alcohol flush reaction


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A group of Tokyo businessmen and businesswomen toast with mugs of beer at a beer garden at the rooftop of Nihonbashi-Mitsukoshi department store in Tokyo

A study shows though that about a third of Japanese, Chinese, and Koreans respond to alcohol by turning beet red. Those fortunate enough not to turn the color of tomatoes after a drink or two laugh at the expense of those who do, and those who do shrug it off as a harmless genetic malfunction and continue with their drinking habits.

It is such a common sight to see a sea of red faces all over bars and clubs in Asia that people don’t even stop and think to question of it.

Some people believe this is due to Asians being unable to metabolize alcohol, and while it may sound scientifically accurate, it is not at all the case.

Alcohol is metabolized in the liver where it is first oxidized to acetaldehude and then converted to acetate by an enzyme called aldehyde dehydrogenase (ALDH2).

People who turn red after a few sips of alcohol have a genetic change in their ALDH2 – the gene variant causes the body to metabolize alcohol faster, but becomes less efficient in breaking down acetaldehyde. The build-up of acetaldehyde is what causes the blood vessels to dilate, and the skin to turn red.

The condition is known as alcohol flush reaction, but is more common in Asians and has thus been nicknamed the ‘Asian flush’ or the ‘Asian glow’.

Higher risk of hypertension, cancer
Recent studies have revealed evidence that ALDH2-deficient individuals are put at much higher risk of developing esophageal cancer from consuming alcohol than those with a fully active ALDH2. Esophageal cancer happens to be one of the deadliest cancers in the world, with very low survival rates.

Acetaldehyde is a metabolite of alcohol, and also an animal carcinogen and mutagen with distinguished cancer-promoting properties.

When the tissues of the upper aerodigestive tract is repeatedly exposed to acetaldehyde, the probability of DNA damage and mutation also increases.

A study done in 2013 showed that flushers who drank the same amount of alcohol as non-flushers were at higher odds of getting hypertension. (That is equivalent to more than four drinks, less than eight.)

The risk of alcohol-related hypertension was also far higher among flushers who consume more than four drinks in a week.

Treatment options
Alcohol flush is a genetic problem, hence there is currently no cure except to avoid alcohol.

While the use of antihistamines can prevent redness, there is still the fact that the body cannot break down acetaldehyde. To continue drinking means putting one’s self at risk for developing esophageal cancer and hypertension.