Thursday, March 18, 2010

The facts behind hangover remedies

The morning after St. Patrick's Day, the D4 Irish Pub & Café in Chicago, Illinois, gets flooded with requests for Bloody Marys, a concoction of tomato juice, celery, vodka and hot sauce.

"People order Bloody Marys in the morning to get them back on the horse so they can start drinking again," said Patrick Macellaio, who manages and bartends at the D4. "That's the most popular hangover drink."

To refresh your memory, a hangover includes symptoms of headache, fatigue, nausea and dizziness several hours after an episode of heavy drinking.

A hangover is really the symptoms of acute withdrawal, in which your body reacts to not having a drug in its system anymore, said Krista Medina, assistant professor of psychology at the University of Cincinnati.

Contrary to popular belief, drinking more while hung over is not going to make you feel better, doctors say. In fact, the other home remedies you may turn to, such as greasy food, probably won't work, either.

Part of the reason there's no good hangover remedy is that, although the phenomenon has probably been around since humans discovered alcohol, there's no single scientifically proven reason for a hangover, although there are correlations with the various symptoms of the "Irish flu."

"There probably won't be a known effective treatment until we understand the physiology better," said Dr. Sharon Horesh Bergquist, assistant professor in the department of medicine at Emory University.

What is a hangover?

One theory blames chemicals in some alcoholic drinks called congeners, said Dr. Samir Zakhari, director of the division of metabolism and health effects at the National Institute on Alcohol Abuse and Alcoholism.

These congeners, which could be toxic, contribute to alcohol's unique taste, but they can also interfere with cell function and leave some lasting physical marks. A 2009 study from Brown University found that the darker the liquor, the more congeners it has, which could exacerbate headaches and other hangover symptoms.

A different theory contends that drinking causes dehydration because alcohol increases urine output. Alcohol inhibits the release of an antidiuretic hormone, meaning the kidneys don't conserve water as well, and you urinate more, Bergquist said.

After a long night of drinking, you may feel like taking a snooze, but alcohol may actually disrupt sleep patterns, Zakhari said. You will not have as much rapid eye movement sleep, the state in which you dream, and you will have more time in deep sleep, research shows. A shorter, poorer quality sleep may await you after a lot of drinking, adding to the hangover symptoms.

Alcohol may also irritate your stomach, prompting a condition called gastritis in which the stomach lining gets inflamed. The related symptoms of vomiting and diarrhea also make you lose fluids and electrolytes, according to psychiatry professors Robert Swift and Dena Davidson, writing in the journal Alcohol Health and Research World.

There is also evidence that a hangover is a marker that you may be damaging your brain with alcohol, Medina said. Research suggests that hangover symptoms are related to abnormalities in the brain's white matter, which may occur in binge drinkers. A lot of withdrawal from substances is related to poor cognitive and brain outcomes, she said.

Can food cure a hangover?

Some people swear by a large meal after a night of drinking to digest that alcohol. Different cultures have different hangover foods, from hearty, greasy diner fare to giant burritos and ethnic soups. Jeanette Casey, bartender at the Playwright Celtic Pub in New York, recommends a "good Irish breakfast," which involves bacon or sausage.

But eating greasy foods after a night of drinking probably won't make you feel better, Zakhari said.

"If a person wants to eat, that's fine," he said. "They should do that during drinking or before drinking, not after. Because if people eat after drinking, it might be too late."

By the time you have a hangover, eating greasy fare won't have much of an effect in alleviating the symptoms, he said.

Bland foods, on the other hand, elevate your blood sugar and settle your stomach, according to the Mayo Clinic. Stick to toast and crackers.

Why shouldn't you drink more alcohol?

Bartenders such as Casey swear by the Bloody Mary as a hangover cure; she's not sure why it works, but it does in her experience. A beer works, as it's also, as the adage goes, "the hair of the dog that bit you," she said.

This belief that drinking more alcohol will alleviate the symptoms of too much drinking "doesn't make sense," Zakhari said.

"You already probably have done enough damage to the different parts of the body like the liver and heart," he said. "You don't want to go back and put more alcohol on top of that."

People believe that drinking is the right remedy because one of the symptoms of hangover is overstimulation of the brain, which makes you feel sensitive to light and sound, said Swift, psychiatrist at Brown University and the Providence VA Hospital. More alcohol will sedate the brain again but can actually be harmful because it increases other negative symptoms such as dehydration.

Can supplements help?

Small studies have shown that, if taken in very large amounts, vitamin B6 may reduce the symptoms of a hangover, Bergquist said. Still, this research did not include many participants and is not definitive.

"There are anecdotes about these things without any evidence," said Dr. James C. Garbutt, a professor of psychiatry in the University of North Carolina at Chapel Hill School of Medicine, who specializes in alcoholism treatment and research. "Medical science doesn't spend a lot of time treating hangovers. We want to try to prevent them."

Other supposed remedies include activated charcoal, which is supposed to absorb alcohol from the stomach but actually wouldn't work because the hangover occurs hours after drinking, Swift said.

"The most outlandish thing is that people who feel badly obviously want to feel better, so they're willing to try untested remedies," he said.

There, however, are some natural remedies that some doctors think merit further research, including prickly pear cactus extract and yeast-based preparations, according to the Mayo Clinic. Some also believe that the borage plant yields a supplement that may help with headache, laziness and tiredness.

Bottom line: Drink water

Doctors do agree that water will help somewhat with hangover symptoms because, as noted above, dehydration is often a symptom.

Zakhari also recommends getting rest. Medina noted that ibuprofen may help with headaches, and caffeine may help boost energy, but no treatments get at the underlying condition of hangover; they only ease symptoms, she said.

Before you go out, aim to drink in moderation or not at all, experts say.

Clinton to attend Mideast session amid crisis

WASHINGTON – With the Mideast peace process stalled and U.S.-Israeli relations in crisis, Secretary of State Hillary Rodham Clinton headed Wednesday to a Mideast strategy meeting of top international diplomats.

As originally conceived, the meeting in Moscow of the so-called Quartet group of peacemakers — the U.S., Russia, the European Union and the United Nations — was intended to lend support for the start this week of indirect talks between the Israelis and Palestinians. But those talks fell apart before they began — a casualty of Israel's provocative approval of new housing in east Jerusalem.

The diplomatic crisis erupted last Tuesday when Israel announced during a visit by Vice President Joe Biden that it would build 1,600 apartments for Jews in disputed east Jerusalem, the sector of the holy city that the Palestinians claim for a future capital. Clinton called the announcement an insult and "a deeply negative signal" for the peace process; she even questioned Israel's commitment to its relationship with the U.S.

Clinton also will use her Moscow visit to discuss another high foreign policy priority of the Obama administration: arms control. The U.S. and Russia are said to be close to concluding a follow to the Strategic Arms Reduction Treaty, which expired in December, but the final bargaining has been rocky.

William Burns, the undersecretary of state for political affairs, told reporters traveling with Clinton that her visit to Moscow was an important opportunity to advance the arms talks, but does not necessarily mean an agreement is imminent.

"We are getting closer," Burns said, but he added he could not estimate how much longer it would take to settle the remaining issues. He declined to identify the specific sticking points.

The agreement is expected to reduce each side's long-range nuclear weapons by about one-quarter from levels set in a 2002 treaty that superseded the earlier START pact. The newer treaty did not include an extension of agreed measures to verify each side's compliance. The current negotiations include verification measures that would replace those in the 1991 deal, which expired last December.

The Quartet group is to meet over dinner Thursday, followed by formal talks on Friday. Joining Clinton will be Russian Foreign Minister Sergey Lavrov, U.N. Secretary General Ban Ki-moon, EU foreign policy chief Catherine Ashton, and the Quartet's special representative, former British Prime Minister Tony Blair.

The group is meant to represent an international consensus on the importance of pressing the Israeli-Palestinian peace process and a commitment to establishing a Palestinian state as part of that process.

Michele D. Dunne, a Mideast expert at the Carnegie Endowment for International Peace, said Tuesday that the Quartet might back U.S.-initiated demands of Israel, including that it reverse the east Jerusalem housing decision and make a gesture to the Palestinians. But she saw little chance of it working.

"To say that you have to rescind approval for this construction in east Jerusalem is very unusual — very unusual for the United States to go that far," she said. "And I don't think Netanyahu will do it." She was referring to Israeli Prime Minister Benjamin Netanyahu, who is due to visit Washington next week.

In an op-ed published Thursday in The New York Times, Israeli Ambassador to the U.S. Michael Oren reasserted his country's opposition to any restrictions on building in east Jerusalem. But he denied that U.S.-Israel relations were "at a historic low point" because of the disagreement.

"Because we share fundamental values — democracy, respect for individual rights and the rule of law — our friendship can sustain occasional disagreements, and remain unassailably solid," Oren wrote.

In remarks at the State Department on Tuesday, Clinton spoke hopefully of getting the peace talks back on track.

"There is just too much at stake for both the Palestinians and the Israelis," for them not to resume bargaining, she said. Negotiations broke off in late 2008 with Israel's incursion into Hamas-ruled Gaza.

George Mitchell, the Obama administration's special envoy for Mideast peace, was supposed to have been shuttling between the Israelis and Palestinians this week, prior to joining Clinton in Moscow on Thursday. But he canceled his Mideast visit as the administration awaited word from Netanyahu on whether he would reverse last week's housing decision and take other steps to reassure Washington and the Palestinians

Bajaur schools reopen

PESHAWAR: Though the political administration in Bajaur Agency has announced reopening of educational institutions in the restive parts of the tribal region after 16-month pause, no steps are in sight for the reconstruction of the destroyed education infrastructure and return of the displaced teachers and students to their native towns.

Almost all schools and colleges in four out of the seven tehsils of Bajaur including Mamond, Salarzai, Nawagai and Chamarkand had been closed since August 2008 when the first military operation was launched.

Educational institutions in the rest of the tehsils namely Khar, Utmankhel and Barang also remained closed intermittently. There were some schools even in the Khar tehsil where educational activities remained suspended since the day one of the operation launched by the security forces.

According to a senior officer in Bajaur education office, the study of some 90,000 students was affected because of the militancy and counter-militancy activities in Bajaur tribal region.

He said almost all of the students and teachers of the agency were displaced during the first phase of the operation in August 2008, but those belonging to Utmankhel, Khar and Barang tehsil returned to their hometowns and educational activities resumed there.

But in the restive parts of the agency like Mamond, Charmang, Nawagai and others, the displaced families could not return home because of the volatile situation, the officials said. Several school and college buildings had been destroyed because of the excessive bombardment by the jetfighters and gunship helicopters, while the militants started blowing up government buildings including schools and colleges in mid-2009.

Some reports suggested that 74 school and college buildings along with some basic health units and veterinary centres were destroyed till January 2010.

An official in the political administration of Bajaur told The News on the condition of anonymity that the militants had blown up all the buildings of educational institutions in Mamond and Nawagai tehsils. “Reconstruction of the demolished buildings is a big challenge before the political administration for smooth resumption of the educational activities in the agency,” he said.

Another hurdle, according to tribesmen, in the resumption of the educational activities was the rehabilitation of the displaced tribal people. Only two to 10 per cent people have so far returned to their villages in most of the areas of Mamond, Charmang and Nawagai, said Abdul Wahab, a resident of Inamkwaro Chinagai, told this correspondent during a visit to the area.

The tribesmen face a lot of problems in the rehabilitation, he said. The returning families had to make registration with the security forces, which was a lengthy process, he said. Because of the registration process and closure of roads leading to Damadola and other parts of Wara Mamond and other areas, the people cannot go back to their homes, he added.

A lecturer at the Government College Khar, wishing not to be named, said a lot of time of the students had been wasted. “It will be difficult to bring back the students to schools after a long break in their education,” he added.

He was of the opinion that many a students had got admissions in other schools in the settled areas or other parts of Bajaur, while many were unable to continue their education.

He said the political administration should make proper arrangement for the rehabilitation of the displaced families and focus attention on resumption of educational activities. Relief should also be given to the students whose time had been wasted due to the closure of their schools, he added.