The affection that drinkers feel for alcohol has led many to believe that it is mixing drinks the wrong way, and not the drinking, which brings misery after a drinking session. One such is the notion that if one were to drink both wine and beer at a sitting, one should drink the beer first and the wine thereafter!  The aphorisms, “Beer before wine and you’ll feel fine, wine before beer makes you feel queer”, or “Wein auf Bier, das rat ich dir, Bier auf Wein, das lass sein”, “Bière sur vin est venin, vin sur bière est belle manière”, in different languages, even, “Grape or grain, but never the twain”, or even “ Blanc sur rouge, rien ne bouge, rouge sur blanc, tout fout le camp”, attest that there is a correct order of drinking, and that it is universally known. Jöran Köchling, Berit Geis Stefan Wirth and Kai O Hensel, researchers at Witten/Herdecke University in Germany and the University of Cambridge in the UK, thought it fit to carry out a rigorous trial to get to the bottom of these nostrums to keep the hangover away.

The American Journal of Clinical Nutrition carries their report of the investigation, which had 90 participants, who were screened and admitted out of 272 volunteers. The task for the participants was to conform to set times of meals and sleep, and to drink, either Premium Pilsner (five per cent alcohol) provided by Carlsberg or a 2015 Edelgräfler quality white wine (11.1 per cent alcohol), or both, till they were fairly drunk, over the course of the experiment. Of course, they had to report, during the course of the drinking, how drunk they were getting and how well or unwell they felt, and again when they surfaced the next morning.

Most people who have experience of drinking alcohol also have the experience of getting drunk and facing the “morning after”. The “morning after” is in stark contrast to the “evening before”, and the euphoria and geniality that alcohol is known to create is replaced by fatigue, dehydration, an acid stomach, usually a headache, and most of all, tremendous dullness of the head and inability to focus.

The main cause, of course, is the high level of the alcohol in the blood stream that drinking sets up for some hours. As alcohol can pass through the blood-brain barrier, it begins to slow the functioning of brain cells. The first cells affected are those that promote caution and inhibit behaviour. The drinker hence feels free, powerful and euphoric. Brain cells that control speech and motor functions are also affected, causing slurred speech and loss of balance.

This is the effect in the brain. The rest of the body is also affected. With the high alcohol content of the bloodstream, water that is the main content of cells, rushes out of the cells to dilute the bloodstream. There is hence continuing dehydration. Another effect is that on the liver.

The normal function of the liver is to maintain a steady level of sugar in the blood stream, pulling excess sugar out, and, more important, pumping sugar back in when sugar is low. The liver is also the main agent that extracts the alcohol from the bloodstream. While it is engaged in this function, the task of replenishing the sugar level in the blood is neglected and sugar levels fall. Now, glucose in the blood is the source of energy for the brain cells.

When the person awakes a few hours after the drinking binge, there is still alcohol to be extracted but there is little sugar for the brain. The person hence feels blank, vacant and incoherent. There are often conditions of an acid stomach, headache and fatigue from unrestrained activity. The combination is a feeling of such discomfort and helplessness that the person often swears never again to “touch the stuff”.

This lasts till the alcohol in the bloodstream is eliminated and the brain is again bathed in glucose. Except when a person has been imposing low glucose levels on the brain for some time, the brain adapts to the presence of alcohol. Now, when the level of alcohol drops, the brain pines for alcohol and the persons begins to crave a drink! And when the person gets that drink, he or she feels good and goes on to have a few more.

Enter the alcoholic!

The paper in the journal starts by noting that alcohol-induced hangover constitutes a significant, yet understudied, global hazard and a large socio-economic burden. Whether the combination and the order of beer and wine consumption had any bearing on the intensity of the hangover was hence taken up for scientific study. If the traditional drinking formulae were found to be true, maybe drinkers could be educated to follow a pattern that would alleviate the hangover. The study consisted of participants divided into three groups. The first group drank beer, till their breath alcohol concentration (BrAC) reached 0.05 per cent. This, incidentally, is the level where “driving skills are significantly affected”. They then switched to wine, till the BrAC was 0.11 per cent, which is nearly the level of “possible criminal penalties”. The second group did the same, but started with wine and finished with beer. The third group drank just beer, till BrAC reached 0.11 per cent. A week later, there was the second round, where the first two groups switched the order of beer and wine, while the third group switched to wine.

Participants were asked about their well-being at regular intervals and at the end of each intervention, they were asked to judge their perceived level of drunkenness on a scale between 0 and 10. They were then given six cc/kg body weight, each, of refrigerated water to drink, before they went to sleep, in similar conditions and under medical supervision. On awakening, and when the BrAC had returned to normal, an Acute Hangover Scale (AHS) of the participants’ was computed. This was based on eight features, including perception of dizziness, nausea, stomach ache, tachycardia and loss of appetite.

The study group consisted of equal number of men and women, between the ages of 19-40, and had been formed into groups of three persons with similar age, gender, weight, height, BMI, reported alcohol consumption rate, and hangover frequency. A number of precautions were also taken to assure statistical reliability of the data and results to be derived. The paper states that the trials do have limitations. For one, specific beers and white wine were used.

Another is that there could be no “blind” trials. The results, however, the paper says, clearly debunk the idea that there could be a form of “tactical drinking”. The only correlation that was found was that high levels of “perceived drunkenness” or the incidence of vomiting did not bode well for the morrow.

(The writer can be contacted at response@simplescience.in)