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Ask Dr. Steve: Asian Flush — What Is it? 

What causes Asian flush?

Dr. Steve: Asian Flush, the red face that many Asian people get when they drink alcohol, is a deficiency in a liver enzyme that metabolizes alcohol, and it's well documented among people with Korean, Chinese and East Asian heritage. Specifically, when they drink alcohol it prevents an enzyme in the liver (aldehyde dehydrogenase 2) from doing its job — breaking down alcohol into acetaldehyde, a highly toxic compound that contributes to the hungover feeling.

In most people, acetaldehyde is rapidly transformed into harmless acetate and water. But in many Asian people who suffer from this, acetaldehyde accumulates in the liver and body and causes blood vessels to dilate and the release of histamine, a chemical in the body associated with immune responses that causes itching and redness, known as the Asian glow or Asian Flush. 

How many people have the Asian Flush?

The Asian Flush is a real thing. The mutation occurs in about 560 million people — about 8% of the world’s population. Because of this, Asian people have a higher risk of liver cancer, so it's really toxic. And there are also studies linking this mutation to alzheimers

How to deal with Asian flush

How can one cope with Asian Flush? 

 1. Drink moderately

This is an obvious one. A suggestion: Men should stop at two drinks per day and women should stick to a maximum of one alcoholic drink per day. One standard alcoholic drink: 1 can of beer (355 ml/5% alcohol) or 1 glass of wine (about 150 ml/12.5% alcohol).

"The thing is, you can't metabolize alcohol faster if you have more of it in your system," said Dr. Steve. "So if you have a sudden buildup of alcohol, like liquor shots, you have a higher amount that leads to more reaction and so it just takes longer to metabolize and the effect is greater."

2. Avoid binge drinking

Binge drinking overloads the body’s ability to metabolize alcohol. That's because the liver can only metabolize about one ounce of alcohol per hour (that’s less than one can of beer or one glass of wine). That’s not much beer pong. 

If you suffer from the Asian flush syndrome, wait until the redness subsides before taking another drink to avoid acetaldehyde overload. (Or just use a filter on your Instagram photo to obscure the red face).

3. Choose drinks with less alcohol content

Read labels. Choose red or white wines with 12.5% or less alcohol per volume (APV). Beers, wine coolers, table wine and sparkling wine have lower APV than liquor. "If you have a beer, sip slowly, you'll dissolve the alcohol a little bit more quickly and it reduces the flushing effect," said Dr. Steve. 

4. Eat before and/or while you drink

Eating food before and during drinking is the only practical way to control alcohol other than the speed and amount of your imbibing. If there is little or no food in your stomach when you drink, the alcohol is absorbed into your small intestine quicker. Tip: fat and carbs take much longer to digest than protein, so snacking on seeds, nuts, cheese, pizza, pasta and bread will slow down absorption. 

Asian flush skincare

5. One word: agua 

Because alcohol is a diuretic, it can increase your thirst. Quench it with water or non-alcoholic drinks, like electrolyte solutions and rehydration drinks. They contain sodium and potassium that are lost during alcohol consumption. 

6. Use H2 blockers 

Some people take a histamine-2 (H2) blocker like Zantac, Pepcid, or Tagament before they start drinking to slow the breakdown of alcohol to acetaldehyde in their bloodstream. "When you have an issue with histamine release, what happens is you get flushing, you get sneezy, and congested," said Dr. Steve. "H2 blocks that so you don't have as much vasodilation in your blood vessels, they don't open as much and you'll get less redness." 

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