Part two can be found here http://highbrowpaleo.wordpress.com/2012/03/30/the-highbrow-paleo-guide-to-binge-drinking-addendum-further-discoveries-and-thanks-i-wuv-u-guys/ (seriously consider reading it, the percentage of people who read the second one is low and it is important)
Disclaimer: If you are a recovering alcoholic/recovering from a health issue or are a modern puritan, this blog post may not be suitable for you. In the case of 1. Good luck. In the case of 2. Get ye gone! I’m sure even reading this blog is sinful in some way. Are you still here? Get! Shoo!
“Paleo diet? But I like booze!”
Is this you on New Year's Eve?
And I like it too. Hi I’m Stabby and I love the sauce, but I also like to be healthy. It is sometimes assumed that these things are mutually exclusive, and that anything more than an ever so modest consumption of alcohol is a deal-breaker when it comes to our health. The notion that excessive drinking is damaging to health permeates the culture, and unlike some common beliefs about health, there is much truth to it. The list of maladies caused by excessive alcohol consumption is quite long, and excessive drinking is no laughing matter. However, some of us have social lives that may occasionally lead us into situations of being passed out on a bathroom floor with clever sharpie artistry augmenting the beauty of our visages. Shit happens, and that is the point of this blog post. In this post I’m not encouraging binge-drinking, just suggesting ways of ameliorating the damage when shit happens. Hot tub parties happen, and judgmental parents in law happen. Some of us have a love affair with booze that isn’t going to go away, but it is my belief that as long as we exercise a little bit of restraint and take some precautionary measures we can have our booze and drink it, too.
But the thing is that various nutritional interventions, particularly nutritional supplements, have a licensing effect on people leading them to feel invulnerable to unhealthy practices like smoking, eating junk food, and drinking, and they take a healthy practice as a license to do more of those unhealthy things. It is a tempting response to the promises of damage reduction, but no matter what we do, we will never completely eliminate alcohol’s effects. “I’m 50% protected against the ill-effects of alcohol, so I can drink 50% more!” is bad reasoning, and it is easy to succumb to it. We want to make drinking less damaging, but we don’t want to use that as a reason to be reckless. Just because you have a helmet doesn’t mean you should run into a wall.
Whew, okay then. I really hate moralizing, so that’s the last of it you’ll hear from me!
Apparently this blog is called Highbrow Paleo, so I’m going to quickly address the Paleotude of alcohol. Our gut flora produce a small amount of ethanol, about 3g, every day. So it isn’t like ethanol is this completely foreign substance that we don’t know how to handle like synthetic trans fats; far from it. Drinking alcohol provides a lot more alcohol than we would have seen during the bulk of evolution, but if the metabolic pathways exist already then there isn’t as much reason to think that alcohol is something that we can’t metabolize. There is definite reason to think that it is problematic, but the degree to which it is depends upon the body’s response to it, and that’s what I intend to investigate in this post. Alcohol doesn’t belong in the same category as trans fats, and while it has been tied to many diseases it is my belief that a generally unhealthy lifestyle deficient in nourishment and high in unhealthy foods, combined with a lifestyle that is at odds with our biology, is the driving factor that determines alcohol’s toxicity. It is still toxic no matter what, but less toxic when we hack our biology with nutrition and other tools. This is a guide on how to do so.
Too much ethanol is toxic, but why? There are many reasons, but the main reason cited has to do with its metabolism inside the liver. Ethanol is metabolized to acetaldehyde, and then hopefully to acetate, because acetaldehyde is very toxic; it is highly reactive and is the main reason why alcohol produces liver damage. When metabolism of acetaldehyde is sluggish, meaning that the aldehyde dehydrogenase enzyme is downregulated, it is a very slow conversion and we see acetaldehyde accumulate all over the place. In the liver of course, in the blood, the heart, and the brain. We all know that feeling and it isn’t a pleasant one. We want to reduce the amount of acetaldehyde that gets produced, and detoxify the acetaldahyde that does get produced while preventing the damage it does while it’s on the loose. Our bodies are well equipped to do this, but if they aren’t properly nourished or if the immune system is sloppy and sluggish, then repairs will turn into demolition and we won’t be built up again but torn down.
So we need to upregulate the aldahyde dehydrogenase enzyme first and foremost. This will clean up acetaldehyde and reduce the toxicity of alcohol by converting it into a more benign molecule. By far the most effective way I know how to do it is to take pantethine. Pantethine is the precursor of coenzyme A, which is needed for various metabolic conversions. One of them is the Acetaldehyde –> Acetate –> Acetyl CoA pathway, and its effects on reducing acetaldehyde in the blood are quite pronounced (1). Unfortunately, it is only effective in some people; for those who have significant facial flushing from alcohol consumption, pantethine won’t do much to reduce acetaldehyde after drinking. But for everyone else it is excellent for reducing the toxic acetaldehyde load. Those who get very flushy are out of luck here, and aren’t the best candidates to be drinking to the extreme in the first place, but then again there is much that can be done to make drinking healthier for these people, which takes us to the heart of the topic.
Even if we can find biohacks to reduce the amount of acetaldehyde we have to deal with, we can’t eliminate its production entirely, so we must protect against it and detoxify it. The best way to do this is by supporting the body’s natural defenses, the sulfur-containing antioxidant enzymes, namely glutathione, one of our best antioxidants and detoxifiers which works in tandem with the rest of our antioxidant team.
Much of the work in the field of alcohol research is done in rodents, because apparently it is unethical to try to kill people with booze. The evidence that can be garnered from rat studies isn’t a perfect reflection of what would happen in humans, but it can give us good grounds to experiment for ourselves, and usually the mechanisms are the same in humans and rats and I’m confident that supporting the same defenses in humans will produce the same results in the major aspects discussed.
The format of these studies usually goes something like this: A big mean scary scientist guy tries to kill some rats with toxic doses of booze, oh sure it’s fun at first and every rat gets lucky, but sooner or later the alcohol takes its toll and the rats in the control group get diseases. The rats in the intervention group get the protective nutrients, and we compare the difference in health between them. Science, bitchez, it, like, works!
Significant improvements in health after alcohol feeding have been seen with basic combinations of nutrients that you can get at a supplement store. The scientists in reference (2) had this to say in their summary:
“Greatest protection against anesthesia and lethality was obtained at 2 mM/kg with each of the following:l-cysteine N-acetyl-l-cysteine, thiamin HCl, sodium metabisulfite, andl-cysteic acid. A combination of l-ascorbic acid with l-cysteine, and thiamin·HCl at reduced dose levels (2.0, 1.0 and 0.3 mM/kg, respectively) gave virtually complete protection.”
Lucky rats, take that Mr. Reaper! L-cystine and n-acetyl-l-cysteine are precursors to glutathione, and ascorbic acid (Vitamin C) is important for glutathione’s redox. Thiamin, vitamin B1, appears to be important in protecting against acetaldehyde toxicity, and is greatly reduced by consumption of large amounts of alcohol. Sulfur (MSM in supplement form) improves glutathione status as well, acting as a rate-limiting factor for its synthesis from amino acids. We want to be supporting the synthesis of glutathione and our other antioxidant enzymes daily with a healthy diet and reasonable supplementation. But if we’re drinking frequently, supplementation is going to be a boon. Physical activity prior to drinking is also very protective as it increases production of antioxidant enzymes and protects against ethanol toxicity in the liver and the brain. (3) (4) (5)
The active component of milk thistle, silymarin, has a pronounced protective effect on the liver when it is under stress from alcohol. It too works to preserve the health of the liver and its antioxidant enzymes (6), so do consider it.
Alcohol is intimately tied to another aspect of the cirrhosis spectrum diseases called fatty liver disease. Some of you may have heard about non-alcoholic fatty liver disease, which some believe sugar to play a role in. It is by far the less fun fatty liver disease to give yourself. The gist of it is that fat accumulates in the liver (steatosis) where it impairs its functioning, the liver becomes inflamed (steatohepatitis) as all of the damage needs to be repaired, but the dysfunctional immune system ends up being the nail in the coffin of the liver. There is fibrosis, an abnormal growth of fibrous connective tissue, and our liver becomes very insulin resistant, creating problems elsewhere. If we’re going to be abusing our livers, we should at least be sure that our immune system is on our side and we are doing everything we can to control inflammation. We’re degenerates, not imbeciles, thank you very much!
Possibly the biggest part of that is avoiding excessive amounts of omega-6 fatty acids, particularly the ones that have been oxidized and come from seed oils. Mice fed a diet high in omega-6 fatty acids develop the final stage of non-alcoholic fatty liver disease (and were lucky to not get any alcohol or it would have been worse) but conversely, when they are fed coconut oil or other saturated fatty acids it is actually protective due to the generation of adiponectin, a protective hormone that prevents insulin resistance and is a powerful anti-inflammatory signaler (7) (8). Adiponectin is lower in people with a lot of visceral fat, people eating low fat diets, low fiber intake, low activity level, excessive inflammation, and other generally unhealthy practices (9) (10). But I’m assuming that you’re health-conscious, probably following the paleo diet, and don’t need to be told to do any of these things. Regardless, you absolutely can’t be low in choline or your liver won’t be able to metabolize fat (11), so eat your eggs or else! Keeping the liver in good shape allows it to deal with a toxic load when it happens.
The list of maladies associated with excessive consumption of alcohol also includes brain damage and damage to the mucosal barrier of the gut, leading to a permeable or “leaky” gut. Reducing and detoxifying acetaldahyde will play a big role in preventing this, but we also want to enhance cellular defenses as much as we can. We already touched on glutathione, and it has also been found that polyphenols in strawberries protect the mucosa through stimulating production of defenses (12), and zinc has also been shown to be protective (13) (14). Various amino acids like glycine and glutamine will help to repair the mucosa, as well as Vitamin A. Carnosine, found in red meat, is an excellent protector of the brain (15) As are all sorts of berries. These things are all prevalent in the paleo diet for most, but it may be wise to ensure an especially high intake around the time of drinking or afterwards. Bone broth and gelatin have significant amounts of glycine, glutamine, and arginine which protect the gut and liver from alcohol as well (16) (17). It would be a great next-morning breakfast along with coffee or tea.
There are many nutrients that can curtail the inflammatory cascade that occurs when the liver is damaged, and while the paleo diet is generally strongly anti-inflammatory, extra ammunition will help nearly anyone. Ginger tea, quercetin, curcumin, resveratrol, and various herbs and spices protect the liver against ethanol toxicity and are helpful prior to or after a night of drinking (10) (18) (19) (20) (21). Red wine and quercetin are apparently a match made in heaven as red wine facilitates the absorption of quercetin (22). Score one more for booze! How’s that for healthy pills in your drink? Bound to confuse somebody, but not you.
Of course we want to stress moderation if possible, but if you find yourself just a little too drunk, consuming sugar will eliminate the alcohol from your blood faster (23). I recommend fresh fruit, which also has other protective elements.
Prior to drinking
- Glutathione-supporting nutrients: n-acetyl cysteine 500mg, alpha-lipoic acid, 500mg, MSM powder or comparable amount of sulfur from food – 5g
- Thiamin 100mg
- Choline 500mg
- Carnosine 500mg
- Milk thistle 500mg
- All kinds of spices
- Vitamin E (gamma tocepherol and tocetrienols, not just alpha-tocepherol and definitely not the synthetic form)
During or just before drinking
- Curcumin 500mg
- Quercetin 500mg
- Ginger tea
- Resveratrol 200-500mg
- Anything else that is anti-inflammatory
- Vitamin C
- Vitamin E
The next day
- Tea including ginger tea
- Gelatin/bone broth
- All other nutrients that were consumed prior to drinking, because they will be low
This isn’t an exhaustive presentation of ways to protect yourself from alcohol’s ill-effects, and everyone should search further to find more remedies that work. There are other mechanisms that I haven’t touched upon, but the tips and tricks proposed within this article are likely to be protective in other ways that weren’t mentioned. If you have a particularly good remedy please share it, and have a happy holiday season, hopefully you will remember it! Cheers.