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許多人喜歡在喜慶聚會等場合或用餐時喝酒,卻也可能濫飲。了解飲酒對人體的影響很重要,知道自己的酒量有助於避免危害。
酒精對人體的影響取決於喝的量,以及喝的人和喝法。
本節概述人體如何代謝酒精及酒對健康的影響。最重要的,這些都因人而異。
有任何與酒精相關的疑問或擔憂,建議諮詢專業醫療人員,協助評估飲酒對個人的影響。
酒精下肚後,部分進入血液,循環至全身。 [i][ii]
大部分會進入肝臟,被酵素代謝成乙醛。 [iii]
體接著迅速將具有毒性的乙醛再分解為二氧化碳和水,和其他廢物一起排出體外。
如果喝太多或太快,肝臟來不及代謝,乙醛就會累積造成危害。
有些人因為遺傳因素,無法有效分解乙醛,酒後容易出現臉紅、噁心、頭痛等不良反應。這些人飲酒的長期健康風險也比較高x。 [iv]
[i]Lachenmeier, D.W. et al. The impact of unrecorded alcohol use on health: what do we know in 2020?(私酒對健康的影響:我們在2020年了解多少?) J Stud Alcohol Drugs, 2021. 82: 28-41.
[ii] Paton, A. Alcohol in the body(酒和人體). BMJ, 2005. 330: 85-7.
[iii]Martin, T.L. et al. A review of alcohol-impaired driving: the role of blood alcohol concentration and complexity of the driving task(酒駕綜述:血液中酒精濃度的作用與駕駛作業的複雜性). J Forensic Sci, 2013. 58:1238-1250.
[iv]National Institute on Alcohol Abuse and Alcoholism (NIAAA). Alcohol’s effects on health(酒對健康的影響). Bethesda, MD: NIAAA, 2022.
[v]National Institute on Alcohol Abuse and Alcoholism (NIAAA). Alcohol flush reaction: does drinking alcohol make your face red?(酒後臉紅反應:你喝酒臉會紅嗎?) Bethesda, MD: NIAAA, 2022.
Some people of Chinese, Japanese, and Korean origin experience an unpleasant ‘flushing’ reaction when they drink, which makes their faces turn red.
They are likely have a genetic trait that prevents the liver from breaking down acetaldehyde efficiently.
If you have this genetic trait, your health risk may be higher than it is for other people. Getting medical advice is a good idea.
酒精在體內如何代謝
大部分國家都根據酒精對協調性、反應時間、判斷力、注意力的影響,對駕駛人可以飲用的酒精量設有法定容許上限。 [i][ii]
血液中酒精濃度可以測出飲酒量。正常成人1小時內飲用約1個酒精標準單位,血液中酒精濃度會增加約0.02%。
換算結果只是約略推估,不可以用來判斷是否適合開車。喝酒不開車,開車不喝酒。
各國針對開車和駕駛機動車的血液中酒精濃度規定不盡相同。[iii] 駕駛人應熟知當地法定容許上限。
[i] Martin, T.L. et al. A review of alcohol-impaired driving: the role of blood alcohol concentration and complexity of the driving task(酒駕綜述:血液中酒精濃度的作用與駕駛作業的複雜性). J Forensic Sci, 2013. 58:1238-1250.
[ii] Irwin, C. et al. Effects of acute alcohol consumption on measures of simulated driving: A systematic review and meta-analysis(急性酒精攝取對模擬駕駛指標的影響:系統性回顧與統合分析). Accid Anal Prev, 2017. 102: 248-266.
[iii]World Health Organization (WHO). Global Status Report on Road Safety 2023(2023年全球道路安全現況報告). Geneva: WHO, 2023.
台灣規定汽機車駕駛人血液中酒精濃度不得達0.05%以上。
Your blood alcohol content (BAC) reflects the percentage of alcohol in your blood. A BAC level of 0.02, for example, means that the 0.02% of your blood volume is alcohol.
Because some alcohol is exhaled from your lungs before it enters the rest of your body, breath alcohol is used as a quick and efficient indicator of BAC and helps in road traffic law enforcement. Different countries set different BAC limits.
酒後影響血液中酒精濃度高低的因素有很多。
Your BAC depends not only on how much alcohol you drink, but also on:
If you are drinking alcohol, no matter how much you drink, the best choice is to not drive, whether it is a car, a motorbike or other motorized two-wheeler, or even if you are riding a bicycle.
酒精很快會到大腦,先影響行為。依飲酒量多寡,可能會感到困倦、興奮、迷茫。但酒精也會影響長期身心健康。
飲酒對健康的影響程度取決於喝的量,喝法,喝的人。可以參考各種建議指引作出明智選擇。
一開始喝酒時,可能會感到放鬆,但愈喝愈多,行為、協調性和反應時間就會受到影響。
飲酒過量會影響判斷力,可能因而對自己的行為、和他人的互動方式、自身安全,做出錯誤決定。飲酒過量會增加自己或他人受傷甚至死亡的風險。
飲酒對健康的影響會隨時間進展。飲酒過量危害身心健康,沒有例外。適量飲酒與健康的關係比較複雜,對大多數健康成人而言,適量飲酒和平衡健康的生活方式可以相容。 [i]
飲酒愈多,罹患各種疾病的風險愈高,包括:
心血管疾病。酒喝愈多,高血壓、心臟病、中風風險愈高。 [ii] 科學研究同時顯示,適量飲酒可能降低部分人罹患心血管疾病的風險。[iii][iv]
癌症風險。腔癌、咽喉癌、乳癌、大腸直腸癌、肝癌等癌症風險與酗酒相關。[v] 即使適量飲酒也可能增加女性罹患乳癌的風險。 [vi][vii]
肝病及消化系統健康。長年酗酒可能會導致肝硬化和肝癌,且增加胰臟炎和膽囊疾病風險。 [viii]
糖尿病。酗酒會增加第二型糖尿病風險,但科學研究顯示,適量飲酒並維持健康生活方式可以降低風險。[ix][x]
記憶和認知功能。酗酒會導致失智症和認知能力下降。研究顯示,老年人適量飲酒與記憶力和認知功能改善相關。[xi]
酒精對胎兒的影響。孕期飲酒會增加胎兒酒精症候群(FAS)等嚴重先天性認知和生理異常風險。孕婦不應飲酒。[xii]
酒精使用障礙(AUD)。長年酗酒的人可能會形成酒精使用障礙或對酒精產生「依賴」。酒精使用障礙是一種精神疾病,需要透過心理或藥物治療謹慎觀察治療。[xiii]
[i] Hendriks HFJ. Alcohol and human health: what is the evidence?(酒與人類健康:有什麼證據?) Annu Rev Food Sci Technol. 2020, 11:1-21.
[ii] Briasoulis, A. et al. Alcohol consumption and the risk of hypertension in men and women: a systematic review and meta-analysis(男女飲酒量與高血壓風險:系統性回顧與統合分析). J Clin Hypertens (Greenwich). 2012. 14(11): 792-8.
[iii] Yoon, S.J. et al. The protective effect of alcohol consumption on the incidence of cardiovascular diseases: is it real? A systematic review and meta-analysis of studies conducted in community settings(飲酒對心血管疾病發生率的保護作用:是真的嗎?對社區研究的系統性回顧和統合分析). BMC Public Health. 2020. 20(1): 90;
[iv] Ronksley, P.E. et al. Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis(飲酒與特定心血管疾病結果的關聯:系統性回顧與統合分析). BMJ. 2011. 342: d671.
[v] Cao, Y. & Giovannucci, E.L. Alcohol as arisk factor for cancer(酒是癌症的危險因子). Semin Oncol Nurs. 2016. 32(3):325-31.
[vi] Bagnardi, V. et al. Alcohol consumption and site-specific cancer risk: a comprehensive dose-response meta-analysis(飲酒與特定部位癌症風險:綜合劑量反應統合分析). Br J Cancer. 2015. 112(3): 580-93.
[vii] Choi, Y.J. et al. Light alcohol drinking and risk of cancer: a meta-analysis of cohort studies(輕度飲酒與癌症風險:世代研究的統合分析). Cancer Res Treat. 2018. 50(2):474-487.
[viii]Zhang, R. et al. Risk factors and protective factors for alcohol-related liver disease: a systematic review and meta-analysis(酒精性肝病的危險因子和保護因子:系統性回顧與統合分析). Alcohol Clin Exp Res. 2022. 46(12): 2128-2136.
[ix] Li, X.H. et al. Association between alcohol consumption and the risk of incident type 2 diabetes: a systematic review and dose-response meta-analysis(飲酒與第二型糖尿病發病風險間的關係:系統性回顧與劑量反應統合分析). Am J Clin Nutr. 2016. 103(3): 818-29.
[x] Llamosas-Falcón, L. et al. The relationship between alcohol consumption, BMI, and Type 2 diabetes: a systematic review and dose-response meta-analysis(飲酒、BMI 和第二型糖尿病之間的關係:系統性回顧和劑量反應統合分析). Diabetes Care. 2023.46(11): 2076-2083.
[xi] Rehm, J. et al. Alcohol use and dementia: a systematic scoping review(飲酒與失智症:系統性回顧). Alzheimers Res Ther. 2019. 11:1.
[xii] Popova, S. et al. Fetal alcohol spectrum disorders(胎兒酒精類群障礙). Nat Rev Dis Primers. 2023. 9(1):11.
[xiii] American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders(精神疾病診斷與統計手冊), Fifth Edition, Text Revision (DSM-5-TR). 2023. Washington, DC: APA.
絕不可為保健喝酒,原本不喝的人也不應該以健康為由開始喝。飲酒還會讓某些疾病惡化。
對個人健康受飲酒影響的任何疑問,建議諮詢專業醫療人員,協助針對個人情況判斷最適合的飲酒方式。
酒對健康的影響很大程度取決於個人情況和生活方式。了解影響因素有助於透過飲酒適量或選擇不喝酒,管理並降低健康風險。[i]
Everybody has a different relationship with alcohol and has different factors that can increase or decrease risk of harm.
How alcohol will affect you over the long term depends on:
Most diseases that involve alcohol as a risk factor also occur in people who do not drink at all.
[i]World Cancer Research Fund / American Institute for Cancer Research. (2018). Diet, nutrition, physical activity and cancer: A global perspective(飲食、營養、體力活動、癌症:全球視角) (Continuous update project expert report 2018).
[ii]Erol, A. & Karpyak, V.M. Sex and gender-related differences in alcohol use and its consequences: Contemporary knowledge and future research considerations(飲酒行為及後果的性別和性別相關差異:當代知識和未來研究考慮). Drug Alcohol Depend, 2015. 156: 1-13.
[iii] Maddern, X.J. et al. Sex differences in alcohol use: is it all about hormones?(飲酒方面的性別差異:全都是荷爾蒙的關係嗎?) Endocrinology, 2024. 165(9):bqae088.
[iv]Lees, B. et al. Effect of alcohol use on the adolescent brain and behavior(飲酒對青少年大腦和行為的影響). Pharmacol Biochem Behav. 2020, 192:172906.
[v]Xu, Q. et al. The risk of falls among the aging population: A systematic review and meta-analysis(老年人口跌倒風險:系統性回顧與統合分析). Front Public Health, 2022. 10:902599.
[vi]Fenollal-Maldonado, G. et al. Alcohol Use Disorder in older adults(年長者酒精使用障礙). Clin Geriatr Med, 2022. 38(1):1-22.
[vii]Kaminsky, L.A. et al. The importance of healthy lifestyle behaviors in the prevention of cardiovascular disease(健康生活方式行為對預防心血管疾病的重要性). Prog Cardiovasc Dis, 2022. 70:8-15.
[viii]English, L.K. et al. Evaluation of dietary patterns and all-cause mortality: a systematic review(飲食模式與全因死亡率的評量:系統性回顧). JAMA Netw Open, 2021. 4(8):e2122277.
[ix] Akerlind, I. & Hörnquist, J.O. Loneliness and alcohol abuse: a review of evidence of an interplay(孤獨與酗酒:相互作用的證據回顧). Soc Sci Med, 1992. 34: 405-414.
[x] Lees, B. et al. Effect of alcohol use on the adolescent brain and behavior(飲酒對青少年大腦和行為的影響). Pharmacol Biochem Behav, 2020. 192:172906.
[xi] Cservenka, A. & Azma, S. Neural correlates associated with a family history of alcohol use disorder: A narrative review of recent findings(與酒精使用障礙家族史相關的神經相關性:對近期發現的敘事回顧). Alcohol Clin Exp Res (Hoboken). 2024, Epub ahead of print.
[xii]Zhou, H. & Gelernter J. Human genetics and epigenetics of alcohol use disorder(酒精使用障礙的人類遺傳學和表觀遺傳學). J Clin Invest. 2024, 134(16):e172885.
[xiii]Edenberg, H.J. The genetics of alcohol metabolism: role of alcohol dehydrogenase and aldehyde dehydrogenase variants(酒精代謝遺傳學:酒精去氫酶和乙醛脫氫酶變異體的作用). Alcohol Res Health. 2007;30(1):5-13.
有些族群不論喝多少酒都可能提高健康風險,因此需要給予特別建議。
例如,孕婦應避免飲酒,以免傷害胎兒。某些國家有針對孕期和哺乳期制定正式指引,其他國家則是警告備孕中的男女雙方都應避免飲酒,以免影響生育。
未成年人比成人更容易受飲酒危害,建議不要在可以合法購買飲用的法定年齡前飲酒。合法年齡由各地政府制定,因國家地區而異。 [xiv] 為便於執行,合法買酒年齡通常視為合法飲酒年齡,不過有些國家的合法年齡是針對兩者分別制定。
台灣的合法年齡是18歲,賣酒給未滿18歲的未成年人是違法行為。
[xiv]International Alliance for Responsible Drinking (IARD). Minimum legal age limits(最低合法年齡限制). Washington, DC: IARD, 2022.
酒的喝法不同,對健康的影響也不同。
適量飲酒可以怡情助興。但短時間內飲用過量酒精,不但醉得很快,還會增加自己和別人受傷的風險,和中毒、昏迷甚至死亡的風險。
如果選擇要喝酒,務必選擇適可而止,切勿作任何可能讓自己或別人陷入危險的事。
Have you wondered what your risk from drinking means?
Usually, it is presented as a comparison between risk to a person who drinks and someone who doesn’t.
This is known as relative risk.
Sometimes these numbers can seem terrifying, but your risk also depends on how common a disease is.
This is known as absolute risk.
Let’s consider the risk of a hypothetical disease “chronitis”.
Absolute risk:
Relative risk:
This example uses a made-up disease but how you calculate risk is the same for a real one.
Risk from drinking alcohol also depends on other factors that need to be considered in making decisions about alcohol consumption.
喝酒會臉紅很可能表示身體的酒精代謝能力不佳,飲酒應格外注意。喝酒會臉紅最常見於華人、日本人、韓國人之中,其他種族較少見。
因為酒精對未成年人和成人的影響不同,且未成年人在飲酒和駕駛方面都經驗不足,所以許多國家針對未成年人(及新手和職業駕駛)制定較低的血液中酒精濃度容許值。
雖然對許多健康成年人而言,健康的生活方式可以適量飲酒,但喝酒不是養生之道。不喝酒的人不應該開始喝,喝酒的人應該考慮個人和生活方式整體所受風險及自己的飲酒量。
一杯標準單位的啤酒與一杯標準單位的葡萄酒或烈酒,純酒精含量都相同。啤酒雖然酒精濃度較低,但啤酒通常用較大的玻璃杯和容器盛裝。每個酒精標準單位的酒精含量都一樣。