Overindulgence

Despite our best intentions to keep our eating and drinking under control during the festive season, is these temptations are usually near impossible to resist. We know we should consume reasonable portions and pass on seconds, but inevitably we overindulge and end up feeling miserable.

What is overindulgence?

Overindulgence is defined as excess, overeating, lack of restraint or to binge.

The liver plays an important role in the digestive process, as it assists with the digestion of fatty foods as well as the breakdown of alcohol. Excessive intake of alcohol and fatty foods may overtax the liver, causing symptoms of overindulgence, such as:

• Indigestion
• Feeling bloated
• Feeling tired
• Abdominal tenderness and discomfort
• Nausea
• Vomiting in extreme cases.

Alcohol

People differ in their tolerance level for alcohol. The dietary suggestion to the public is 1-2 small glasses of wine or 1-2 cans of beer per day – but even this is above the recommended dose for drivers these days.

Alcohol units

Always be aware of the number of alcohol units consumed. A large glass of wine, for instance, contains around 3 units. According to South Africans Against Drunk Driving (SADD) one alcohol unit will result in 0.02g in blood or 0.10 mg in breath. Three units of alcohol will translate into a blood alcohol level of 0.06 g and 0.3 mg in breath calculated for an adult male of about 68 kg who has eaten a meal. The legal limit is <0.05mg in blood and <0.24 mg in breath.

It takes 1 hour or more to get rid of 1 alcohol unit. A few examples:

Sorghum beer             1.5 units

Spirit cooler                1.5 – 1.9 units

Beer (can)                   1.5 – 1.7 units

Cider (can)                  2 units

Red wine (75 ml)        1 unit

White wine (90ml)      1 unit

Tequila (25 ml)           1 unit

Spirits (25 ml)             1 unit

The NHS (?? National Health System) recommends:

• Men should not regularly drink more than 3-4 units of alcohol a day
• Women should not regularly drink more than 2-3 units a day.

Regularly means drinking this amount every day or most days of the week.

Effects of alcohol

Alcohol is broken down by the liver, raising the liver enzymes and potentially leading to hepatitis. Most of the alcohol consumed must be metabolised in the liver; this process requires a lot of work and takes precedence over many other necessary functions. Therefore fat metabolism is decreased and fatty build-up can occur in the liver. Alcohol does not convert to glucose or glycogen, but to fat, which may later lead to obesity with high alcohol use.

Vitamin and mineral interactions show that alcohol diminishes the stores of many of the B vitamins, including vitamin B2 and B6, vitamin A, vitamin E, beta-carotene and magnesium. Alcohol consumption impairs the absorption of the enzymes in the liver that activates these vitamins, therefore, it is essential to supplement.

Hangovers

Hangovers represent the very unpleasant side-effects of drinking alcohol. Alcohol dehydrates the cells, removes fluid from the blood, swells the cranial arteries and irritates the gastrointestinal tract.

Many of the side-effects are caused from dehydration and can be remedied by taking water while drinking and also large amounts before going to sleep. Raising blood sugar levels with a snack of fruit before bed will also help.

The common hangover includes some or all of the following:

• Headache
• Poor sense of overall well-being
• Sensitivity to light and sound
• Diarrhoea
• Loss of appetite
• Trembling
• Nausea
• Fatigue
• Increased heart rate and blood pressure
• Dehydration (dry mouth, extreme thirst, dry eyes)
• Inability to concentrate
• Anxiety
• Difficulty sleeping
• Weakness.

When alcohol is consumed, it enters the bloodstream and causes the pituitary gland in the brain to block the creation of vasopressin (the anti-diuretic hormone). Therefore, the kidneys send water directly to the bladder instead of reabsorbing it into the body. According to studies, drinking about 250 ml of an alcoholic beverage causes the body to expel 800 to 1000 ml of water; four times as much liquid lost as gained.

The morning after heavy drinking, the body sends a desperate message to replenish its water supply — usually manifested in the form of an extremely dry mouth. Headaches result from dehydration because the body’s organs try to make up for their own water loss by taking water from the brain.

The frequent urination also expels salts and potassium that are necessary for proper nerve and muscle function. When sodium and potassium levels get too low, headaches, fatigue and nausea can result.

Alcohol also breaks down the body’s store of glycogen in the liver, turning the chemical into glucose and sending it out of the body in the urine. Lack of this key energy source is partly responsible for the weakness, fatigue and lack of coordination the next morning.

Because alcohol is absorbed directly through the stomach, the cells that line the organ become irritated. Alcohol also promotes secretion of hydrochloric acid in the stomach causing heartburn and eventually vomiting.

Treatment

Painkillers

Certain painkillers are more effective at combating a hangover than others. It will relieve the headache in the short-term but may have some long-term side-effects.

Combination painkillers can be helpful for a headache because it combines paracetamol or aspirin for the pain and caffeine that reduces the size of the pounding blood vessels. However, prolonged combination of alcohol and paracetamol has been shown to cause liver damage. It should also be taken into consideration that caffeine is a diuretic and can worsen the symptoms of dehydration.

Aspirin belongs to the class of anti-inflammatory drugs known as prostaglandin inhibitors. High levels of prostaglandins have been associated with increased hangover severity. In one study, participants who took a prostaglandin inhibitor before bed reported less of a headache and less nausea and thirst than those who had drunk the same amount of alcohol but did not take the prostaglandin inhibitor before bed. Aspirin may aggravate the already irritated mucosa of the stomach.

Over-the-counter remedies

Several OTC products are available to treat a variety of symptoms of a hangover.

Alcohol irritates the digestive system. This can lead to nausea and high acidity levels in the stomach the next day. If nausea is the problem, eating something bland like dry toast should help or possibly take domperidone (Motilium®) to settle the stomach. Avoid cereal because the fatty content of milk can add to queasiness. Popular remedies like Eno® and Rennie® can ease acidity.

The liver can be protected by lipotropic agents containing B-complex vitamins (Essentiale®) while Gurosan® acts as a tonic against fatigue. The KGB® pill is reported to effectively protect the body from alcohol damage.

Rehydration sachets, usually used for treating diarrhoea, can speed recovery from a hangover. This is because they contain small amounts of electrolytes that replace lost fluids quicker than water alone. Mix one sachet with water and drink before you go to bed, then do the same the morning after. Isotonic sports drinks also contain these salts.

Berocca® tablets may help to replace nutrients lost after a drinking session. The effervescent tablets contain vitamins B, C, calcium and magnesium.

Natural treatments

Natural and holistic treatments such as herbal and homeopathic remedies have proven to be highly effective in providing relief for symptoms associated with overindulgence or an alcohol hangover.

Powerful herbs such as Silybum marianus (milk thistle), Althaea officinalis (marshmallow) and Ulmus fulva (slippery elm) support the liver and promote balance and equilibrium in the body during times of excess and overindulgence.

Homeopathic remedies help the body restore balance at a cellular level. Carefully selected ingredients such as Lupulus humulus, Lobelia inflata and Nux vomica is the homeopathic hangover remedy to reduce the side-effects of a dry mouth, dry eyes, headache and nausea.

Home remedies

A number of home remedies exist and have been passed on from generation to generation – but not all of them are effective.

Hangover sufferers usually feel a bit shaky, due to a lack of sugar in the blood. A breakfast of toast with honey is best to combat symptoms, according to the Royal Society of Chemistry. This provides the body with sodium, potassium and fructose – all of which are lost after a night of boozing. Add a banana to further boost potassium and fructose levels.

A glass of pure fruit juice or a smoothie will also lift the blood sugar levels and avoid the quick drop that high sugar fixes like pastries will bring. Fruit is packed with vitamin C which helps the liver to process alcohol.

The drop in blood sugar can also lead to hunger the next day. Be careful not to have to digest  loads of fat as this will put extra strain on the already stressed digestive system. Try scrambled eggs on toast with baked beans. The beans and bread will steady blood sugar levels, while eggs contain cysteine that is thought to mop up the toxins that build up in the liver.

Prevention

Researchers have found the following general regimens minimise the symptoms of a hangover.

Before drinking

• Eat a full meal – A full stomach slows down the absorption of alcohol, giving the body more time to process the toxins. Fatty foods and carbohydrates increase this effect.
• Start with a glass of water – This ensures the body is hydrated before the diuretic effect takes hold.
• Take multivitamins – This better prepares the body for the depletion of vitamins caused by frequent urination.

While drinking

• Drink in moderation – Ideally, drinkers should limit themselves to one drink per hour because the body takes about an hour to process a single drink.
• Drink a glass of water after every alcoholic beverage – In addition to helping keep a drinker hydrated, this will give the body more time to process the alcohol, dilute the toxins and reduce irritation of the stomach. Sports drinks will replenish electrolytes, salts and sugars lost in the urine.
• Avoid mixing drinks – Drinkers generally fare better when they stick with one drink. Each new type of alcohol a drinker puts into his or her system makes the body work that much harder and puts that many more toxins in the body, leading to a more severe hangover.
• Beer has the lowest percentage of alcohol (4 to 6 percent), but is carbonated, which speeds up the absorption and can lead to toxin buildup.
• Wine has a higher percentage of alcohol (7 to 15 percent) than beer. White wine is safer than red or blush because it has fewer congeners (byproducts of fermentation). In general, the cheaper the wine, the higher the congener content and the worse the hangover.
• Liqueur has the highest alcohol content (40 to 95 percent) and therefore increases the likelihood of a hangover. Clear liquors like vodka, rum and gin are better than dark or sweet liquors like bourbon, scotch or tequila because they have fewer congeners.

After drinking

• Take two aspirin with a full glass of water before bedtime and on waking – The prostaglandin inhibitors in the aspirin can decrease hangover severity.

• Take another multivitamin – Replenishing C and B vitamins in particular can help get rid of the rest of the toxins.
• Eat breakfast – A meal that includes eggs (for the cysteine), a banana (for the potassium), and fruit juice (for the fructose) or a sports drink (for the electrolytes, sugars and salts) can get the body on the road to recovery. Keep in mind that caffeinated coffee, tea and soda will further dehydrate a drinker.

Even though one may be more tempted to overeat during the holidays, the right precautions will promote healthy digestion any time of the year when one overindulges in food and drink.