Are you the sort who feels rotten after just one glass of wine, while your friends can down half a bottle or more and feel just fine?
There are many reasons people react to small amounts of booze badly — even the make-up of your gut microbes can play a part — and there are steps you can take to help.
People who feel ill after only one or two drinks often presume they have some sort of allergy to alcohol. In fact, a true allergy is really rare and the symptoms, such as difficulty breathing and abdominal pain, for example, tend to be severe enough to ensure you never touch a drop again.
More common is an alcohol intolerance. This is usually linked to a genetic fault, which means you produce a less active form of an enzyme called aldehyde dehydrogenase.
Are you the sort who feels rotten after just one glass of wine, while your friends can down half a bottle or more and feel just fine?, writes Dr Megan Rossi (pictured)
The liver initially breaks alcohol down into acetaldehyde and, at this point, this enzyme should get to work turning it into acetic acid (the main component of everyday vinegar).
If aldehyde dehydrogenase doesn’t do its job, then acetaldehyde, which is toxic, lingers in the body, causing a cascade of symptoms that often include nausea and vomiting as the body tries to expel it — as well as headaches. It can also cause the blood vessels to widen, leading to facial flushing and a stuffy nose.
How much alcohol anyone with an intolerance can withstand before feeling sick varies — I see people in clinic who can hold a few glasses fine and others who can barely sniff a drink. I’m afraid the only way round this one is to find your limits.
For others, it may be a component of booze — not the alcohol itself — that’s the problem: for instance, the gluten in beer or sulphites added as preservatives to wines and also present on the grapes (levels tend to be higher in white wines).
Sulphites can trigger a range of symptoms including stuffy nose, wheezing, hives and bad hangovers — people with eczema and asthma can be especially sensitive to them.
Swapping to organic wines might help — while they’ll have some sulphites from the grapes, they won’t have added sulphites, so might be easier to tolerate.
A study published in the European Journal of Clinical Nutrition in 2019 found that switching to organic wine led to fewer alcohol-induced headaches among those sensitive to sulphites.
Histamines in wine and beer can also cause a problem. This chemical is produced as part of the fermentation process and can trigger a hot, red face, hives, nausea or diarrhoea when you drink.
The histamine level can vary with the drink, depending on the vintage, type and fermentation process (red wine contains more than white, with 60 to 3,800 micrograms per litre, while white has between three and 120 micrograms), so it’s a question of trial and error to see which suits you.
A more surprising factor in all this is the health of your gut microbes. Research suggests that they support the work of the liver — the so-called gut-liver axis.
So, if your gut microbes are not in good shape, your liver might not be processing alcohol as effectively as it could.
While our understanding of the link between gut microbes and liver function is still in its infancy, one study from the Institute of Liver and Biliary Sciences in New Delhi, India, in 2017, found that giving people with liver disease a daily faecal transplant (ie, a treated stool transplant, which provides a new community of gut microbes) for a week brought about ‘significant’ improvements in liver function, and that improvement remained a year later.
What we do know for certain is that excess alcohol can impact our gut microbes, especially those higher up our gut, where the alcohol is absorbed.
For others, it may be a component of booze — not the alcohol itself — that’s the problem: for instance, the gluten in beer or sulphites added as preservatives to wines and also present on the grapes (levels tend to be higher in white wines)
In turn, they produce less of the organic fatty acids such as butyrate that help fuel the protective gut lining: at the same time, alcohol itself irritates and weakens our gut wall.
As a result, toxins are more easily able to pass from our gut into our bloodstream, creating more inflammation (and leading to the release of histamines) and this can make us feel rough. The effect on the gut is also what leads to ‘grog bog’ — the sloppy poop that can follow a night of one too many.
But if your gut microbes are in good shape, they’re more likely to produce more butyrate, which may well help the body better withstand the inflammatory effects of alcohol.
That’s why, if I’m going to a party, I’ll make sure that the day before and after I eat something like my smoky beans (see recipe). These provide the ideal mix of plant diversity (including prebiotics — plant compounds that are microbe fertiliser) that my gut microbes will feast on, and also satisfy those salty and carby hangover cravings.
And when you get to your party, as a rule, anything with bubbles is likely to make you feel worse.
This is no old wives’ tale. Researchers from the HPRU Medical Research Centre in Guildford put this to the test by giving volunteers fizzy or flat champagne.
Those given the fizz got drunker more quickly. That’s because the bubbles cause the alcohol to be more rapidly absorbed into your bloodstream, overtaking your liver’s ability to digest it at such speed — and the higher your blood alcohol concentration, the more toxic the impact.
And while we’re on the subject of fizzy drinks, be cautious of mixers containing artificial sweeteners.
A 2015 study from Northern Kentucky University found that if you drank vodka and diet soda or vodka and regular soda, the ‘diet’ version actually led to a 25 per cent higher blood alcohol concentration. This is because the sugar slowed the alcohol absorption through the stomach — of course, a high-fibre meal would be even better.
On a night out I always prioritise eating food as I drink to slow the absorption of alcohol and give my liver a chance to keep up, and try to switch every other drink to non-alcoholic — sparkling water with frozen berries, or kombucha.
And if the worst happens and you do end up with a hangover, then the key is hydration. While good old water will do the trick, you could also try an electrolyte drink, which contains salts such as potassium and may help you better absorb fluid while you rehydrate, particularly if you are suffering from diarrhoea or vomiting.
So by all means enjoy partying, but take these steps to reduce the pain the next day.
Try these: Hangover Baked Beans
Serves 4
These are packed with prebiotics (for feeding good gut microbes) and provide 10g of fibre per portion. Top with a fried egg for B vitamins, key for maintaining a healthy liver.
- 2 tbsp olive oill 1 onion, diced
- 3 cloves of garlic, crushed
- 1 tsp smoked paprika
- ½ tsp cayenne pepper
- 1 tsp cumin seeds
- 1 x 400g tin of tomatoes
- 4 sundried tomatoes, preserved in oil
- 1 x 400g tin of borlotti beans, drained and rinsed
- 1 x 400g tin of cannellini beans, drained and rinsed
- 40g black olives, sliced
- 1 tbsp tamari or soy sauce
- 1 tsp sweetener of choice
- 1 tsp vinegar of choice (optional)
- 40g spinach leaves, washed
- 1 tsp chilli flakes
Warm the oil in a frying pan over a low–medium heat, then add the onion, garlic and spices and sauté for a few minutes.
Add the tinned and sundried tomatoes and simmer for 15 minutes on a low heat.
Add the beans and olives and cook for a further 15 minutes.
Finally, add the tamari or soy sauce, sweetener, vinegar (if using) and the spinach leaves and chilli flakes. Simmer for a few minutes, then season.
Serve topped with egg and a dollop of yoghurt, hummus or both.
AskMegan
I remember from my younger days (I was born in the 1930s) bread going stale and being only fit for toast, but now bread develops large spots of green mould. Why?
Alan Griffiths, by email.
It’s a really interesting observation, and it could be partly down to the recipe changes, particularly the lower acidity in modern commercial breads.
This explains why sourdough breads, which tend to taste a little sour as the name suggests, last longer, even without the addition of chemical preservatives such as calcium propionate, potassium sorbate and sorbic acid commonly used today. The longevity of sourdough is thanks to the lactic acid bacteria used to make it, which naturally produces anti-mould acids.
Another factor is how the bread is stored. Bread is surprisingly moist, and mould loves a damp environment.
Nowadays bread is stored in plastic bags, which keeps the moisture in, whereas paper bags were historically used to allow the water out (even better is to wrap it in a tea towel). Although this leads to the bread drying out faster and becoming stale, there is less chance of mould growing.
Contact Dr Megan Rossi
Email [email protected] or write to Good Health, Daily Mail, 2 Derry Street, London W8 5TT — please include contact details. Dr Megan Rossi cannot enter into personal correspondence. Replies should be taken in a general context; always consult your GP with health worries.
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