A Correlation between Alcohol Consumption and Obesity

Nikita Rizky Arimami 030.08.180

FACULTY OF MEDICINE TRISAKTI UNIVERSITY JAKARTA 2011

PREFACE
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This paper

titled the correlation between A Correlation between Alcohol

Consumption and Obesity was created for the purpose of completing the assignment for the Medical English III in Trisakti University, Faculty of Medicine. The reason why this particular tittle was chosen is to know alcohol consumption can caused obesity . By reading the content of this paper, I hope reader will know how alcohol efeected body and how alcohol can caused obesity. Many appreciation to those who have helped in the process of making this paper especially dr. Oktavianus Ch. Salim MS who have agreed upon this title which makes this paper can be done. And so my apologies for any errors contained in this paper for it is created during a learning process.

Jakarta, 12 Juni 2011 Nikita Rizky A.

ABSTRACT

Background : Obesity is an important public health problem. However, the effects of alcohol use on the risk for obesity have not been thoroughly explored. This study focuses on how frequency of alcohol use is related to the risk of obesity . Method of Writing : The creation of this paper is made possible with the aid of various sources such as the library, medical website, and medical journal. Keywords: Alcohol, Obesity, BMI

I.INTRODUCTION Obesity is the fifth leading risk for global deaths. At least 2.8 million adults die each year as a result of being overweight or obese. In addition, 44% of the diabetes burden, 23% of the ischaemic heart disease burden and between 7% and 41% of certain cancer burdens are attributable to overweight and obesity.(1) In 2010, around 43 million children under five were overweight. Once considered a highincome country problem, obesity are now on the rise in low- and middle-income countries, particularly in urban settings. Close to 35 million overweight children are living in developing countries and 8 million in developed countries.(1) The association between alcohol intake and body weight has been investigated in several studies. Alcoholic beverages are energy dense and are probably not substituting food but rather added to the total daily energy intake. Also, inhibition of fat oxidation might occur as a consequence of the antilipolytic properties of metabolites from alcohol degradation. These features could potentially promote fat storage and hence the risk of developing obesity However, results from studies on alcohol intake and body weight are not conclusive. (3)
(2)

II.ALCOHOL Although, the nomenclature Alcohol denotes the entire family of organic compounds like methanol, ethanol, isopropanol, in more general terms we denote Ethanol when we discuss alcohol, the most commonly ingested of these chemicals.(4) Alcohol, Ethanol (C2H5OH) in specific, is an organic compound made up of molecules of Carbon, Hydrogen, and Oxygen. It is highly volatile liquid with distinct odor having great affinity towards water. In fact, its high solubility in water makes it one of the most potent depressant of human central nervous system. It is a powerful hypnotic sedative with an array of side effects. The amount to which extent the central nervous system is affected depends upon the concentration of alcohol in blood, usually denoted by BAC (Blood Alcohol Content). Alcohol can be a significant source of calories particularly if you overindulge. The average twelve ounce beer has around 130 calories; while the average serving of wine will add around 120 calories to your daily total. Obviously, if you drink a few beers or sip several glasses of wine before a meal, you'll have taken in a significant number of calories before you even start to eat. If you do this on a consistent basis, you can see how the calories can add up. The extra calories consumed by drinking alcohol may lead to weight gain and eventually, obesity. According to BBC News, many people are unaware of just how many calories alcoholic beverages actually contain. Over time, the extra caloric intake from beers, wines and hard liquors can lead to obesity.(5)
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II.1 Alcohol Metabolism Metabolism is the body's process of converting ingested substances to other compounds. Metabolism results in some substances becoming more, and some less, toxic than those originally ingested. Metabolism involves a number of processes, one of which is referred to as oxidation. Through oxidation, alcohol is detoxified and removed from the blood, preventing the alcohol from accumulating and destroying cells and organs. A minute amount of alcohol escapes metabolism and is excreted unchanged in the breath and in urine. Until all the alcohol consumed has been metabolized, it is distributed throughout the body, affecting the brain and other tissues(6)

Blood alcohol concentration (BAC) after the rapid consumption of different amounts of alcohol by eight adult fasting male subjects.* (Adapted from Wilkinson et al., Journal of Pharmacokinetics and Biopharmaceutics5(3):207-224, 1977.) 100 mg% is the legal level of intoxication in most States. 50 mg% is the level at which deterioration of driving skills begins. (JAMA 255:522-527, 1986.) *If the same number of drinks are consumed over a longer period of time, BAC's will be lower.

II.2 The Metabolic Process When alcohol is consumed, it passes from the stomach and intestines into the blood, a process referred to as absorption. Alcohol is then metabolized by enzymes, which are body chemicals that break down other chemicals. In the liver, an enzyme called alcohol dehydrogenase (ADH) mediates the conversion of alcohol to acetaldehyde. Acetaldehyde is rapidly converted to acetate by other enzymes and is eventually metabolized to carbon dioxide and water. Alcohol also is metabolized in the liver by the enzyme cytochrome P450IIE1 (CYP2E1), which may be increased after chronic drinking. Most of the alcohol consumed is metabolized in the liver, but the small quantity that remains unmetabolized permits alcohol concentration to be measured in breath and urine. The liver can metabolize only a certain amount of alcohol per hour, regardless of the amount that has been consumed. The rate of alcohol metabolism depends, in part, on the amount of metabolizing enzymes in the liver, which varies among individuals and appears to have genetic determinants . In general, after the consumption of one standard drink, the amount of alcohol in the drinker's blood (blood alcohol concentration, or BAC) peaks within 30 to 45 minutes. (A standard drink is defined as 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80-proof distilled spirits, all of which contain the same amount of alcohol. The BAC curve, shown on the
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previous page, provides an estimate of the time needed to absorb and metabolize different amounts of alcohol .Alcohol is metabolized more slowly than it is absorbed. Since the metabolism of alcohol is slow, consumption needs to be controlled to prevent accumulation in the body and intoxication.(7) II.3 Factors Influencing Alcohol Absorption and Metabolism Food. The rate at which alcohol is absorbed depends on how quickly the stomach empties its contents into the intestine. The higher the dietary fat content, the more time this emptying will require and the longer the process of absorption will take. One study found that subjects who drank alcohol after a meal that included fat, protein, and carbohydrates absorbed the alcohol about three times more slowly than when they consumed alcohol on an empty stomach. Gender. Women absorb and metabolize alcohol differently from men. They have higher BAC's after consuming the same amount of alcohol as men and are more susceptible to alcoholic liver disease, heart muscle damage, and brain damage. The difference in BAC's between women and men has been attributed to women's smaller amount of body water, likened to dropping the same amount of alcohol into a smaller pail of water. An additional factor contributing to the difference in BAC's may be that women have lower activity of the alcohol metabolizing enzyme ADH in the stomach, causing a larger proportion of the ingested alcohol to reach the blood. The combination of these factors may render women more vulnerable than men to alcohol-induced liver and heart damage.

III.OBESITY III.1 Definition Obesity is defined as abnormal or excessive fat accumulation that may impair health. Body mass index (BMI) is a simple index of weight-for-height that is commonly used to classify overweight and obesity in adults. It is defined as a person's weight in kilograms divided by the square of his height in meters (kg/m2). (1) The WHO definition is:

a BMI greater than or equal to 25 is overweight a BMI greater than or equal to 30 is obesity.

BMI provides the most useful population-level measure of overweight and obesity as it is the same for both sexes and for all ages of adults. However, it should be considered a rough guide because it may not correspond to the same degree of fatness in different individuals. III.2 Etiology The fundamental cause of obesity is an energy imbalance between calories consumed and calories expended. Globally, there has been:

an increased intake of energy-dense foods that are high in fat, salt and sugars but low in vitamins, minerals and other micronutrients; and

a decrease in physical activity due to the increasingly sedentary nature of many forms of work, changing modes of transportation, and increasing urbanization.

Changes in dietary and physical activity patterns are often the result of environmental and societal changes associated with development and lack of supportive policies in sectors such as
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health, agriculture, transport, urban planning, environment, food processing, distribution, marketing and education.(8) III.3 Complications Raised BMI is a major risk factor for noncommunicable diseases such as (9):

cardiovascular diseases (mainly heart disease and stroke), which were the leading cause of death in 2008;

diabetes; musculoskeletal disorders (especially osteoarthritis - a highly disabling degenerative disease of the joints);

some cancers (endometrial, breast, and colon).

The risk for these noncommunicable diseases increases, with the increase in BMI. Childhood obesity is associated with a higher chance of obesity, premature death and disability in adulthood. But in addition to increased future risks, obese children experience breathing difficulties, increased risk of fractures, hypertension, early markers of cardiovascular disease, insulin resistance and psychological effects. III.4 Management obesity, as well as their related noncommunicable diseases, are largely preventable. Supportive environments and communities are fundamental in shaping peoples choices, making the healthier choice of foods and regular physical activity the easiest choice, and therefore preventing obesity. At the individual level, people can:
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limit energy intake from total fats; increase consumption of fruit and vegetables, as well as legumes, whole grains and nuts;

limit the intake of sugars; engage in regular physical activity; achieve energy balance and a healthy weight.

Individual responsibility can only have its full effect where people have access to a healthy lifestyle. Therefore, at the societal level it is important to:

support individuals in following the recommendations above, through sustained political commitment and the collaboration of many public and private stakeholders;

make regular physical activity and healthier dietary patterns affordable and easily accessible too all - especially the poorest individuals.

The food industry can play a significant role in promoting healthy diets by:

reducing the fat, sugar and salt content of processed foods; ensuring that healthy and nutritious choices are available and affordable to all consumers;

practicing responsible marketing; ensuring the availability of healthy food choices and supporting regular physical activity practice in the workplace.

IV. CORELATION Alcohol can be a significant source of calories, but the calories couldnt used effectively to made energy, meanwhile inhibits other energy to used by cell. The body felt that
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the calories is enough but the same time the calories couldnt used to made some energy so that the person had encouraged to eat more and more. Alcoholic beverages are energy dense and are probably not substituting food but rather added to the total daily energy intake. Also, inhibition of fat oxidation might occur as a consequence of the antilipolytic properties of metabolites from alcohol degradation. These features could potentially promote fat storage and hence the risk of developing obesity (2) Although might assume that alcohol would cause significant weight gain under these circumstances, some studies have actually shown that drinking moderate amounts of alcohol may lower the risk of weight gain. One study published in the American Journal of Epidemiology showed that women who drink one to seven alcoholic drinks per week had a lower risk of gaining weight than women who abstained completely from alcohol. The reason for this is unclear, although various theories have been proposed. It's possible that women who consume alcohol on a regular basis may be less inclined to eat other high calorie, sweet foods. Some studies have also shown that alcohol can slightly boost the metabolic rate which could lead to weight loss. (10)

V.CONCLUSION Possible effect of alcohol on weight development might be mediated by other habits, such as smoking, eating and physical activity. The key in determining whether alcohol causes weight gain may lie in how much and how often it's consumed. It's possible that light to moderate alcohol consumption may actually have some benefit when it comes to alcohol use
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would most likely promote weight due to the excess calories taken in.controlling weight, although studies addressing this issue are still ongoing. Higher levels of of alcohol use would most likely promote weight due to the excess calories taken in.

VI. REFERENCES

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WHO.Obesity and Overweight. Available at : http://www.who.int/mediacentre/factsheets/fs311/en/index.html . Accessed June 3th 2011 J S Tolstrup, B L Heitmann, A M Tjnneland, O K Overvad, T I A Srensen ,M N Grnbk. The relation between drinking pattern and body mass index and waist and hip circumference. International Journal of Obesity.2005. Available at: http://www.nature.com/ijo/journal/v29/n5/full/0802874a.html. Accessed June 3th 2011 Mikyung Ryu, Heejin Kimm, Jaeseong Jo, Sun Ju Lee, Sun Ha Jee. Association between Alcohol Intake and Abdominal Obesity among the Korean Population. Epidemiology and Health.2010. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2984859/pdf/epih-32-e2010007.pdf. Accessed June 3th 2011
1. Bosron, W.F.; Ehrig, T.; & Li,T.-K. Genetic factors in alcohol metabolism and

alcoholism. Seminars in Liver Disease 13(2):126-135,1993 Sarah Davis. Facts on Alcohol and Obesity. Available at: http://www.livestrong.com/article/69121-alcohol-obesity/. Accessed June 3th 2011
2. Wallgren, H. Absorption, diffusion, distribution and elimination of ethanol:

Effect on biological membranes. In: International Encyclopedia of Pharmacology and Therapeutics. Vol. 1. Oxford: Pergamon, 1970. pp. 161-188

3. Jones, A.W., & Jnsson, K.A. Food-induced lowering of blood-ethanol profiles

and increased rate of elimination immediately after a meal. Journal of Forensic Sciences 39(4):1084-1093, 1994.
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Dixon JB, Dixon ME, O'Brien PE.Alcohol Consumption in the Severely Obese: Relationship with the Metabolic Syndrome. Obesity Research (2002). Available at: http://www.nature.com/oby/journal/v10/n4/full/oby200233a.html. Accessed June 3th 2011 Fauci, Braunwald, Kasper, Hauser, Longo, Jameson, Loscalzo. Harrisons Principles of Internal Medicine.Vol II. Ed 17. 2008.McGraw-Hill p 462-464 Leong K. Does Alcohol Cause Weight Gain?. Available at: http://www.associatedcontent.com/article/1567107/does_alcohol_cause_weight_gain.h tml?cat=51. Accessed June 3th 2011

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