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Alcohol ingestion and temperature regulation during cold exposure
Abstract and Figures
Outdoor or wilderness activities are sometimes combined with the ingestion of alcoholic beverages. Despite the feeling of warmth induced by alcohol ingestion, it is widely believed that alcohol actually causes a decrease in body core temperature and increases the risk of hypothermia during cold exposure. However, the literature on the effects of alcohol ingestion on thermoregulation is conflicting. This review summarizes the scientific findings concerning this topic and identifies a number of confounding factors that may explain the conflicting observations. These factors include quantity of alcohol ingested, severity of the cold stress, nutritional state of the individual, composition of the drink, body composition of the individual and alcohol tolerance of the individual. When these factors are considered, it appears that (1) alcohol acts as a poikilothermic agent, causing a reduction in body core temperature during cold exposure, with the magnitude of reduction related to blood alcohol concentration, (2) the severity of cold and the individual's body composition modify the thermoregulatory effects of alcohol, and (3) hypoglycemia greatly exacerbates the reduction in body temperature caused by alcohol ingestion. Furthermore, the primary mechanism by which alcohol ingestion exacerbates the fall in body core temperature during cold exposure appears to be via an impairment of shivering thermogenesis resulting from alcohol-induced hypoglycemia, rather than by increasing heat dissipation via vasodilation as commonly believed.
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... Death rates for poisoning were much higher for AN ages 20-44 and 45-64 while persons aged 65+ had the highest UI death rates of transport-other (land) and natural environment incidents. The majority of elder AN natural environment deaths were cold-related, perhaps a result of decline in body response to temperature change with increasing age [12,13]. ...
... Alcohol or other drugs were a contributing factor for a much higher proportion of natural environment deaths among AN than AKWs, a pattern also documented in a national study of American Indian/Alaska Native and USW mortality [20]. Although commonly believed to warm the body, alcohol consumption has been demonstrated to lower core body temperature in cold weather conditions, thereby exacerbating hypothermia risk [12,13]. ...
We compared rates of unintentional injury (UI) deaths (total and by injury category) among Alaska Native (AN) people to rates of U.S. White (USW) and Alaska White (AKW) populations during 2006–2015. The mortality data for AN and AKW populations were obtained from Alaska Bureau of Vital Statistics and USW mortality data were obtained from WISQARS, the Center for Disease Control and Prevention online injury data program. AN and AKW rates were age-adjusted to the U.S. 2000 Standard Population and rate ratios (RR) were calculated. AN people had higher age-adjusted total UI mortality than the USW (RR = 2.6) and AKW (RR = 2.3) populations. Poisoning was the leading cause of UI death among AN people (35.9 per 100,000), more than twice that of USW (RR = 2.9) and AKW (RR = 2.5). Even greater disparities were found between AN people and USW for: natural environment (RR = 20.7), transport-other land (RR = 12.4), and drowning/submersion (RR = 9.1). Rates of AN UI were markedly higher than rates for either USW or AKW. Identifying all the ways in which alcohol/drugs contribute to UI deaths would aid in prevention efforts. All transportation deaths should be integrated into one fatality rate to provide more consistent comparisons between groups.
... Ils sont donc plus à risque de souffrir d'hypo ou d'hyperthermie (Stocks, Taylor, Tipton et Greenleaf, 2004). Enfin, la prise de médicaments, de caféine et d'alcool peut aussi affecter négativement la thermorégulation (Freund, O'Brien et Young, 1994 ;Thompson-Torgerson, Holowatz et Kenney, 2008). ...
Bouger ! C’est ce que les scientifiques nous recommandent pour une meilleure
santé et cela fait consensus auprès des scientifiques (Carson, Chaput, Janssen et
Tremblay, 2017). Mais plus encore, l’activité physique pratiquée à l’extérieur en
plein air serait un excellent moyen de promouvoir un mode de vie sain et actif
autant chez les jeunes, que chez les adultes ou encore les plus vieux. En complément,
l’activité physique pratiquée dehors permettrait d’obtenir des bénéfices
supplémentaires sur la santé, le développement et l’apprentissage des êtres humains.
Ce chapitre propose quatre axes de réflexion entre l’activité physique et le plein
air sous la forme de leurs influences mutuelles. Il propose une synthèse actualisée
des bienfaits connus du plein air et de l’activité physique ainsi que des grandes
approches qui existent mêlant activité physique et plein air. Il présente aussi les
réponses et adaptations physiologiques majeures de l’activité physique en milieux
extrêmes naturels à l’usage des intervenants et des pratiquants. En lien avec les
préoccupations actuelles sur la préservation de l’environnement, ce chapitre expose
les liens étroits connus entre activité physique et changements climatiques. Enfin,
le chapitre se termine en proposant des pistes de recherches futures pour le plein air
et l’activité physique et les axes d’un futur agenda de recherche sur ces thématiques.
... Požitie alkoholu spôsobuje pokles teploty telesného jadra počas expozície chladu. To spočíva skôr v zhoršení trasovej termogenézy v dôsledku hypoglykémie vyvolanej alkoholom, než vo zvýšení rozptylu tepla vyvolanej vazod ilatáciou (Freund, O'brien a Young 1994). ...
Monografia je zameraná na otužovanie prostredníctvom vodného prostredia s fokusáciou na rekreačne otužujúcich jedincov. V publikácii opisujeme jednotlivé štruktúry a procesy v ľudskom tele, ktoré sú v interakcií s vodným prostredím (ako toleruje organizmus rôzne tepoty prostredia, tvorba a transport tepla v ľudskom organizme, tukové tkanivo, biorytmus a iné). Taktiež rekcie a spôsoby adaptácií ľudského tela na chladové podnety. Pre začínajúcich otužilcov uvádzame odporúčané metodiky ako začínať s otužovaním vodou. Záver publikácie ja zameraný na účinky chladovej expozície a jej rôzne variácie s ich účinkom pri využití v športovej aktivite.
... In this paradigm, animals are administered a high dose of ethanol, and their change in body temperature over time is recorded. However, data on body temperature is not regularly collected in most human studies (but see [216]), thus diminishing its translational utility. Still, given its reliability and ease of collection, ethanol-induced hypothermia may have value as an endophenotype if it is correlated with SR in humans. ...
Alcohol use disorder (AUD) is a complex, chronic, relapsing disorder with multiple interacting genetic and environmental influences. Numerous studies have verified the influence of genetics on AUD, yet the underlying biological pathways remain unknown. One strategy to interrogate complex diseases is the use of endophenotypes, which deconstruct current diagnostic categories into component traits that may be more amenable to genetic research. In this review, we explore how an endophenotype such as sensitivity to alcohol can be used in conjunction with rodent models to provide mechanistic insights into AUD. We evaluate three alcohol sensitivity endophenotypes (stimulation, intoxication, and aversion) for their translatability across human and rodent research by examining the underlying neurobiology and its relationship to consumption and AUD. We show examples in which results gleaned from rodents are successfully integrated with information from human studies to gain insight in the genetic underpinnings of AUD and AUD-related endophenotypes. Finally, we identify areas for future translational research that could greatly expand our knowledge of the biological and molecular aspects of the transition to AUD with the broad hope of finding better ways to treat this devastating disorder.
... These physiological changes are influenced by individual characteristics such as body composition, ethnicity, sex, age, and fitness levels [6]. But other factors could also affect these responses such as medication, caffeine and alcohol [15][16][17]. For example, consuming acetaminophen may decrease core temperature and heat production [18]. ...
Outdoor activity can help to promote an active lifestyle; however, it is often
associated with risks from its surrounding environment. Understanding physiological responses to several outdoor activities and how to use simple monitoring
tips to reduce risks will provide real-life applications in the preparation of outdoor
recreation. The purpose of this chapter focuses on common stressful conditions:
thermoregulation, energy demand, musculoskeletal injuries risks, sleep and
recovery. These are some constraints that can be encountered in any outdoor
context. The physiological responses and recommendations based on up-to-date
research will provide useful methods for risk assessment and how to manage
them. Finally, the health benefits from outdoor activity in different populations
will complete this chapter in order to help specialists structured and adapted their
intervention planning.
... occasionally) were less likely to stay in bed longer to stay warm and less likely to turn the heating off because of worries of the costs. To our knowledge, these findings were not previously reported and may indicate reduced sensitivity of alcohol consumers to cold [24] or an indicator of greater financial resources. It is also plausible that daily drinkers spent more time outside and thus required less home heating. ...
Purpose:
Living in a cold home increases the risk of dying in winter, especially in older people. However, it is unclear which individual factors predict whether older people are living in cold homes.
Methods:
Thousand four hundred two men aged 74-95 years from a U.K. population-based study reported difficulties in keeping warm during winter, answering four simple "yes/no" questions. Associations between individual's characteristics and each of the four self-reported measures of cold homes were estimated using logistic regression models. Next, we investigated whether measures of cold homes predict mortality over the subsequent 2.1 years.
Results:
Manual social class, difficulties making ends meet, and not being married were each associated (P < .05) with each of the four measures of cold homes (adjusted odds ratios ranged from 1.61 to 4.68). Social isolation, poor respiratory health, and grip strength were also associated with reports of cold homes. Hundred twenty-six men died; those who reported the presence of at least three measures cold homes had increased mortality (adjusted hazard ratios 2.85 [95% confidence interval, 1.11-7.30, P = .029]).
Conclusions:
Older people who find it hard to keep warm in winter, and have an elevated mortality, could be identified using a self-report questionnaire.
Introduction:
Alcohol and drug (illicit or prescription) intoxication impairs motor skills, coordination, decision making abilities, hazard perception, and is known to increase the risk of death in coastal environments. Prior coastal safety research has focused largely on the impact of alcohol on drowning, with less research on the influence of drugs and leaving a significant number of other non-drowning fatalities largely excluded, despite being preventable with mitigation of injuries or medical factors.
Method:
This retrospective cross-sectional study explored the impact of alcohol and drugs on unintentional Australian drowning deaths and other coastal fatalities over a 16-year period to identify higher-risk populations and coastal activity groups for which alcohol/drug use is increased.
Results:
It was found that alcohol, benzodiazepines/sedatives, and amphetamine usage was prevalent in coastal deaths. Of the 2,884 coastal deaths, 80.6% of decedents had known toxicological data. Alcohol and/or drug intoxication contributed to 23% of coastal drowning deaths and 19% of fatalities. For drowning and other fatalities combined, 8.7% were due to alcohol, 8.7% due to drugs, and 4.1% due to both alcohol and drugs. Australian-born decedents were more likely to involve alcohol (RR = 1.7, 95%CI = 1.26-2.3, p < 0.001), drugs (RR = 2.62, 95%CI = 1.85-3.7, p < 0.001), or both alcohol and drugs (RR = 4.43, 95%CI = 2.51-7.82, p < 0.001) with an increased risk identified in Indigenous Australian populations (RR = 2.17, 95%CI = 1.12-4.24, p = 0.04). The impact of alcohol and drug intoxication varied by activity, with Personal Watercraft users more likely to die due to alcohol intoxication (RR = 2.67, 95%CI = 1.23-5.78, p = 0.035), while scuba divers (RR = 0, p < 0.001), snorkelers (RR = 0.14, 95%CI = 0.036-0.57, p < 0.001), and rock fishers (RR = 0.46, 95%CI = 0.22-0.96, p = 0.03) were less likely. Recreational jumping and fall-related coastal deaths were more likely to involve alcohol and alcohol/drugs combined.
Practical applications:
This study identifies factors to further investigate or target with prevention strategies to decrease the holistic burden of mortality due to alcohol and/or drug usage on the Australian coast.
Alcohol and substance misuse can cause a range of neurobiological disturbances. These may result from acute intoxication, following chronic misuse or drug withdrawal. This chapter will address these disturbances on a drug-by-drug basis. Relevant neurobiological mechanisms of drug action will also be described.
As societies become more complex and interconnected, the global risk for catastrophic disasters is increasing. Demand for expertise to mitigate the human suffering and damage these events cause is also high. A new field of disaster medicine is emerging, offering innovative approaches to optimize disaster management. Much of the information needed to create the foundation for this growing specialty is not objectively described or is scattered among multiple different sources. This definitive work brings together a coherent and comprehensive collection of scientific observations and evidence-based recommendations with expert contributors from around the globe. This book identifies essential subject matter, clarifies nomenclature, and outlines necessary areas of proficiency for healthcare professionals handling mass casualty crises. It also describes in-depth strategies for the rapid diagnosis and treatment of victims suffering from blast injuries or exposure to chemical, biological, and radiological agents.
This investigation studied the importance of muscle glycogen levels for body temperature regulation during cold stress. Physiological responses of eight euglycemic males were measured while they rested in cold (18 degrees C, stirred) water on two separate occasions. The trials followed a 3-day program of diet and exercise manipulation designed to produce either high (HMG) or low (LMG) preimmersion glycogen levels in the muscles of the legs, arms, and upper torso. Preimmersion vastus lateralis muscle glycogen concentrations were lower during the LMG trial (144 +/- 14 mmol glucose/kg dry tissue) than the HMG trial (543 +/- 53 mmol glucose/kg dry tissue). There were no significant differences between the two trials in shivering as reflected by aerobic metabolic rate or in the amount of body cooling as reflected by changes in rectal temperature during the immersions. Postimmersion muscle glycogen levels remained unchanged from preimmersion levels in both trials. Small but significant increases in plasma glucose and lactate concentration occurred during both immersions. Plasma glycerol increased during immersion in the LMG trial but not in the HMG trial. Plasma free fatty acid concentration increased during both immersion trials, but the change was apparent sooner in the LMG immersion. It was concluded that thermoregulatory responses of moderately lean and fatter individuals exposed to cold stress were not impaired by a substantial reduction in the muscle glycogen levels of several major skeletal muscle groups. Furthermore, the data suggest that, depending on the intensity of shivering, other metabolic substrates are available to enable muscle glycogen to be spared.
Infusion of 67 g ethanol over four hours in fasted, non-obese normal men (a) induced hypoglycaemia by inhibiting gluconeogenesis; (b) produced noticeable increases in blood lactate, 3-hydroxybutyrate, and free fatty acid concentrations; (c) depressed plasma growth hormone concentrations, despite hypoglycaemia; and (d) raised plasma cortisol concentrations before significant hypoglycaemia occurred. These metabolic changes were explained by the reduction of redox state which accompanies ethanol oxidation. The pronounced changes in metabolic values recorded during this study suggested that the use of parenteral feeding regimens including ethanol needs to be reconsidered.
The effects of alcohol on core cooling rates (rectal and tympanic), skin temperatures, and metabolic rate were determined for 10 subjects rendered hypothermic by immersion for 45 min in 10 degrees C water. Experiments were duplicated with and without a 20-min period of exercise at the beginning of cold water immersion. Measurements were continued during rewarming in a hot bath. With blood alcohol concentrations averaging 82 mg 100 mL-1, core cooling rates and changes in skin temperatures were insignificantly different from controls, even if the exercise period was imposed. Alcohol reduced shivering metabolic rate by an overall mean of 13%, insufficient to affect cooling rate. Alcohol had no effect on metabolic rate during exercise. During rewarming by hot bath, the amount of 'afterdrop' and rate of increase in core temperature were unaffected by alcohol. It was concluded that alcohol in a moderate dosage does not influence the rate of progress into hypothermia or subsequent, efficient rewarming. This emphasizes that the high incidence of alcohol involvement in water-related fatalities is due to alcohol potentiation of accidents rather than any direct effects on cold water survival, although very high doses of alcohol leading to unconsciousness would increase rate of progress into hypothermia.
The effects of the ingestion of a moderate dose of alcohol, a known vasodilator, upon the cooling rate of four human subjects immersed in 7.5 degrees C water for periods of time ranging from 38 to 75 min is reported. In three of the cases the cooling rate was retarded, in no case was it accelerated. This result, while lacking statistical significance, has not previously been reported. The difficulties attendant upon such research are noted.
Subjects who had not been exercising, were immersed for 20 min in water at 13 degrees C after ingestion of alcohol. During the immersion period, total ventilation, end-tidal PCO2, rectal temperature, aural temperature, and mean skin temperature were recorded. Control experiments were carried out at the same water temperature. Blood samples (3 ml), taken immediately before the immersion period, were analyzed by gas liquid chromatography. The mean blood alcohol level was 90+/-11.2 mg-(100 ml)-1. There was no significant difference in ventilatory responses, rectal temperatures, aural temperatures, or mean skin temperatures achieved during the two cold water immersions. It would appear that for a 20-min immersion at 13 degrees C, relatively high blood alcohol levels do not affect ventilatory responses or increase body heat losses.
Blood glucose and rectal temperatures were monitored in two strains of genetically obese mice (C57 BL/6J ob/ob) prior to and following intragastric ethanol administration in an attempt to relate the hypothermic response to ethanol to extracellular glucose concentration. In contrast to expectation, ethanol administration was typically associated with a hyperglycemia and a hypothermic response. In the ob/ob genotype, the hypothermic response was associated with pronounced hyperglycemia which was more emphatic in older animals. The data support the conclusion that ethanol-induced hypothermia is independent of blood glucose levels. In light of the known sensitivity of ob/ob mice to insulin, it is suggested further that the observed hypothermic response was not a function of the animals' ability to transport glucose into peripheral cells. The observed hyperglycemia of the obese animals was most likely stress-related.