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The Mystery of Asian Blushing: Why Does Drinking Trigger This Reaction?
With the widespread consumption of alcohol in social situations, many East Asians will experience obvious facial flushing after drinking alcohol. This phenomenon is called the "alcohol flush reaction." The underlying cause of this reaction is due to the accumulation of a metabolite in the body called acetaldehyde, which is a by-product of alcohol metabolism. For many people, this is not just a physiological reaction but a sign of potential health risks.
Alcohol flush reaction mainly manifests itself as flushing, nausea, headache and rapid heartbeat on the face and body of an individual after drinking alcohol.
Causes of flushing
The alcohol flush reaction is usually due to a deficiency of aldehyde dehydrogenase 2 (ALDH2), the enzyme in the body responsible for breaking down acetaldehyde. For East Asians, this condition is quite common, with about 30% to 50% of Chinese, Japanese and Koreans exhibiting this physiological response. This reaction is also found in some Southeast Asian and Inuit groups.
Among East Asians, about 20%-30% carry a genetic mutation called rs671, which causes a reduction in the function of aldehyde dehydrogenase.
Mutations in this gene can cause these East Asians to have abnormally high acetaldehyde concentrations after drinking alcohol, leading to facial flushing. As a result of this abnormal response, many affected individuals experience feelings of discomfort after drinking alcohol, which may also lead them to reduce their alcohol consumption and thus, to some extent, reduce the risk of alcohol dependence. However, some studies have pointed out that such responders may face a higher risk of esophageal cancer if they still choose to drink alcohol.
Genes and risks
In studies, it was found that individuals with ALDH2 deficiency have a risk of esophageal cancer that is four to eight times higher than that of normal drinkers. In some people, this risk is reduced by the presence of another genotype variant (ADH1B*2), which makes them metabolize alcohol faster and more efficiently.
People with ALDH2 enzyme deficiency who do not have ADH mutations have a higher risk of esophageal cancer because the effects of these risk factors are additive.
Symptoms and diagnosis
The most obvious symptom of alcohol flush reaction is undoubtedly the flushing of the face after drinking alcohol. However, this reaction is not limited to changes in the appearance of the skin, as many patients also experience nausea, headaches, and a general feeling of physical discomfort. The most accurate way to diagnose this reaction is to measure the concentration of acetaldehyde in the blood, which can be done with a breath test or a blood test.
Challenges faced
Many drinkers may confuse alcohol flush with other skin conditions, such as rosacea or allergic reactions, because these conditions cause redness and swelling of the skin. Therefore, when faced with flushing, seeking professional medical advice and proper diagnosis will help with symptomatic management.
Not only that, alcohol may trigger other respiratory reactions that may worsen allergic rhinitis and asthma symptoms.
Conclusion
As research into alcohol flushing continues, many people still have questions about the phenomenon. It is not only a physiological response, but also the result of the intersection between genes and health risks. Not only does this cause us to rethink our own health, it also gives us a new understanding of how we consume alcohol. Have you ever wondered how your drinking habits affect your health?
