Ethanol may be the active ingredient that keeps bartenders in business, but there is often speculation as to whether mixers effect our immediate intoxication or the morning after. Does what we consume with our drinks help us to process alcohol, or should we always ask for it neat?
The Straight Talk
Intoxication is largely based on our bodies’ ability to absorb and detoxify ethanol, so it makes sense that anything that can prevent the absorption will slow its effects, and anything that speeds this process will result in our becoming drunker faster. In addition to the obvious things that affect this process—drinking on an empty stomach, drinking at a fast rate, being fatigued, to name a few—it turns out that the type of mixer does matter, at least a little, in our ability to remain standing at the end of a night.
Champagne is notorious for going to the head faster than other alcoholic beverages and a recent study, published in the Journal of Forensic and Legal Medicine, may help explain why. The researchers gave 21 people three different concoctions: straight vodka, vodka with water, and vodka with carbonated water. Using a breathalyzer, the researchers found that subjects absorbed the diluted alcohol drinks at a faster rate than the pure alcohol, and that they absorbed the carbonated drink the fastest.
Why is that? It seems that the bubbles in carbonated beverages help speed gastric emptying, which is the process of food leaving the stomach and entering the small intestine. Since the majority of alcohol enters the bloodstream from the small intestine, increased gastric emptying means a faster rate of alcohol absorption, which means feeling tipsier, earlier. Without food to help delay absorption, carbonated drinks will move even quicker to the bloodstream.
Though technically not a mixer, smoking and drinking often go hand in hand, and most “social smokers” do so when having drinks or when they’re at a bar. But do the two vices have any effect on each other?
Evidence indicates they do. A small study in the British Medical Journal measured gastric emptying and blood alcohol levels, with and without smoking. The results found that cigarette smoking slows gastric emptying and thus, delays alcohol absorption.
But that’s not all. Numerous studies have shown that nicotine and ethanol induce one of the cytochrome p450 enzymes, CYP2E1, which is involved in metabolizing foreign chemicals. Since alcohol is partially metabolized by this enzyme (the majority is done by alcohol dehydrogenase), smoking increases the rate by which ethanol is cleared from the body. Therefore, smoking not only prevents absorption of ethanol by delaying gastric emptying, it can also increase the rate at which it is cleared from the body.
For those looking to drink a lot and show little effects, this may sound like a good thing. But the synergistic actions of ethanol and tobacco are harmful. Studies in rats have shown that long-term nicotine exposure increases ethanol consumption, and this may be a similar case for humans; the rate of alcoholism is ten times higher among smokers than it is for nonsmokers.” Studies also indicate that induction of CYP2E1 by both alcohol and nicotine leads to the formation of procarcinogens, and they may work in tandem to increase the risk of liver and organ disease. Plus, you have to spend more at the bar.
Sugar—With or Without?
I’ll never forget meeting a very large, very tough man at a bar who confessed to me that because he was on the Atkins diet, he was drinking (his fifth) Captain Morgan’s and Diet Coke. Though I wanted to make fun (who drinks diet at a bar?), I thought better of it—maybe diet sodas were easier to stomach than no drinks at all.
But a recent study suggests that diet drinks may be giving drinkers more than just low cal. Comparing the rate at which alcohol was absorbed when drinking a vodka beverage with an orange flavored mixer versus a vodka beverage mixed with a diet mixer, they found that peak blood ethanol concentrations were greater with the diet drink. This may have been due to a faster rate of gastric emptying, or because sugar helps slow the rate of absorption in the stomach. Whatever the reason, diet drinks may give new meaning to cheap date.
But a common theory is that sugary drinks lead to worse hangovers. Should you avoid them for this reason?
The evidence on the subject thus far seems to conclude that mixers with sugars in them don’t result in a worse hangover. Two studies have looked at the effect of simple carbohydrates (glucose or fructose) on hangover severity. Compared with those that received alcohol alone, those that drank either a fructose or a glucose solution reported no change in subjective or objective hangover measures. However, neither study looked at mixers with high fructose corn syrup, common today in soda and packaged mixers, so it’s unclear how those may affect severity of a hangovers.
Energy drinks are popular mixers, and their high caffeine content is believed to counteract the depressant effects of alcohol. The problem, or so a few studies have shown, is that drinkers perceive themselves to be more sober than they think. (And we all know how that usually ends up.)
One study compared subjects who received a vodka drink with those that received vodka with Red Bull. The subjects who drank the energy drink reported less headaches, impairment of motor coordination, and weakness, but objective measurements showed no difference compared to the vodka alone drinkers. Breath alcohol concentrations were the same for both groups. Another study showed that energy drinkers perceived themselves to be less intoxicated, though objective error measurements were the same as the alcohol only group.
What is clear is that the type of alcohol you drink matters. Darker liquors have more congeners, which are byproducts of distillation that can cause or aggravate hangovers. In one study, 33 percent of participants who drank bourbon (which has a high congener level) had a severe hangover, compared with just 3 percent of those who consumed the same dose of vodka.
The Take Away
If you’re looking to maintain your cool while having a few, avoid carbonated drinks and diet drinks, opt instead for fruit juice mixers. Energy drinks will have you thinking you’re on top of the world, while in fact you’re stumbling like everyone else. And while it seems like smoking may decrease the rate at which your body absorbs alcohol—thereby increasing your tolerance—the synergistic effect may increase your propensity for organ damage, and because you may end up drinking more, hangovers. Finally, though we often attribute sugar as a reason for a bad hangover, there’s no evidence of this, but darker drinks will make the morning after a bit rougher. And although we can troubleshoot our mixers and bar-time accessories, our level of intoxication and severity of hangover is ultimately dependent on one thing—the amount of alcohol we ingest.
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Say What? is a series created to support or debunk common health myths. If you have a question for Brie, please send it to her in care of the editor at email@example.com.