22:56 GMT, 23 December 2013
00:12 GMT, 24 December 2013
Alcohol irritates the stomach and disrupts sleep, causing nausea and exhaustion the next day
Waking up with a pounding head, a delicate stomach and mouth as dry as a desert is an all-too-familiar scenario for many over the festive season.
It’s not just the pain you have to worry about.
Having a hangover could also make you a danger behind the wheel, suggests a recent study from the University of the West of England, which found that hungover drivers made significantly more mistakes even once the alcohol had cleared their system.
Hangovers occur for several reasons.
As alcohol is a diuretic (triggering the production of urine), it causes dehydration, which in turn leads to symptoms such as headache, dry mouth, reduced concentration and irritability.
Meanwhile, blood-sugar levels drop because the body produces too much insulin in response to the high sugar content of alcohol.
This contributes to a throbbing head, as well as driving the rampant hunger that many drinkers experience.
Alcohol also irritates the stomach and disrupts sleep, causing nausea and exhaustion the next day.
Many people have their theories about what causes hangovers, how to avoid them and how best to treat them. We talked to the experts to find out the truth behind the popular theories …
YES, SOME PEOPLE ARE IMMUNE TO HANGOVERS
What’s perceived as a high tolerance may be a sign the body is already damaged by alcohol
We all know someone who boasts ‘I never get hangovers’ as they merrily sink pints. But are they kidding themselves?
‘It’s true that some people are less prone to hangovers,’ says Dr Sarah Jarvis, a GP and medical adviser to the charity Drinkaware.
This is partly because some people are for some reason less prone to headaches when dehydrated.
Others may be less susceptible to the effects of acetaldehyde, the toxic substance produced when alcohol is first metabolised in the liver.
‘But that does not mean they are immune to the longer-term effects of alcohol,’ warns Dr Jarvis.
‘One concern is people assume because they have high tolerance or relatively high threshold to hangovers they won’t come to harm.
‘Ironically, they will probably come to more harm, because hangovers should reduce the likelihood of drinking to excess.’
Indeed, what’s perceived as a high tolerance may be a sign the body is already damaged by alcohol.
‘The more alcohol your body processes, the more your tolerance to short-term effects increases,’ says Dr Jarvis. ‘But long-term damage to the body depends on how much alcohol you have processed in your lifetime.’
The specific symptoms suffered during a hangover may vary for individuals, too.
‘One person’s threshold for a headache trigger may be higher, but they might be more likely to suffer nausea or other symptoms,’ explains Dr Andrew Dowson, director of headache services at King’s College Hospital, London.
It is also true that some ethnic groups suffer more after drinking because of their genetic make-up.
‘We know East Asians have very low levels of acetaldehyde dehydrogenase (an enzyme that breaks down acetaldehyde), which can make them get drunk more quickly and contribute to hangovers,’ says Dr Jarvis.
OLDER DRINKERS COPE BETTER
We tend to expect young people to be better at coping with excess drinking, but new research suggests the reverse may be true.
In a study of 50,000 adults, researchers in Denmark found older people had less severe hangover symptoms after a heavy night: 21 per cent of women aged 18 to 29 suffered nausea with a hangover, compared with 3 per cent of women aged 60 and over.
And 62 per cent of men in the young age group had exhaustion when hungover, compared with 14 per cent of those over 60.
This is partly because younger people binge drink more intensely (typically nine drinks in a session, compared with six drinks for older people). But another explanation is that older drinkers are more tolerant to short-term effects, having drunk more over their lifetime.
Of course, it may also be because they take better precautions thanks to the wisdom of experience.
And natural selection could mean only those who experience bearable hangovers are likely to continue drinking later in life, researchers said.
But despite these findings, the jury is still out on older people suffering less.
As Dr Jarvis says: ‘There is some suggestion that you suffer worse hangovers as you get older because your body’s production of acetaldehyde dehydrogenase decreases.’
THE REAL REASON WOMEN SUFFER
A study found women get drunk faster and their hangover symptoms were more severe
If you’re a sturdy woman, you might think you can drink any scrawny man under the table — but don’t be fooled, says Dr Jarvis.
‘Even if a woman is the same size as a man, she will have more body fat and less body water.
‘Since alcohol is only distributed in body water, you’ll have a higher proportion of it in your bloodstream.’
This, she says, may be why women tend to suffer from worse hangovers.
In a 2006 study of more than 1,200 students at the University of Missouri-Columbia, researchers found that not only do women get drunk faster, but their hangover symptoms were more severe, even though they drank the same amount as the men.
SPRITZERS MAKE THINGS WORSE
There is some evidence that bubbly drinks intoxicate you more quickly than flat drinks.
A study at the University of Surrey in 2001 found volunteers given two glasses of fizzy champagne had an average of 0.54 milligrams of alcohol per millilitre of blood after five minutes, while those given the same amount of flat champagne had 0.39 milligrams.
One theory is the carbon dioxide in bubbles speeds up the flow of alcohol into the intestine.
Indeed, turning your wine into a spritzer may not be the restrained option you think, as the researchers said mixing fizzy water with wine could have a similar effect.
The principle could apply to all carbonated drinks, including beer, adds Dr Emma Derbyshire, a senior lecturer in nutrition at Manchester Metropolitan University and independent adviser to the Natural Hydration Council.
Although this won’t necessarily increase the severity of your hangover, getting drunk faster may impair your judgment more quickly and spur you to drink more, Dr Jarvis warns.
DARKER DRINK IS MORE DANGEROUS
It’s true that certain drinks will result in a worse hangover, say experts.
A hangover is due mainly to dehydration, and the effect of impurities and preservatives in the drinks. Dr Derbyshire says: ‘Certain alcohols contain chemicals called congeners [produced during fermentation] that give them their flavours and colours.
‘The darker the alcohol, then the higher the congener content — and these are thought to contribute to headaches and hangover symptoms, although it’s not clear why.’
So red wine or brandy could make your head throb more than gin.
This is borne out by a U.S. study, which found that whisky drinks caused significantly worse hangovers than vodka, when at the same blood alcohol level.
And will cheap plonk result in more pain than a pricey wine?
‘It’s possible that cheaper brands have a higher congener content — perhaps because the distillation process hasn’t filtered them out,’ suggests Dr Derbyshire.
THE ‘DON’T MIX YOUR DRINKS’ MYTH
There’s a popular assumption that mixing drinks will make your hangover worse.
‘The idea behind this is probably that the greater the variety of drinks you have, the more likely you are to take in different impurities and a higher number of congeners,’ says Dr Jarvis.
However, sticking to the same drink doesn’t mean you’ll escape a sore head in the morning. It depends how much of it you drink and how many impurities that drink contains.
DOES LINING YOUR STOMACH WORK?
Some people say you should have two spoonfuls of mashed potato with plenty of butter before a drink
It’s sensible to avoid drinking on an empty stomach, as food slows down the speed at which alcohol gets into the system.
Dr Nick Read, a gastroenterologist and medical adviser to the IBS Network, says: ‘It’s not about lining your stomach as such — but if you put fat in your stomach before a drink, once it gets into the duodenum [the first part of the small intestine] it will slow down gastric emptying, so that drink will not be emptied so quickly from the stomach.
‘This means you’ll get drunk less quickly, which could mean a milder hangover.
‘In some cultures, they drink olive oil before alcohol for this reason.
‘The same applies to mashed potatoes: some people say you should have two spoonfuls with plenty of butter before a drink.
‘It’s the fat in the butter that’s important.’
IS BEER SAFER THAN WINE?
We’ve all heard the saying: ‘Beer before wine and you’ll feel fine, but wine before beer and you’ll feel queer.’ And although there’s no evidence to support this, there are many theories as to how it came about.
‘A possibility is that beer has a higher water content than wine, so you’re getting more fluids into your body if you drink beer,’ says Dr Derbyshire.
People tend to drink more at the beginning of a session to quench their thirst, so beer may keep you slightly better hydrated.
‘But rather than have beer first, it’s best to have some water before drinking any alcohol,’ she advises.
PAINKILLERS CAN ADD TO YOUR WOE
Tempting as it may be to nurse a sore head with a Bloody Mary, experts say this only delays the onset of hangover symptoms.
‘If you drink more alcohol, you may not notice the hangover so much, as alcohol has a sedative effect and may distract you from the pain,’ says Dr Jarvis.
Painkillers may help — but you should exercise caution.
Dr Jarvis explains: ‘Anti-inflammatories, such as ibuprofen, are more effective painkillers for headaches than paracetamol, but if you already have inflammation of the stomach (caused by the alcohol), these drugs could make indigestion worse.’
DRINK A GLASS OF MILK AS YOU HEAD TO BED
Experts agree drinking water before you go to bed will help stave off some of the damaging effects of dehydration, which contributes to a hangover.
But migraine specialist Andy Dowson recommends milk before bed instead.
‘Drinking milk will combat many symptoms,’ he says. ‘Hangovers are thought to be triggered by low blood sugar and dehydration, both of which are potent triggers for migraine — so if you can stomach it, drink milk before sleeping.
‘This will give you the volume of fluid as well as help get your blood sugar levels back up.
‘Milk is also an anti-diuretic (stopping kidneys producing urine).’
This should mean fewer trips to the loo, minimising sleep disruption.
The fact that milk is alkaline might also counteract any inflammation of the stomach caused by excess acidity.