.S.
  • 50 chance of death within 4 years
  • Advance stages are not reversible
  • Second leading cause of the need for liver
    transplant

42
Malnutrition in Alcoholism
  • Typical deficiencies include the fat-soluble
    vitamins (A, D, E and K) and water soluble
    vitamins (thiamin, niacin, B-6, folate, B-12 and
    C)
  • Mineral deficiencies calcium, phosphorus,
    potassium, magnesium, zinc and iron

43
Malnutrition in Alcoholism
  • Arise due to poor nutritional intakes and fat
    malabsorption and increased urinary losses
  • May also be at risk for toxicities of A and iron
  • Malnutrition makes the liver more vulnerable to
    toxic substances (deficiency of C and folate)
  • Most important treatment abstention from alcohol

44
Other Problems Related to Alcohol Abuse
  • Drinking in the workplace
  • Operating motor vehicles and equipment
  • Sexually transmitted diseases
  • Unplanned pregnancy
  • Children of alcoholics

45
Alcohol-Related Health Care Costs
  • Twenty-five to forty percent of all patients in
    U.S. general hospital beds (not in maternity or
    intensive care) are being treated for
    complications of alcohol-related problems. 1
  • Annual health care expenditures for
    alcohol-related problems amount to 22.5 billion.
    The total cost of alcohol problems is 175.9
    billion a year (compared to 114.2 billion for
    other drug problems and 137 billion for
    smoking).2

http//www.marininstitute.org/alcohol_policy/healt
h_care_costs.htm
46
Alcohol-Related Health Care Costs
  • In comparison to moderate and non-drinkers,
    individuals with a history of heavy drinking have
    higher health care costs. 3
  • Untreated alcohol problems waste an estimated
    184.6 billion dollars per year in health care,
    business and criminal justice costs, and cause
    more than 100,000 deaths. 4

http//www.marininstitute.org/alcohol_policy/healt
h_care_costs.htm
47
Consequences of Alcohol
  • Alcohol-related car crashes are the number one
    killer of teens. Alcohol use is also associated
    with homicides, suicides, and drownings-the next
    three leading causes of death among youth. 7
  • Alcohol is the drug most frequently used by 12 to
    17 year-olds-and the one that causes the most
    negative health consequences. More than 4 million
    adolescents under the legal drinking age consume
    alcohol in any given month. 8

http//www.marininstitute.org/alcohol_policy/healt
h_care_costs.htm
48
Alcohol and Students
  • gt1400 die from unintentional injuries
  • gt600,000 assaults by drinking students
  • gt70,000 victims of sexual assault/date rape
  • 400,000 unprotected sex
  • 100,000 too drunk to remember

49
Alcohol and Students
  • Academic problems (25 of students)
  • Vandalism (11 participate)
  • Police involvement (5 contact with police/campus
    security)
  • 110,000 arrests

50
Fetal Alcohol Syndrome
  • Alcohol reaches the fetus
  • Deprive brain of oxygen and nutrients
  • 4 drinks a day or binge drinking while pregnant
  • First trimester drinking greatest danger (women
    are unaware they are pregnant)
  • Abstinence from alcohol is the best advice

51
Fetal Alcohol Syndrome
  • Leading preventable birth defect
  • 3.3 per 10,000 births
  • Mental retardation
  • Poor growth
  • Physical deformities

52
Brain Damage
  • Subtle cognitive dysfunction and motor nerve
    deficit
  • Shrinks the brain
  • Reduces oxygen and nutrients to the brain
  • Alcohol is a powerful depressant

53
Advice
  • U.S. surgeon generals office, the National
    Academy of Science, and the USDA/DHHS do not
    recommend drinking
  • Drink in moderation
  • Avoid drinking and driving
  • Avoid drinking while pregnant

54
Alcohol Dependency
  • Genetic links
  • Risk is increased fourfold in children of
    alcoholics
  • Can be addictive and dangerous for some
  • Warn these children by the age of 10
  • Low threshold may be genetic
  • requires greater amounts of alcohol to produce
    same effects
  • Ethnic

55
Depression
  • Goes with alcohol abuse
  • Alcohol only alleviates depression in the short
    run
  • No longer concerned about their health/behavior

56
Diagnosis
  • Physiological dependence on alcohol
  • Tolerance to the effects of alcohol
  • Evidence of alcohol-associated illnesses (memory
    loss, liver disease, etc.)
  • Continued drinking in defiance of medical and
    social contradictions
  • Depression and blackouts
  • Flushed face/reddened skin

57
CAGE Screening
  • C Have you every felt you ought to cut down on
    drinking?
  • A Have people annoyed you by criticizing your
    drinking?
  • G Have you ever felt bad or guilty about your
    drinking?
  • E Have you ever had a drink first thing in the
    morning to steady your nerves or to get rid of a
    hangover? (As an eye-opener)

58
Do You Have a Problem with Alcohol?
  • Have you had memory lapses or blackouts due to
    drinking?
  • Do you continue to drink although you have health
    problems caused by alcohol?
  • Do you get withdrawal symptoms such as headaches,
    chills, shakes and a strong craving for alcohol,
    and drink more to get rid of those symptoms?

59
Do You Have a Problem with Alcohol?
  • Do you take part in high-risk behaviors, such as
    having unsafe dex in a non-monogamous
    relationship or driving a boat or car when under
    the influence of alcohol?
  • Has drinking caused trouble at home, at work, or
    in relationships with others?

60
Do You Have a Problem with Alcohol?
  • Do you have to drink alcohol for any of the
    following reasons?
  • To get through the day or unwind at the end of
    the day
  • To cope with stressful life events
  • To escape from ongoing problems
  • If yes to any, consult your family physician or a
    certified counselor for help

61
Alcoholism 4 symptoms
  • Craving
  • Loss of control
  • Physical dependence
  • Tolerance
  • 7 of Americans meet criteria
  • gt50 of adults have alcoholic family member
    active or recovering

62
Treatment
  • Guidance from a physician
  • Counseling
  • Total abstinence
  • AA 12 step program
  • Treatment program
  • Medication (blocks craving or cause physical
    reaction when drinking)

63
Alcohol Poisoning
  • Warning Signs
  • Semiconsciousness or unconsciousness
  • Slow respiration (8 or fewer per minute or lapse
    of greater than 8 seconds)
  • Cold, clammy, pale, or even bluish skin
  • Strong odor of alcohol
  • Others?
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