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- HEALTH, Page 61Why Men Can Outdrink Women
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- It's not a matter of macho, but of enzymes
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- It is a familiar refrain at parties and in bars: women just
- can't hold their liquor. They are quicker to get giddy, and
- they stay drunk longer than men matching them drink for drink.
- For years, the difference was attributed to gross anatomy: On
- average, women are smaller than men, and thus alcohol gets into
- their tissues more rapidly. And because they carry
- proportionately more fat and less water in their bodies, liquor
- is diluted more gradually, prolonging its heady effects.
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- But that explanation has never been completely convincing,
- either to scientists or to laymen. It fails to explain fully
- why when men and women of the same size have identical drinks,
- women tend to get tipsy faster. Scientists have long wondered
- if there might not be a more compelling biochemical explanation
- for the drinking puzzle. Last week a team of Italian and
- American researchers offered what looks to be the answer: women
- have far smaller quantities of the protective enzyme alcohol
- dehydrogenase that breaks down alcohol in the stomach.
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- The enzyme is crucial in curbing intoxication. When a shot
- of vodka or a beer is swallowed, it travels to the stomach and
- then to the intestine, where it passes through the organ's wall
- into the bloodstream. Once there it circulates to the brain,
- where it finally exerts its inebriating effect. Alcohol
- dehydrogenase breaks down spirits in the stomach, reducing the
- amount of pure alcohol that enters the bloodstream about 20%;
- the rest is eventually metabolized by similar enzymes in the
- liver.
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- According to a study of 43 men and women reported in the New
- England Journal of Medicine, women possess significantly less
- of the active stomach enzyme. The result is that they absorb
- about 30% more alcohol into their bloodstreams than men do --
- and voila! Taking into account the weight difference between
- the average man and woman, a mere 2 oz. of liquor has about the
- same effect on a woman as 4 oz. would on a man. Just why there
- is such a discrepancy remains a mystery.
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- The researchers made another startling discovery: men who
- are alcoholics have about half as much alcohol dehydrogenase
- as their healthy counterparts, but alcoholic women show almost
- no enzyme activity at all. The falloff may result from
- alcohol's injuring the stomach wall, where the enzyme is
- manufactured. Whatever the cause, "alcoholic women appear to
- lose all gastric protection," says Dr. Charles Lieber of Mount
- Sinai School of Medicine in New York City, who collaborated on
- the study with Dr. Mario Frezza of the University School of
- Medicine in Trieste, Italy. "For them to drink alcohol is the
- same as shooting it up directly into their veins."
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- Experts say this lack of protection may help explain why
- alcoholic women suffer more heavily from liver damage than do
- alcoholic men. Women may be more vulnerable to cirrhosis for
- another reason, says Dr. Jack Mendelson of Harvard Medical
- School. Studies by a team at Johns Hopkins indicate that
- women's livers metabolize alcohol faster than men's and thus
- may be more subject to wear and tear. Mendelson speculates that
- in female alcoholics a lack of gastric enzyme means that "their
- livers have to work even harder," accelerating the destruction.
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- The study supports the common notion that it is better to
- drink on a full stomach than on an empty one. Booze takes
- longer to pass through a well-fed stomach, allowing more time
- for the enzyme to digest the alcohol. Fasting does the
- opposite: it speeds the stomach's emptying. Taking the popular
- ulcer medication cimetidine (Tagamet) also appears to interfere
- with alcohol metabolism by suppressing enzyme activity.
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- The new findings intensify earlier warnings that drinking
- holds special risks for women. Labels on liquor bottles and
- placards in some restaurants and bars already caution that for
- a pregnant woman to drink can cause serious birth defects in
- her baby, including physical deformities and mental
- retardation. The new research indicates that women who are not
- pregnant need to take heed as well.
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- "For social drinkers," observes Dr. Lieber, "what is
- moderate drinking for men is not moderate drinking for women.
- To reach a given blood-alcohol level, women need to drink only
- about half of what men drink." Women should be especially aware
- of their greater sensitivity if they are driving or performing
- any other task that requires close attention or fine
- coordination.
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- What the study emphatically does not suggest is that men now
- have a green light to drink. Stresses Harvard's Mendelson:
- "This should not be taken in any sexist way -- that is, `Men
- can handle it, women can't.' Men can tolerate alcohol in
- slightly higher doses than women, but that's about it. There
- are other factors that might mitigate this difference, for
- example, how one behaves when drunk." In other words, men may
- be better enzyme makers, but they are not better drinkers.
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- By Anastasia Toufexis. Reported by Andrew Purvis/New York.
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