Lecture Outline

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Alcohol

Chapter 9

Welcome to Week 1 Day 2c

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Objectives for Chapter 9

• Explain what alcohol is and how it is made.• Explain why people drink alcohol.• Describe how alcohol is absorbed and

metabolized in the body.• List the harmful effects of alcohol in the body.• Describe the difference between alcohol abuse

and alcoholism.

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What Is Alcohol and How Is It Made?

• Alcohol is not an essential nutrient• Ethanol is the type of alcohol consumed in alcoholic

beverages– Methanol (in antifreeze) and isopropanol (rubbing

alcohol) are both poisonous to humans– Ethanol is safe for consumption, but excessive

amounts are toxic and can be fatal– Made by fermentation of yeast and natural sugars in

grains (beer) and fruits (wine)• Liquor is concentrated alcohol collected through distillation

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Beer

• Beer is made from the fermentation of yeast and the natural sugars from grains

Misc 9.1

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Why Do People Drink Alcohol?

• People drink to relax, celebrate, and socialize• Moderate alcohol consumption may have health

benefits: may reduce risk of heart disease– Moderate alcohol consumption: no more than one

drink daily for adult women, two for men– Alcohol can increase HDL cholesterol and may make

blood platelets less "sticky": less likely to form unwanted blood clots

– Health benefits only shown in women ≥55 years of age and men ≥45 years old, not in younger people

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Why Do People Drink Alcohol?

• Moderate consumption is based on standard drink sizes, which contain about half an ounce of alcohol

• A standard drink is one of the following:– 12-ounce serving of beer– 1.5-ounce shot of liquor– 5-ounce glass of wine

• Moderate drinkers should pay attention to:– Size of drinks– Frequency of drinking

• Abstaining from alcohol for several days, then overdrinking one day is not moderate drinking

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What Is a Standard Drink?

Figure 9.1

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When a Drink Is More Than a Drink…

Figure 9.2

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Practical Nutrition Tips Video: Alcohol Serving

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Practical Nutrition Tips Video: Step Up To The Bar

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What Happens to Alcohol in the Body?

• Alcohol is a toxin, and the body works quickly to metabolize and eliminate it

• You absorb alcohol in your stomach and small intestine– Some alcohol is metabolized by alcohol

dehydrogenase enzyme before it's absorbed– Women are more susceptible to effects of alcohol

than men• Have 20 to 30 percent less alcohol dehydrogenase than

men, so absorb more alcohol in stomach

– Food in stomach slows alcohol absorption

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Animation: Alcohol Absorption

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What Happens to Alcohol in the Body?

• You metabolize alcohol primarily in your liver: one standard drink is metabolized in 1½ to 2 hours– Alcohol dehydrogenase converts alcohol to

acetaldehyde (eventually metabolized to CO2 and water)

– The microsomal ethanol-oxidizing system (MEOS) also metabolizes alcohol and is revved up when chronically high levels of alcohol are present in liver

• Alcohol circulates in your blood until metabolized– Blood alcohol concentration (BAC) correlates with

amount of alcohol in your breath

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The Metabolism of Alcohol

Figure 9.3

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What Happens to Alcohol in the Body?

• Effects of alcohol on your brain– Depressant of central nervous system– Slows down transmission of nerve impulses

and reaction time to stimuli– Impairs thoughts, actions, behavior– The more consumed, the more areas of brain

affected– If enough consumed, activities of brain stem

are suppressed (breathing, heart rate), resulting in death

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Progressive Effects of Alcohol

Table 9.2

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The Brain and Alcohol

Figure 9.4

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How Can Alcohol Be Harmful?

• Alcohol can disrupt sleep and cause hangovers– Even moderate amount in late afternoon/evening can

disrupt sleep cycle• Alcoholic beverages may contain congeners, which

contribute to hangover symptoms– Symptoms: headache, fatigue, nausea, increased

thirst, rapid heart beat, tremors, sweating, dizziness, depression, anxiety, irritability

• Alcohol is a diuretic; can cause dehydration and electrolyte imbalances

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How Can Alcohol Be Harmful?

• Alcohol can interact with hormones– Interferes with insulin and glucagon that regulate

blood glucose level– Negatively affects parathyroid hormone and other

bone-strengthening hormones; can increase risk of osteoporosis

– Can increase estrogen levels in women; may increase risk of breast cancer

– Affects reproductive hormones and associated with both male and female sexual dysfunction

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How Can Alcohol Be Harmful?

• Alcohol may lead to overnutrition and malnutrition– Provides 7 calories per gram, contributing to weight

gain• Increases fat and weight around stomach

– Alcohol calories can displace nutritious foods– Excessive alcohol can interfere with absorption

and/or use of protein, zinc, magnesium, thiamin, folate, and vitamins B12, A, D, E, K• Thiamin deficiency affects brain function and increases risk

of Wernicke-Korsakoff syndrome

© 2015 Pearson Education, Inc.Table 9.3

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Too Much Alcohol Costs You Good Nutrition

Figure 9.5

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How Can Alcohol Be Harmful?

• Alcohol can harm your digestive organs, heart, and liver

• Excessive amounts of alcohol can cause:– Inflammation of esophagus– Cancers of the esophagus, mouth, and throat– Gastritis and stomach ulcers– Hypertension and damage to heart tissue– Alcoholic liver disease

• Three stages: fatty liver, alcoholic hepatitis, cirrhosis

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Alcoholic Liver Disease

Figure 9.6

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Effects of Alcohol on the Body

Figure 9.7

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How Can Alcohol Be Harmful?

• Alcohol can put a healthy pregnancy at risk– Exposure to alcohol prenatally can cause

fetal alcohol spectrum disorders (FASDs)• Most severe form is fetal alcohol syndrome (FAS)

– Causes physical, mental, and behavioral abnormalities

• Effects of FASDs are permanent• The only proven, safe amount of alcohol a

pregnant woman can consume is none

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Fetal Alcohol Syndrome

Figure 9.8

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What Are Alcohol Abuse and Alcoholism?

• Binge drinking, drinking and driving, and underage drinking are forms of alcohol abuse

• Binge drinking: consumption of 5 or more drinks by men, 4 by women, in a short time– Increased likelihood of injuries, car accidents,

drowning, unplanned sexual activity, death– Associated with sexual aggression, assaults,

suicide, homicide, child abuse, and health problems (hypertension, heart attack, sexually transmitted disease)

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What Are Alcohol Abuse and Alcoholism?

• Binge drinking (continued)– Can cause blackouts and lead to alcohol

poisoning– Chronic drinking can lead to alcohol tolerance

• Brain becomes less sensitive to alcohol, needing more to get same intoxicating effect

• CAGE: screening tool to assess if patients have problem controlling alcohol consumption

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Consequences of College Binge Drinking

Figure 9.9

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Discussion Questions• Who should be held responsible in a potentially

dangerous situation that involves a visually intoxicated woman and a male who attempts to take advantage of her? (i.e., the bartender, her friends, herself)?

• Would you feel responsible for helping a visually intoxicated woman who is seemingly being taken advantage of by a male patron at the bar? How would you react in a similar situation to the ones in the video?

• Discuss ground rules or ways to keep friends safe while on spring break if one of your friends gets intoxicated.

Sloppy Spring Breakers

© 2015 Pearson Education, Inc.Table 9.4

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What Are Alcohol Abuse and Alcoholism?

• Drinking and driving: illegal to drive with BAC of 0.08– One drink impairs alertness, judgment, coordination

• Underage drinking– Increases risk of violence, injuries, health risks– Can also interfere with brain development and lead to

cognitive and memory damage in teenagers– Underage drinking and driving is extremely risky– The earlier in life a person starts drinking, the higher

the risk for alcoholism

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"Buzzed driving is drunk driving"

Misc 9.8

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What Are Alcohol Abuse and Alcoholism?

• Alcoholism is a disease• Four classic symptoms:

– Craving for alcohol– Continued drinking despite physical,

psychological, social problems– Can't control or limit intake– Dependency on alcohol

• Craving, loss of control, and dependency distinguish an alcoholic from an alcohol abuser

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What Are Alcohol Abuse and Alcoholism?

• Alcoholism runs in families– Children of alcoholics are four times more susceptible

• Environment also has an impact– Influences: home life, habits of family and friends,

social pressures, access to alcohol• No cure, but can be treated with:

– Medication to reduce cravings – Psychological help and support– Complete elimination of alcohol – Alcoholics Anonymous: 12 steps for recovery and

supportive group meetings

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What Are Alcohol Abuse and Alcoholism?

• Dietary Guidelines for Americans states that the following should abstain from alcohol:– Women of childbearing age who may become

pregnant– Pregnant and lactating women– Children and adolescents– Those with specific medical conditions, taking

certain medications, or operating machinery or driving

– Those who cannot restrict their intake