Alcohol intolerance: understanding your drunk Asian friends Toast to 2012 by Hakee Chang

Alcohol intolerance: understanding your drunk Asian friends

Alcohol tolerance differs among people.This especially gets clear when drinking with people of Asian descent. After a few drinks, they often show a red face and vomiting is imminent. Now don’t make fun of them, while it’s not their fault, it’s their genes.

The liver metabolises alcohol (ethanol) in two steps: in the first step, an enzyme (Alcohol Dehydrogenase; ADH) turns the toxic alcohol into another toxic substance, called acetaldehyde. The second step takes care of the toxic acetaldehyde by turning it into acetate, which is safe for the body. This last step is facilitated by the enzyme Aldehyde Dehydrogenase (ALDH). In people from Asian descent, it’s this particular enzyme they lack

This is caused by a gene variant of the alleles responsible for the enzyme ALDH. Most people carry the ADH1B*1, ADH1C*2 or ALDH2*1 gene that codes for ALDH, but around half of the Asian people carry at least one of the ADH1B*2, ADH1C*1 or ALDH2*2 genes that code for inactive ALDH. Consequently, the acetaldehyde will not be metabolized in acetate and thereby rapidly accumulates in the body, causing redness of the skin, often referred to as “Asian flush”. Besides this, it can cause nausea, headache and even hangovers.

These consequences of the acetaldehyde build-up are the least concerning. Recent studies by Akira Yokoyama and colleagues in Japan showed that the alcohol-related acetaldehyde build-up can even cause esophageal cancer. Yokoyama compared East-Asian people with and without the inactive ALDH-gene. The study showed that the participants with the inactive ALDH-gene are 6-10 times more likely to develop esophageal cancer in comparison with the ones from the active ALDH-gene group. Moreover, compared to non-drinkers, individuals with the inactive ALDH-gene who drink 33 or more drinks (U.S. standard) per week are 89 times more likely to develop alcohol related esophageal cancer,

In summary, around 50% of the Asian people have inactive ALDH, which causes problems when drinking alcohol. These problems include the so-called Asian flush, nausea, headache, hangovers and even esophageal cancer. So next time you have Asian people over, go easy on the bottle, don’t laugh at them when they turn red or vomit, give some advice instead.

This blog was written as an assignment for the course Pharmacology of Cognition, part of the minor Brain and Cognition.



This is absurd do you people even look at how strong Asian liquors are there is NO WAY that people wouldn't build up resistance to them after thousands of years of drinking stuff that's at least 50% alcohol


If after work with friends about the drink, how pleasant
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/ One of the reasons for the silo <a href="">mecrtis</a> situation described in this example and Howard's comments is that HR data is so siloed. With Staffing data in one application, performance info in an Access database, separation data in the HRMS, etc etc there is no place for the wholistic analysis that can provide HR folks with the insight they need into the real correlations that exist. Luckily workforce analytics tools now exist that can easily integrate critical information independently of the technology platform and provide the data necessary for reliable and valid, strategic and operational analytics. Without accurate and actionable information HR will never have credibility with business leaders.


/ Relevant, End-2-End Metrics have been elusive and neeedd for years! I have to hand it to Dubs for his red face and call center example. The call center, bad referral scenario is particularly noteworthy. Please allow me to explain.While the example illustrates the need for better metrics, I would like to point out today's metrics simply focus on metrics in a vacuum. More simply stated, most metrics are based on the silo in which they live. In the call center case, this is a silo view where the data is extracted from the pre-employment or applicant tracking system. This metric sadly excludes other pertinent data including, but not limited to: performance data (were our referrals bottom, middle or top performers?); true cost data (were our referrals simply unhealthy people that exploited the medical or Rx plan (and then simply left after their surgery?))? Were these referrals voluntary or involuntary (were they gaming the system for unemployment?)?The good news is the data is available to address the real root cause. The less than good news is, end-2-end metrics are elusive since the world generally operates in silos. Given the cost pressures on just about everything, if HR really wants a seat at the C-suite table, HR needs to start thinking and acting in business terms. Relevant, end-2-end metrics are the future and will become the next best practice frontier in the not too distant future.


Nicely explained, I've never understood something so clearly after reading an article about it. The author has a great talent and I wish him the best of luck in the future.


I am very glad you wrote this article, hopefully it will helps my friends and fellow asians understand this controversial problem.


Thank you for this well written and informative article. I hope to read a lot of articles from this author in the nearby future.

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