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Alcohol

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  1. Alcohol Chapter 8

  2. Learning Outcomes • Describes the sources of alcohol and the calories it provides • Define standard serving sizes of alcoholic beverages and the term moderate drinking • Summarize how alcoholic beverages are produced • Outline the process of alcohol absorption, transport and metabolism

  3. Learning Outcomes • Define binge drinking and explain how it increases the risk of alcohol poisoning • Explain how alcohol consumption affects blood alcohol concentration • Describe guidelines for using alcohol safely • Discuss potential benefits of using alcohol • Summarize the risks of alcohol consumption

  4. Learning Outcomes • Describe the effects of chronic alcohol use on the body and nutritional status • List the signs of alcohol dependency and abuse • Outline the methods used to diagnose alcohol abuse • List the strategies and resources available for the treatment of alcoholism

  5. Alcohol can be made from many sources

  6. Sources of Alcohol • Contains 7 kcal/gm • Beer, wine, distilled spirits, liqueurs, cordials and hard cider • Vary in alcohol and caloric content • Standard drink provides 15 g of alcohol • 12 oz beer, 10 oz wine cooler, 5 oz wine or 1.5 oz of hard liquor • Moderate intake • 1 drink a day for women • 1-2 drinks a day for men

  7. How those calories add up… • 5 oz wine 120 • 5 oz champagne 95 • Wine cooler 210 • Guiness 210 • Lite beer 140 • 1 shot hard liquor 50 • 1 shot Bailey’s 160 • Rum and coke 180 • Martini 220 • Margarita (restaurant) 540 • Pina colada (restaurant) 650 • 4 pints of beer = 4 x 180 = 720 kcal • 1 bottle of wine = 5-6 glasses x 120 =650 kcal

  8. Production of Alcoholic Beverages • Fermentation • Must get carbohydrate to monosaccharide form • Keep sugar + yeast + water at room temp • Yeast uses sugar for energy to make more yeast • Oxygen depletes and yeast ferments sugar to ETOH and carbon dioxide • If a starch must be malted: grains sprouts and makes enzymes that break sugars to simple sugars • Distillation • Separating the alcohol out of the product • Boil off alcohol, save vapors and condense to make hard alcohol

  9. We drink Ethanol

  10. Alcohol Absorption and Metabolism • Alcohol is absorbed throughout the GI tract by simple diffusion • Metabolism • Low to moderate intakes • Alcohol dehydrogenase pathway • ETOH Acetaldehydate Acetyl- CoA

  11. Alcohol Absorption and Metabolism • Moderate to excessive intakes • Microsomal ethanol oxidizing system (MEOS) • Liver treats alcohol as foreign substance • Similar to ADH pathway but requires energy • Pathway becomes more efficient with increasing alcohol intake- allows “tolerance” • Same pathway used to metabolize drugs, but alcohol metabolism takes precedence • Catalase pathway • Plays minor role

  12. Alcohol Absorption and Metabolism

  13. Alcohol Metabolism • Factors affecting alcohol metabolism • Ethnicity, gender and age • Alcoholic content, amount consumed, individual’s usual intake • Rate of alcohol metabolism • Average ½ drink an hour • Blood alcohol levels rise • Intoxication and alcohol poisoning • Binge Drinking (4+ drinks females, 5+ for males in single sitting)

  14. How much is too much?

  15. Estimated alcohol concentration by number of drinks for average 130# female Peak usually 30-90 min after drinking

  16. Estimated alcohol concentration by number of drinks for average 175# male Peak usually 30-90 min after drinking

  17. Alcohol Consumption in North American • 62% adults consume alcohol • 70% of college students who drink, at least 45% engage in binge drinking • 4% of US population is alcohol dependent • 9% of young adults are alcohol dependent • By age 14/15 almost half have consumed alcohol

  18. Health Effects • Guidelines for Using Alcohol Safely • Drink in moderation • Should not be consumed by some individuals • Should not be consumed during some activities

  19. Health Effects • Potential Benefits • Appetite stimulant • Cardiovascular benefits

  20. Risks of Excessive Alcohol Intake • A hangover describes the sum of unpleasant physiological effects following heavy consumption of alcohol. • Headaches, dry mouth, and lethargy: Ethanol increases urine production (dehydration) which leads to decreased fluids in brain • Nausea: Alcohol's irritates the stomach lining • Fatigue, weakness, mood disturbances and decreased attention and concentration: three enzymes of the Citric Acid Cycle are inhibited leads to low blood sugar and prevents gluconeogenesis • Acetaldehyde (ethanal) is between 10 and 30 times more toxic than alcohol itself

  21. Risks of Excessive Alcohol Intake • TRUE OR FALSE: some drinks are more likely to cause hangovers? • TRUE OR FALSE: Drinking coffee or taking cold showers will help bring your blood alcohol content down • TRUE OR FALSE: eating and drinking water will help bring your blood alcohol content down • TRUE OR FALSE: some people are more or less prone to hangovers, even if age, gender, and size are equal

  22. Risks of Excessive Alcohol Intake • Alcohol affects many organs and systems • Brain, heart damage, high blood pressure • Cancers: oral cavity, esophagus, trachea, larynx and throat • Cirrhosis of the liver

  23. Health Effects of Excessive EtOH

  24. Cirrhosis

  25. Alcohol Posioning

  26. Beer belly • The average adult drinker gets around 10 percent of his/her total daily calories from an alcoholic beverage • When you drink alcohol, the liver burns alcohol instead of fat • Gender, age, smoking, genetics • Treatment options

  27. Effects of Alcohol Abuse on Nutritional Status • Water soluble vitamin deficiency common (why?) • Thiamin • Wernicke-Korsakoff Syndrome • Niacin • B-12 and B6 • Folate • Fat soluble vitamins • A, D, E and K

  28. Effects of Alcohol Abuse on Nutritional Status • Minerals • Calcium, magnesium, zinc and iron • Protein-energy malnutrition

  29. Alcohol Consumption During Pregnancy and Breastfeeding • Most severe damage occurs in the first 12-16 weeks of pregnancy • Fetal alcohol syndrome • Fetal alcohol effects • Breastfeeding • Alcohol does pass through breast milk

  30. FAS

  31. Alcohol Abuse and Alcoholism • Alcohol Abuse • Alcohol Dependency (Alcoholism) • Genetic influences • Effect of gender • Age of onset of drinking • Ethnicity • Mental health

  32. How drugs work

  33. Diagnosis and Treatment of Alcoholism • Determining whether a problem exists • 75% of people with alcohol problems do not seek treatment • Recovery from alcoholism • Medications • Alcoholics Anonymous (AA)