BEER BELLY S1E3

One night when I was 20 years old, a girl-friend caught me drinking beer and told me that vodka held fewer calories. When I turned 21, I was sure to only smoke cigarettes socially. And by the time I was 24, alcohol and cigarettes seemed to go hand-in-hand. But it was not until my most recent hangover that I began to question how malignant my social habits really were.

This hangover was living up to its clinical definition. It was truly a temporary state of unpleasant next-day effects taking that made me wish my blood-alcohol levels didn’t reach zero (Karadayian et al., 2013). Drowsiness, fatigue. Dry mouth, a headache that felt less painful if you squinted only one eye, as well as the odd pang-of-disappointment – it was only natural to question every decision ever made in my young adult life (Karadayian et al., 2013; Heffernan, 1995). This alone may have been a little melodramatic. But, when I found a bevy of ignored drunk [booty] calls from every contact saved on my phone: I couldn’t help but wonder, had I really let myself go, or did everyone know I never intended to follow suit?
Explaining my unusual inability to stomach rejection, alcohol-induced hangovers have been found to contribute towards lessened mood – of which has been said to occur in stages. First, causing a decrease in pain perception, then an elevation in anxiety and fear-related behaviors by the 2nd hour; finishing off with symptoms of depression by the 14th hour (McKinney, 2010; Karadayian et al., 2013). I must have been asleep for the first two stages, Just as I was about to dive deeper under the covers, I checked phone once more and then suddenly I heard Noelle from the kitchen – I’m surprised she’s awake so early.  My stomach grumbled as I crawled out of bed and passed the mirror beside the door; praying that I didn’t fall asleep with my make-up on – but of course, I did.

Following the smell of bacon down the hall and into the kitchen, Noelle greeted me while she was on the phone to Clare – they had been reading my old opinion piece. As much as I wanted to join in, I knew I was no use to anyone without having something to eat. In addition to being a hopeless romantic, it’d seem that my 1st World Misfortune continued, for there was also no pizza.
Too lazy to scramble around the cabinets, I came to Noelle’s side and lowered what was left of the bread loaf into the toaster by the stove. Her eyes widened as I reached for a piece of bacon right from the pan – burning my fingers.
“Aren’t you sick from last night? I’ve been feeling terrible all morning!”, Noelle said watching me react childishly to the pain.
“The difference between us is that I actually did some sleeping.”. With that, Noelle’s jaw dropped into a small smile. “We’ll have to call you back later, Clare.”, she said ending the call.

Judging by the look on her face, she’d found herself with the much shorter end of the stick. Sliding the rashers of bacon onto a plate, Noelle caught one sniff and her face scrunched up. “Don’t worry Noelle, you might not have an appetite for the next eight hours…”, I said over my shoulder, lifting the toast from the machine. “It’s fine. I deserve to starve!”, she laughed manically before passing the plate to me.

After retelling last night’s antics and playing the blame game, it was agreed: calling my ex-boyfriend last night was a bad idea. With this, we vowed to never reach that level of intoxication again, but this made my face scrunch up.
In this day and age modest drinking was unrealistic, and binge-drinking was fashionable and equated to fun. Noelle agreed, “Surely, there’s another way…”. Intrigued by the idea, we moved into the study and began our web-search.

As told by the faceless writers of the internet, it would appear that the key to a successful night-out is to not die in the long run. Beginning with thorough preparation of the stomach and the gut before drinking alcohol, two things are of concern: gastric emptying, and the absorption of alcohol from the small intestine. Characteristics of food that impose an effect towards gastric emptying and intestinal absorption include: timing, meal size, and meal composition– however trying to optimize either one is difficult as the two are connected via a tight-rope effect (Gentry, 2000). When assessed individually, the details appeared as follows:

Timing
A meal before > a mean during alcohol consumption.

Although both eating times reduce intestinal absorption, a meal before alcohol consumption slowed gastric emptying while a meal during accelerated it (Wedel et al., 1991).

Meal size
Small > Big

The rate at which the stomach emptied itself within the first 2 hours of eating was determined by the physical and caloric weight of the meal (Velchik, Reynolds & Alavi, 1989; Moore et al., 1984). Where, meals of greater energy value emptied much slower into the small intestinal across both hours (Velchik, Reynolds & Alavi, 1989).

Meanwhile, the literature exploring the effect of meal weight to intestinal absorption is limited. However, it has been thought that eating a large meal can put you to sleep, as the body literally exhausts itself to digest and absorb the nutrients from the small intestine (Levine, 2016).

Meal composition
In one study, gastric emptying was similar across meals of different compositions, thereby suggesting that the effect of food is not caused by specific interactions with meal constituents (Ramchandani, Kwo & Li, 2001). However existing pieces of literature suggest consumption of a meal containing high-sucrose [table sugar] levels can delay gastric emptying – particularly meals with a high-sucrose and high-carbohydrate content (Ramchandani, Kwo & Li, 2001).

Meanwhile, remnants of this literature skeleton seemed to be self-contradictory. Where one study suggested that high-fat meals slow gastric emptying (Gentry, 2000), while another reported high-fat meals promote gastric emptying (Ramchandani, Kwo & Li, 2001). Having that said, further research studying the effect of macronutrients towards gastric empty may be of order. But for now, the best point of action would be to focus on delaying intestinal absorption.

Precedent of the tight-rope effect, energy-dense foods containing greater calories from high levels of fat and carbohydrates have been found to increase intestinal permeability (Bischoff, 2014). As a result, we are left with the option to coat the stomach with high fibre foods, to ensure that man’s poison is slowly absorbed into the blood.
Surprisingly so, other substances such as cigarette smoking has been found to slow the absorption of alcohol from the small intestine. However, these effects took place when four cigarettes were smoked within an hour by recently abstained individuals; whether this affect outweighs the comparative increase in mortality remains up for debate (Johnson et al., 1991).

***

Suddenly my phone sounded; the responding text message read: “Drinks tonight?”.  I looked to Noelle’s direction, trying to remember if there was anything I had to do this afternoon. As my witness, Noelle’s eyes followed mine as she watched fall to the knees of yet another hangover debuff; struggled with performing everyday prospective memory (Heffernan, 1995). Taking advantage of said reduced and thinking time, she pressed that it would be rude to say no (Weissenborn & Theodora, 2003). I looked at her and was reminded of the time she corrected my choice of drink, reminding myself that she was yet to be wrong since. Before I could try and contest, a tall shadow shrouded over the computer screen. The figure reached over my shoulder to the plate of bacon. “Good morning”, Nathan chuckled as he ripped the piece of meat with his teeth.

 

References

Bischoff, S. C., Barbara, G., Buurman, W., Ockhuizen, T., Schulzke, JD, Serino, M., Tilg, H., Watson, A. & Wells, J. M., 2014. Intestinal permeability – a new target for disease prevention and therapy. BMC Gastroenterology, 14: 189. https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-014-0189-7  

Gentry, T. R., 2000. Effect of food on the pharmacokinetics of alcohol absorption. Alcoholism: Clinical and Experimental Research, 24(4). http://onlinelibrary.wiley.com.ezproxy.lib.rmit.edu.au/doi/10.1111/j.1530-0277.2000.tb01996.x/epdf

Heffernan, T., 1995. Does a state of alcohol hangover impair event based prospective memory? European Psychiatry, 41: 864-865. https://primo-direct-apac.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_sciversesciencedirect_elsevierS0924-9338(17)31745-5&context=PC&vid=RMITU&adaptor=primo_central_multiple_fe&tab=default_tab)

Johnson, R. D., Horowitz, M., Maddox, A. F., Wishart, J. M. & Shearman, D. J., 1991. Cigarette smoking and rate of gastric emptying: effect on alcohol absorption. British Medical Journal, 302(6767): 20-23. https://www-ncbi-nlm-nih-gov.ezproxy.lib.rmit.edu.au/pmc/articles/PMC1668727/  

Karadayian, A. G., Busso, M. J., Feleder, C. & Cutrera, R.A., 2013. Alterations in affective behavior during the time course of alcohol hangover. Behavioral Brain Research, 253: 128-38. doi: 10.1016/j.bbr.2013.07.011 – https://www.ncbi.nlm.nih.gov/pubmed/23850352

Levine, B., 2016. Physiology of the small intestine, part 2. Baseline of health foundation. https://jonbarron.org/article/physiology-small-intestine-part-2

McKinney, A., 2010. A review of the next day effects of alcohol on subjective mood ratings. Current Drug Abuse Reviews, 2(3): 88-91. http://www.eurekaselect.com/94055/article

Moore, J. G., Christian, P. E., Brown, J. A., Brophy, C., Datz, F., Taylor, A. & Alazraki, N., 1984. Influence of meal weight and caloric content on gastric emptying of meals in man. Digestive diseases and Science, 29(6): 513-9. https://www.ncbi.nlm.nih.gov/pubmed/6723483

Ramchandani, V. A., Kwo, P. Y. & Li, T., 2001. Effect of food and food consumption on alcohol elimination rates in healthy men and women. The Journal of Clinical Pharmacology, 41(12): 1345-1350. http://onlinelibrary.wiley.com.ezproxy.lib.rmit.edu.au/doi/10.1177/00912700122012814/abstract

Velchik, M. G., Reynolds, J. C. & Alavi, A., 1989. The effects of meal energy content on gastric emptying. Journal of Nuclear Medicine, 30: 1106-1110. http://jnm.snmjournals.org/content/30/6/1106.full.pdf

Wedel, M., Pieters, J. E., Pikaar, N. A. & Ockhuizen, Th., 1991. Application of a three-compartment model to a study of the effects of sex, alcohol dose and concentration, exercise and food consumption on the pharmacokinetics of ethanol in healthy volunteers. Alcohol Alcohol, 26(3): 329:336. https://academic-oup-com.ezproxy.lib.rmit.edu.au/alcalc/article/26/3/329/article

Weissenborn, R. & Theodora, D., 2003. Acute alcohol effects on cognitive function in social drinkers: their relationship to drinking habits. Psychopharmacology, 165(3): 306-312. https://link.springer.com/article/10.1007%2Fs00213-002-1281-1?LI=true

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