Opinions on alcohol consumption differ depending on who you ask. For some, it’s a necessity for winding down after a stressful day at work. It might not even be a consideration to take a drop for others. For many of you, you will likely fall in between these schools of thought. You may appreciate that alcohol isn’t exactly ‘healthy’, but then again, life is short and to be enjoyed. However, knowing how to balance a social life along with training and recovery can certainly be a challenge.

Rather than expecting people to completely abstain from alcohol, it is reasonable to expect that there will be occasions when you may drink a bit too much. It would be great if we could have a night on the town with no side-effects, but to date, unfortunately, there is no prevention or cure for the dreaded hangover.

Are we thinking ahead?

Recent research has explored the long-term effects of alcohol consumption and brain health and investigated the key time-points within a person’s life where our brains are more sensitive to the long-term effects of alcohol consumption. The three key life stages identified by this research are; gestation (from conception to birth), between the age of 15-19 and in adults over 65 years of age. The reason for this sensitivity to alcohol during these time periods is due to different stages of development, growth in the fetus and early years and deterioration in later life (1).  While we are not trying to rain on your parade, it is very important to be aware that throughout our lives, even day-to-day, we may be more sensitive to the long-term effects of substances such as alcohol and unfortunately, we do not always consider the long-term effects of our behaviours. Food for thought!

Alcohol consumption, even at moderate levels, is associated with adverse brain outcomes including hippocampal atrophy (early characteristic of alzheimers disease). These results support the recent reduction in alcohol guidance in the UK. But what actually is moderate consumption?

What even is Moderation?

‘I’d have an odd drink’ or “I’ll only go for one or two’ can mean completely different things to different people.

Even within studies, moderate alcohol consumption differs. Some studies define moderation consumption to less than 1 drink per day while in others they refer to 3-4 drinks per day as moderate. Within research there is also no universally standard definition of an alcohol measure.

Moderate drinking sits at the point at which the health benefits of alcohol clearly outweigh the risks.

The Cure?

So what about the morning after the night before? Hangover pills and the many proposed hangover remedies tend to offer only a little help, but are there some simple nutrition strategies that you can take that can ease the headache, reduce the feeling of nausea and help bring you back to a semi-normal state the next day. First, we need to understand how alcohol is broken down by the body. 

To fully appreciate the effects of alcohol, it’s important to first consider just what alcohol contains, and how the body processes it. Just as protein, carbs and fat contain different caloric values and metabolic requirements for digestion, so too does alcohol. Realizing the cascade of events and demands required by the body upon alcohol consumption can lead to better understanding of why it’s so important to determine how, if any, alcohol should be incorporated in day-to-day life.

The metabolism of alcohol

Alcohol (or ethanol) contains 7 calories per gram and has no micronutrient value. The body cannot store alcohol and must metabolise it (use it for energy) when it is consumed. When you drink alcohol it goes through a process of absorption, distribution and then metabolism. Absorption is primarily through the small intestine into the veins whose first destination is the liver. This process is influenced by multiple factors including genetics, ethnicity, gender, age, body type, type of beverage, if food has been consumed and food type, drinking history and, of course, the volume of alcohol consumed. These are some of the reasons why some people can drink more than others and why alcohol consumption can have highly variable physiological responses in different people.

Alcohol metabolism occurs mainly in the liver through a number of metabolising enzymes namely alcohol dehydrogenase and aldehyde dehydrogenase. When you drink alcohol, your body makes metabolizing this alcohol a priority over all other metabolic processes, and because your body can’t store alcohol and must metabolise it right away, other metabolic processes suffer, mainly the efficient metabolism of fats and carbohydrates. This is most obviously seen on the day following excessive alcohol consumption as shakiness and a craving for sugary  foods as the body struggles to appropriately balance sugar levels in the blood.

Physical effects of overconsumption of alcohol on the body

• Temporary increase in heartbeat and blood pressure
• Peripheral blood vessels dilate resulting in heat loss and feeling of warmth (the noticeable red colour on your cheeks)
• Reduction in peripheral vision
• Difficulties in processing and recalling information 
• Significant memory loss occurs with high doses of alcohol
• To quote Shakespeare “Drink provokes the desire, but takes away from the performance”
• Poor quality sleep: decreases in REM (deep) sleep resulting in impaired concentration, tiredness, and irritability.

What is a hangover?

A hangover is a result of the excess consumption of alcohol that your body is unable to metabolise at the rate it is being consumed. Excess alcohol consumption results in dehydration (alcohol-induced diuresis, which can cause headaches), damage to the lining of your stomach that causes nausea, inflammatory responses that result in tissue damage to name but a few. Another major contributor to the hangover results from acetaldehyde, which is created when an enzyme called alcohol dehydrogenase breaks down ethanol in the liver. Acetaldehyde is a highly reactive and toxic by-product that can contribute to tissue and cell damage as a result of the formation of damaging molecules known as reactive oxygen species (ROS). When alcohol is consumed acetaldehyde dehydrogenase and glutathione (an antioxidant) are released by the body to break down acetaldehyde. When drinking moderately your body can manage the alcohol load and you don’t suffer the negative effects of a hangover. However, if you binge drink and consume more alcohol than your body can manage, this acetaldehyde, which is even more toxic than ethanol, accumulates in your body.

Eat before you drink

What you eat before you start drinking can have a huge effect on how you feel the day after. Food helps slow the absorption of alcohol, which will prolong the time it takes alcohol to reach your bloodstream. Never drink on an empty stomach. 

Keep sipping water 

Drinking water between drinks is another simple approach that will help – even a few small glasses will make a big difference to your hydration and your body’s ability to deal with the alcohol. If you can’t manage that, then at least drink a couple of glasses of water when you get home. Taking a multivitamin tablet and a pinch of salt with the water is also no harm as excess alcohol consumption depletes vitamin stores, which are important for recovery, and many vitamins are important co-factors in the metabolism of ethanol. 

Choose wisely

Another aspect is your choice of drinks. Studies have shown that certain alcoholic beverages result in worse hangovers than others. For example, whiskey, wine and certain beers can result in more severe hangovers than drinking equal amounts of vodka or other clearer alcohols. This is mainly because certain alcoholic drinks result in greater levels of acetone and acetaldehyde being produced during the metabolism of the drinks, which in turn puts greater stress on your body to remove the toxins. Hence, it makes logical sense to drink alcoholic drinks that are less of a challenge to your body. And we don’t need scientists to tell us that mixing drinks is a bad idea, so aim to stick with the same drink. A drink that works well for a lot of people is gin or vodka with a squeeze of fresh lime, ice and sparkling/soda water.

Consider non-alcohol options

There are plenty of non alcohol options out there now that can help us moderate intake while also feeling like we’re joining in on the social buzz. You might want to go out for a few alcoholic drinks but consider rotating between some 0:0 options to help reduce total consumption for the night.

Treatment

The reality is that there is no cure for the side-effects of what we know as the hangover, but there are steps you can take to support your body’s recovery from the damage that excess alcohol consumption can inflict.

Start by eating antioxidant-rich foods that help your body to reduce the inflammatory response to the alcohol. Fresh berries, green leafy vegetables, nuts, seeds, fresh oily fish and eggs are all great food options to help your body recovery. Eggs are particularly interesting because they are rich in the amino acid cysteine that is important in the liver for the metabolism of acetaldehyde.

Ginger has long been used to treat nausea and various illnesses. Being hungover often results in nausea as the body tries to dispose of toxins so ginger is an obvious food to include. Try having some fresh ginger with a green tea or in a fresh fruit smoothie. Read more about ginger in this blog. And check out our recipe page for some delicious recipes using ginger as a key ingredient. 

Fluids are a priority so begin by sipping on some water to help replace the fluids that you lost on all of those trips to the toilet the night before.  Mixing an electrolyte sachet into your water to replace lost electrolytes is a good idea if you are having trouble eating solid food. Coffee has been the go-to drink for treating hangovers for generations, mainly because it helps people feel more alert after a heavy night out. Recent research has shown that drinking coffee can help to treat hangovers due to the antioxidant compounds that freshly brewed coffee contains. In my opinion, drinking coffee to treat your hangover is a personal thing – some people find it works wonders but for others it makes them feel worse. My advice is that if you find it helps, then stick with it, but if it doesn’t help, then stick to water and herbal teas.

Exercise is the last thing most people will want to do with a hangover but some physical activity has its merits. Exercise increases your metabolic rate and blood flow, which can help speed the removal of toxins. Make sure you are hydrated before you head off for your exertions, and bring some water to replace lost fluids.

What NOT to do!

Everyone has their own ideas about what helps them get over their hangover: the big fry, greasy food, pizza, white toast, more alcohol and energy drinks are commonly mentioned as recovery foods. None of these are foods that I would recommend as although they might offer temporary enjoyment and comfort, they don’t support the recovery process and can often make you feel worse. 

Summary

Hangovers and the negative effects of alcohol can be minimised by a number of common sense strategies. However, this advice should not be seen as an endorsement of heavy drinking or a manifesto to help you “get away” with doing so. In short, eat some nutritious  slow-digesting food before you start drinking, drink in moderation, don’t mix your drinks, and drink some water while drinking and before you go to bed. If you ignore all of these things and end up drinking more than you should, don’t compound matters by eating processed foods that provide no support to your recovery. Try eating some of the suggested foods above and get out for some light exercise – even if you don’t feel better right away, you will feel better for doing something.

Visit drinkaware.ie for more information regarding responsible and safe alcohol consumption.

Sign up today to become a PRO member of the daveynutrition website! PRO members have access to an exclusive Facebook community group, weekly meal plans to suit all goals and regular articles on a wide range of health and performance topics. 

References:

1. Mewton, L., Lees, B. and Rao, R.T., 2020. Lifetime perspective on alcohol and brain health.
2. Shirreffs, S. M., & Maughan, R. J. (2006). The Effect of Alcohol on Athletic Performance. Current Sports Medicine Reports, 5(4), 192-196. doi:10.1097/01.csmr.0000306506.55858.e5
3. Topiwala, A., Allan, C.L., Valkanova, V., Zsoldos, E., Filippini, N., Sexton, C., Mahmood, A., Fooks, P., Singh-Manoux, A., Mackay, C.E. and Kivimäki, M., 2017. Moderate alcohol consumption as risk factor for adverse brain outcomes and cognitive decline: longitudinal cohort study. bmj, 357.