Oeno-File, the Wine & Gastronomy Column

by Frank Ward


September 2018. In a truly fascinating article published in Decanter magazine a year or two ago, Dr Michael Apstein, a leading gastroenterologist (liver doctor) throws a great deal of light on how the alcohol in wine affects the human body. Its impact, both positive and negative, depends hugely on such factors as the sex of the drinker, the quality of the wine, and the rate, volume, and periodicity of consumption.


A key factor is BAC, or blood alcohol concentration. The more easily a person metabolises alcohol, as is the case with those with a low BAC, the less of it gets into the blood stream – which is good. For the less alcohol that gets into the blood the better. People with a lower BAC run a lower risk of any adverse effects of alcohol and also become less drunk, he says.


Of crucial importance is the fact that the BAC is lower in those who drink when they eat than in those who imbibe on an empty stomach. Eating while drinking is of crucial importance. Drinking wine with food “results in the alcohol staying longer in the stomach, allowing more of it to be broken down. As a result, less alcohol reaches the small intestine and less is absorbed into the blood.”


It’s widely thought that occasional drinking is more healthful than regular drinking. Dr Apstein believes the opposite to be the case: people who drink wine daily are more able to metabolise alcohol than those who drink only at weekends. This is because the livers of regular drinkers contain more alcohol dehydrogenase, an alcohol-metabolising enzyme. By lowering the BAC, they soften the impact of alcohol on the system. These enzymes are said to be “inducible”, meaning that the liver can produce more of them when needed.


“When we eat – especially when we eat fat or protein – the stomach automatically slows the speed with which it delivers the food to the small intestine, allowing for a slow and steady absorption of nutrients from the small intestine. Consequently, drinking wine with a meal…results in the alcohol staying longer in the stomach, allowing more of it to be broken down.”


Dr Apstein points out that when a regular drinker stops drinking for a week or more, “the first glass of wine has a bigger impact than usual”. That’s simply because a mere week’s abstinence causes the liver to lose some of its alcohol-metabolising capacity. He goes on to suggest that “giving your liver a rest” by abstaining from wine for a month may not have any positive effect – except for a possible slight weight loss. He stresses, however, that this insight should not encourage people to go in for binge drinking – “a very hazardous activity”.


Women, it seems, have a much lower tolerance for alcohol than men. If an average (60kg) woman and an average (80 kg) man each drink two 175 ml glasses of 12 ABV wine over 90 minutes, the woman will have a BAC of 0.080 (the legal limit for England and Wales) while the man’s will stand at 0.037. the corresponding figures for a wine with 14 ABV (more and more common these days) are 0.098 and 0.047 respectively.


(That, of course, is a generality: we all know women who can drink a man under the table!).


All true wine-lovers should salute Dr Apstein, of the Beth Israel Deaconess Medical Centre in Boston and Assistant Professor of Medicine at Harvard Medical School, for these valuable insights.


© Frank Ward 2018


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