Alice,

I'm a Filipino-Chinese student who has discovered drinking recently. There is one problem, I turn really red!!! I have heard that this happens because I am Asian. I like to drink socially, but am very embarrassed by the whole red thing. What is it that causes this and what can I do about it?

— Wanna drink

Dear Wanna drink,

You're probably not the only red one in the bar; as many as 50 percent of people of Asian descent experience a flushed complexion after drinking alcohol. Alcohol flush reaction, the more technical name, describes the body's inability to break down ingested alcohol completely. You and others like you have an inactive enzyme, aldehyde dehydrogenase 2 (ALDH2), which is normally responsible for breaking down acetaldehyde, a byproduct of the metabolism of alcohol. Acetaldehyde is a toxin and if your body can't break it down, it accumulates and causes flushing. Other symptoms you might experience include dizziness, nausea, headaches, and an increased pulse.

Scientists don't know why the enzyme is inactive primarily in people of Asian descent, but it is genetic and can be passed on by either or both parents. Some researchers find that the presence of the mutation can help account for the lower levels of alcoholism in Asian communities, since many of the symptoms of alcohol flush reaction discourage people from drinking. There is some evidence that ALDH2 is inactive in higher than average levels in people of Jewish descent as well.

Because it's genetic, there isn't much you can do to prevent your red face. Tolerance levels and the severity of flushing and other symptoms vary from individual to individual, so you might want to test how much alcohol it takes before your rosiness becomes noticeable. If your coloring makes you self-conscious, sometimes the room is dark enough that people may not notice. If people do notice, they may think you are warm or excited to see them. You could also explain to any drinking partners why you're turning red, but it's likely they will soon forget about your flushed face.

There is some suspicion that a build up of acetaldehyde can cause cancer, but more research needs to be done before a definitive answer can be given. Otherwise, there are no known long-term health consequences resulting from the alcohol flush reaction.

Alice!
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