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What to drink in a heatwave
With temperatures well into the 30's this week it's not a bad idea to cut down on the alcohol. Here's how to make your drinks a little less boozy
Choose wines and beers that are naturally lower in alcohol
Mosel riesling - generally about 8-9% - is the obvious choice but may be a bit sweet for some. Portugal’s Vinho Verde, often at 10-11% might be more palatable if you’re used to a drier white and there are plenty of lighter reds around 12-12.5% if you look out for them, Beaujolais being a good example. Natural wines also tend to be lower in alcohol than conventionally made ones.
There are also many good no- and low-alcohol beers around such as Kernel’s Table Beer and The Small Beer Co’s Original Small Beer. See my recent Guardian column for other suggestions
Forget the oak
If your normal tipple is a full-bodied chardonnay or shiraz you might want to wait until the weather cools down a bit to enjoy them.
Dilute your drink
Almost anything you drink can be diluted, gin and tonic being the obvious example (though maybe make it a single rather than a double in this weather). Serve white wine as a spritzer by adding chilled soda or sparkling water to it and beer as a shandy. Sherry and white port are delicious with tonic too. Traditional long drinks such as Cinzano (or other ‘bianco’ style vermouths) and soda are also great in the summer.
9 wine cocktails with a summer twist
Chill everything
Not just your white wines and rosés but reds too. And if you’ve forgotten to put it in the fridge pop a couple of ice cubes into your glass, stir and take them straight out again. Or leave them in if you don’t mind a bit of dilution.
Freeze it
Yes, freeze your wine! Frosé (frozen rosé) was a thing a few years back and not a bad thing to bring back in this sweltering heat.
Stay hydrated
Finally even if you are drinking stay hydrated - with water rather than with fizzy drinks like Coke - you should be drinking at least 2 litres a day. If you find it unpalatable add a slice of lemon or a couple of slices of cucumber to your glass. Cold brew tea is also a refreshing alternative - do try it if you haven't.

Which tea to drink for the Chinese New Year?
Chinese tea on the face of it would seem the perfect drink to welcome in the Chinese New Year but it’s slightly more complicated than that as Lu Zhou and Timothy d’Offay of Postcard Teas explain.
“Happy Chinese New Year! This year is The Year of the Ox and it begins on February 12th so the 11th is the day to get ready by tidying up the house, preparing a family feast and staying up to see the New Year in with fire crackers.
Traditionally you might also make and eat some sticky rice cakes and dumplings. Though these delicacies sound like the perfect accompaniment to tea, tea is not a major tradition during the festival and alcohol is the traditional drink of the New Year meal and most fine dining.
Usually in China, good tea is not drunk with food because Chinese people think the strong tastes as well as the oil from food will interfere with the purity of teas. In one memorable tea scene from China’s most celebrated novel “Dream of the Red Chamber” the heroine Dai Yu has dinner with the Jia family for the first time and after the meal, unused to such a grand occasion, commits a faux pas by drinking the lower quality tea meant for rinsing out one’s mouth before the special tea is served.
When drinking fine Chinese tea, the tea takes centre stage and so is often accompanied by a simple selection of nuts, melon seeds, and dried fruits. But if those New Year’s dumplings or sweet cakes are still crying out for some Chinese tea here are some options.
As it is winter, a roasted oolong tea may be appropriate as the roasting would be considered to give the tea a warming quality whereas a white or green tea would be considered to be cooling and more appropriate for summer. We would suggest a Wuyi Oolong from last summer which needs about 6 months to settle down before being enjoyed or maybe an aged Pu-erh or a Chinese black tea like Keemun if heavily roasted teas are not your thing.
All these teas can be easily brewed with just boiled water between 90-100°C. Indeed even Chinese green tea if it is of a high standard can be brewed with water between 85-90°C, much hotter than is appropriate for Japanese green teas.
The major tea pairing obsession in China has historically been with water. Lu Yu,the original Sage of Tea, believed that water taken from mountain streams was the best and well water the worst.
Through the ages tea connoisseurs have matched local waters to teas. Two famous pairings we have tried and been impressed by were West Lake Long Jing with Hupao Spring water and Wuyi Oolong teas with water from the source of the Jiuqu Yi River.
So why not celebrate by brewing some tea with a new source of water? At our shop we use a mixture of tap water, Volvic and Highland Spring, depending on the tea, but we also enjoy a local Sussex mineral water called Pear Tree Well. Although not widely available it is still easier to obtain than the water from melted snow from plum blossom branches aged for five years mentioned in another famous tea chapter of 'Dream of the Red Chamber'!"
(Postcard Teas has a charming shop and tea room in Dering Street, just off the Oxford Street end of New Bond Street - one of my favourite places to drink tea in London. Tim also has a beautiful book called The Life of Tea (£30 Mitchell Beazley) which you'll definitely want to own if you're a tea-lover.)
Photo © Michael Freeman

What to drink with a kebab - and it's not lager!
Inspired by the British Kebab awards Zeren Wilson wonders what the perfect wine pairing is for a kebab and comes up with some surprising conclusions.
Zeren writes: "Something is stirring in the world of Turkish dining in London, a subtle shifting of the landscape. This week the 2014 British Kebab Awards were held in the Park Lane Sheraton, a celebration of the finest purveyors of this most primal and visceral form of eating, that of slamming bits of animal over white hot coals (sometimes the skewer is flourished), turning them every now and again, and waiting until they are done.
The roots of the Turkish word kebap can be traced back to Mesopotamia, it's origins arriving through the Persian and Urdu languages, with its original meaning summing things up cutely: meat cooked with flames.
As the son of a Turkish Cypriot mother, the kebab has played a role in my upbringing from a disconcertingly early age. At six months old my parents took me along to their favourite Kebab restaurant and Britain's first, Nasreddin Hoca (named after a historical Ottoman figure), and slung me under the table while they chowed on meat, hummus and garlicky yoghurt dip, cacik. If Twitter had existed back then, I would probably have sent my first tweet from under the table.
We Brits have evolved a great tradition of getting plastered on a Saturday night (as one should sometimes) and soaking up all that booze with a late night kebab, which may be a gourmet delight, but so often can be something....less appealing.
The British Kebab Awards were not bigging up the potentially shocking Elephant Leg here (which with good meat, can also be great), but rather theTurkish restaurants that have been serving up thoroughly decent meat, chargrilled with a bit of love.
Apart from hoovering up a few bottles of the Turkish lager Efes (it does a job, but won't shake your shish in an earth-changing way), there are a few styles of wine that have the weapons in their armoury to cope with the bold flavours involved and the smoke of the grill.
Turkish wines have improved considerably over recent years, but on a recent visit to Istanbul I found prohibitive taxes applied to wine, making drinking anything decent an almost impossible task without being shafted on price.
Importers in the UK have started to notice the improvements*, and one of the first to take the leap has been Armit, who bring in wines from the very decent Urla winery, which Jancis Robinson featured on her site a couple of years ago.
Turkish varietals have some wonderful names, chief among them being the burly, tannic grape Bogazkere (poetically translated as 'throat scraper'), and the somewhat fluffier, friendlier Oküzgözü* (meaning 'bull's eye', which is often blended with its more abrasive, tannic cousin to achieve balance and roundness.
A Turkish white varietal which perked up my palate was the versatile Narince, a Riesling-esque wannabe, with great acidity and a broad spectrum of fruit flavours ranging from lime and grapefruit, through to lusher tropical notes. It can also cope with a touch of oak in the right winemaker's hands.
Doluca is another example of a Turkish winery making clean, accessible wines which have the potential to enter International markets and compete on the quality front.
Let's see what else we can pour successfully when perched up against the heat of the mangal . . .
ADANA KEBAB - For me this is the 'daddy' of the kebab restaurant experience, and I never feel satisfied unless I have at least a bite of this glorious 'köfte on a stick'. Named after the fifth largest city in Turkey, this is a boldly flavoured assemblage of minced lamb meat (often with tail fat), sweet red peppers, garlic, onion, parsley, red pepper flakes, with some variations depending on the venue.
Wrapping this in a Turkish flatbread (dürüm) which has been moistened with the fat from the cooking meat, with some salad, makes for a joyous experience. A glorious version in Istanbul involved pistachio nuts. Meaty, fatty, spicy — I would go for reds with big gobs of dark fruit, a ballsy Chilean Cabernet Sauvignon or Merlot, Argentinian Malbec, Aussie Shiraz - that kinda thing.
CHICKEN SHISH - The 'vanilla' of the kebab world, but some mangals marinade their chicken in such a way, that suddenly chicken is not the boring option any more. There is often some heat from the spice of the marinade involved too. A broad-shouldered white or lighter red are the wines to think about here, so perhaps New World Chardonnay that doesn't have too much of a slap of oak, such as a Chardonnay from Mornington Peninsula, Australia (I love Kooyong), or South African or New Zealand Chardonnay or white varietals with a bit of lushness to them - a New World Pinot Gris perhaps. Tempranillo from Spain, or Grenache dominated- Rhône reds should feel at home here too.
LAMB SHISH - The classic cubes of lamb shoulder are the archetypal Turkish kebab item, and no kebab feast would be complete without it. Reds from Ribera del Duero work very well here as do fuller-bodied reds from the Languedoc-Roussillon and South-West France such as Cahors. (These tend to be great value, too).
QUAIL - If you're lucky, a good mangal will have quail on the menu. A chance to pull out your favourite Pinot Noirs and lighter reds. My ideal would be a Californian Pinot Noir, something from the Sonoma Coast. Or top red Burgundy, if you are bringing the wine. Thanks.
LAMB BELLY - Another option which won't always be there but is a joy to eat, stripping the meat and fat from the bone until there is no DNA left. Reds with great acidity work best to slice through all of that fat, so good Northern Rhône Syrah is an option here: St Joseph, Cornas, or Côte-Rôtie if someone else is paying. Sonoma Coast Syrah is having a bit of a moment too. Step forward, Arnot-Roberts Syrah, which is brought in by Roberson Wines.
Any kebab feast will involve a whole host of flavours, a melange of spice and fat, meat and smoke, and it may be hot, sweaty, and bloody noisy. When it comes down to these myriad factors, wine matching thankfully takes a step back from the discussions of perfect wine combos and you may end up surprising yourself with the combinations that work.
I enjoyed a white that sailed through every course without flinching in the face of the assault of smoke, meat, spice and fat-slicked fingers. This accolade fell to Ataraxia Chardonnay 2012, from South Africa, made by husband and wife team Kevin and Hanli Grant. A modern barrel-fermented Chardonnay with plenty of elegance alongside the heft of New World fruit.
Right, I'm off to Green Lanes in Harringay**, N16, for the mother of all kebab crawls...
* Marks & Spencer has recently started listing one which I made my wine of the week a few weeks back.
** There may be those of you that wonder whether this should be Haringey. I did but Zeren assures me that's how the locals spell it!
Zeren Wilson is a food and wine writer with a background in the wine trade. He publishes his own blog Bitten & Written.
Image by Ðикита Лазоренко from Pixabay

10 wines I enjoyed in 2019 that I'd like you to try too
Why do we enjoy making (and, hopefully, reading), lists? I guess for some, like the “top-5” obsessed staff at Nick Hornby’s imaginary record store in High Fidelity, the idea of selection and hierarchy has inherent merit. For others, it can be the idea of taxonomies: putting some order into the chaos. Probably for all of us, the opportunity of thinking back to what we have experienced is what makes a landmark special. So, with the New Year approaching, I thought back to the wines that marked 2019 for me.
A list, however, that attempts to catch the “Top” or “Best” always runs the risk of turning too personal, too self-indulgent. After all, the most memorable wine moments we have are rarely because of the liquid itself. So, if you’ll indulge me, instead of my “best” wines of the year, here are 10 wines I had in 2019 that I think you should have too.
Happy new year everyone!
1. Billecart-Salmon Brut Sous Bois NV
Whisper it, but not everyone loves champagne. Or, to put it more accurately, not everyone loves the sparkling wines aficionados do. Friends and family have often had to fake approval after trying my latest favourite extra brut franciacorta or pas dosé champagne; it can be a challenging predicament being caught between a rather steely drink and a loved one staring back like an overexcited labrador. You don’t run any such risks with Billecart-Salmon’s Sous Bois, a blend of the classic champenois grape varieties, vinified and aged in oak casks. This is a rich, powerful champagne that understands elegance as muscle tone. It also speaks of grandness and festivity, so a good one for this time of the year – and even better for this time of the year 2021, as it will improve. Warning: you will need some serious canapés for this if young. I have served it to accompany a dinner of sea bass with roast vegetables and it shrugged that off casually. Proceed accordingly.
(£67.95, Fortnum & Mason)
2. Duran 5V Gran Reserva Brut 2012
Wine writers often feel that there are some wines that are perpetually misunderstood by the public and mistreated by the market. On the antipode of champagne’s glory and fame comes cava. Identified with the mass-produced offerings of Spanish conglomerates, it’s unsurprising most consider it a low-cost, entry level sparkling, like a brackish alternative to prosecco. That is, of course, only part of the story. There is another cava: fine, elegant, on par with any quality sparkling, yet distinctly different. Duran’s 5V, a blend of the three traditional varieties of macabeo, parellada, and xarel·lo, with the Champenois chardonnay and pinot noir, was one of my favourite examples this year. As above, you can serve this as an aperitif with suitably interesting starters (seafood would work particularly well), but I prefer it to accompany a main. I had it with salmon fishcakes and it worked like a charm.
(£18, Vinissimus)
3. Domaine Peillot, Roussette du Bugey-Montagnieu Altesse 2018
The concept of Alpine wines fascinates me. There is something particularly romantic about grapes that are grown in such a challenging environment. I don’t drink as many of them as I would like, partly because their availability is limited in the UK. For example, I’ve struggled to track down most labels described in Artisan Swiss, an excellent blog covering the wines of the Confoederatio Helvetica. You would probably find it similarly tricky to grab a bottle of the best product of the Alps I’ve had this year, the Aostan Les Cretes Fleur 2017, an electric, formidable wine keeping a fine balance between Northern coolness and an almost Mediterranean salinity. For a more easily available, and financially much less punishing, stand-in, I refer you to the ever-reliable Wine Society. Peillot’s Altesse has the gentleness and clarity I associate with the grape, but enough citrus on the palate and aftertaste to keep things interesting. Just the thing if you’re planning a fondue with the leftover Christmas cheese.
(£16, The Wine Society)
4. Planeta Eruzione 1614 Bianco 2017
It might not feel like it now, but summer does eventually come back every year and with it the appetite for fresh salads, fried zucchini, and grilled fish. You won’t be surprised to hear I favour Santorini whites above all else, but I’m always open to a supporting cast: Fiano and Falanghina from Campania, Albariño from Galicia and Xarel·lo from Catalonia, the Great White Classics of Burgundy. I’ve not always had a perfect track record with Carricante, Sicily’s answer to Assyrtiko, but Planeta’s Eruzione has been a favourite of mine lately. I don’t know if I can actually taste the small quantity of Riesling, or it’s just the idea it’s there, but I find an Alsatian twist in the aftertaste that works particularly well - and I’ve laid down a few bottles to see how it’ll do over time too.
(£29.50, Great Western Wine)
5. Gikas Pine Forest NV
Those more inclined to national stereotyping might think Greeks always need to have a retsina in their wines of the year. In reality, retsina is more a source of frustration than pride amongst the country’s vinerati, seen as unfairly sullying the good name of Greek wine to the older segments of Western populations. It might surprise you to hear that things have moved on. Earlier this year, I did a survey of the contemporary retsina scene. Amongst the novelties and oddities (pet-nat retsina, rosé retsina, retsina in amphora) one stood out: Pine Forest is 100% Assyrtiko, with only the gentlest suggestion of pine resin. Full-bodied, tense, and saline, it is probably the only retsina that will develop over the next two to four years - and it’s one for a Springtime seafood feast.
(approx. £10, Greece and Grapes)
6. The Society’s Exhibition Pauillac 2010
Supermarket and wine merchants’ own labels are rarely anything to write home about: unsurprisingly, producers do not reserve their finest wines for someone else’s brand. Happily though, there are still some reasonable buys to be found in the better years. The Wine Society’s 2010 Pauillac, from their premium Exhibition range, was released about this time last year and is just entering young adulthood now. A wine made for Beef Wellington, it provides a peek into the combination of firmness, leanness, and elegance associated with this most aristocratic of Bordeaux communes. Granted, it not exactly the finest example of its kind, but at £24 it is at least priced within the occasional reach of us mortals – you can buy a case of the allegedly monumental 2016 Lafite instead, but you’ll need to sell a moderately used Subaru Impreza for the privilege.
(£24, The Wine Society)
7. COS Pithos Rosso 2015
There must be few grapes in the wine world as mistreated as Nero d’Avola, usually making the bulk of bland, sugary concoctions, whose main aim seems to be to stay below the psychological threshold of £5, the inflation-unaware price ceiling first decreed, I believe, by Disraeli’s Super Market Minister. The COS Pithos feels like it’s made with the express intention of being the polar opposite. A blend of Nero d’Avola with the gentler Frappato, it could pass for Fixin in the glass. On the nose, it has earthiness and elegance; on the palate red fruit and freshness; on the aftertaste, length and hints of tannin. It is almost the platonic ideal of an accompaniment to a midweek plate of pasta with a rich red sauce. In a perfect world, it would also have a price to make it a midweek wine. Alas, as so often, quality comes with a price tag to match.
(£27, Buon Vino)
8. T-Oinos Mavro 2012
Santorini Assyrtiko has been arguably the greatest success Greek wine has ever had, with prices seemingly ever higher. While I mourn the loss of its status as one of the wine world’s greatest bargains, I can see it going even further up and deservedly so. I have struggled, however, to justify the dizzyingly high prices of Santorini’s red grape, Mavrotragano, which often appears to be over-oaked beyond any grape or terroir recognition. Thus, I approached the T-Oinos Mavro, a Mavrotragano-Avgoustiatis blend from Santorini’s Cycladic neighbour Tinos, with similarly low expectations. The dark, Argentian Malbec-like colour seemed to suggest more of the same. Yet, it all changed when I brought the glass to my nose, the aromas (ripe red fruit, hints of dark chocolate) promising that most elusive of qualities, finesse. The texture was pure velvet, the tannins having softened considerably after a few years in the cellar. It is not necessarily the best Greek red I’ve had this year, but it is the only one I would unhesitatingly call suave.
(£40, Corking Wines)
9. Château Suduiraut (for Waitrose) Sauternes 2011, Bordeaux
Sweet wines hold a peculiar position in the festive meal. By the time they arrive at the table, everyone is at least pleasantly tipsy, and thus very open to more drink. On the other hand, few are still in a frame of mind to fully appreciate how complex such wines can be. This, then, might not be the perfect time to serve your very best Sauternes. Yet, it is also not the time for something bland – and I am sorry to say that a good chunk of own label offerings I’ve tried are just that. An honourable exception is Waitrose’s Château Suduiraut 2011, delivering the tension between sweetness and acidity I am looking for in a Sauternes. The canonical match with Roquefort is not really my thing anymore (I’m more inclined to think lemon tart), but I’ve seen it perform admirably for others.
(£16 for 37.5 cl, Waitrose)
10. Graham’s 20 yo Tawny Port
Another plight of sweet wines is that they’re often called to accompany over-sweet desserts. Serve the Sauternes above with a traditional Christmas pudding, for example, and that beautiful tightrope walk will plunge into the rum-and-raisin depths. For such hearty fare, you’ll need something more substantial, such as Madeira, Maury, or, for something more off-piste, the sweet wines of Samos, about which I’ve written before. At this time of the year, however, I like to keep to the classics – and there is nothing more classically Christmassy as a tawny port. It’s a wine made for Christmas pudding, the nut and caramel aromas echoing the dessert’s spices, and the fortified backbone balancing the pudding’s richness. Do invest in the 20yo, a substantial upgrade over its 10yo sibling. It is Christmas after all.
(£30 on offer Ocado, and widely available for £40)
Image © Autthaseth
Peter Pharos likes drinking, talking and writing about the wines of Greece and Italy. He also writes a bimonthly column for timatkin.com.

All you need to know about hangovers
In his latest guest post GP Jonathan Tricker explains why we get hangovers, how to avoid them and how to get over them.
You open an eye, the ceiling wobbles. Your mouth, so dry. There’s no water to hand. You need a wee. The bathroom is way too far away. You sit up. Big mistake. Feel dizzy. A wave of nausea thwacks you. Saliva thickens in your mouth. You are sweating. You lie back down. Your heart is pounding. You roll over. Is that guilt you’re feeling? No wait, it’s indigestion. Urrgh. Too much thinking. You’re never drinking again.
Feels familiar? You may ask yourself, why does this always feel so bad?
What causes a hangover? How can you prevent it? How can you treat it if you get one?
Truth be told, if you don’t want to read to the end of this post, here are the abbreviated answers. We’re not too sure, we don’t really know and there’s no proven treatment. And strangely, given their frequency, they’ve received surprisingly little formal scientific enquiry.
And hangovers are common. There’s been a lack of large (and recent) epidemiological studies, though one Dutch study has shown 92% of the respondents were drinkers and 61% reported a monthly average of 2.7 hangovers. Another US study concluded 25% college students had experienced a hangover the previous week. 10% British men have reported having a hangover in the previous month.
Hangovers comprise a menacing array of symptoms including: stomach pain, nausea, vomiting, thirst, dry mouth, dizziness, fatigue, weakness, irritability, short-term memory problems, fast heart rate and headache. These start when blood alcohol concentration (BAC) approaches zero and will usually abate in 8-24 hours. But how often have these symptoms affected your everyday life, not to mention your ability to work productively?
The economic costs are hard to disentangle from the more general cost of alcohol, but through work absenteeism and reduced job performances the estimated cost of hangovers to the UK economy in 1987 was around £2 billion a year. More recently it has been estimated in the US, the annual opportunity costs of hangover at $2000 per working adult. Staggering stuff, really.
Why hangovers make you feel so bad
The stomach pain, nausea, and vomiting can probably be explained by the direct effect of alcohol on the gut. Alcohol irritates the lining of the stomach, delays the emptying of the stomach, relaxes the muscles at the bottom of the oesophagus (that’s the food pipe from the mouth to the stomach), allowing acid to regurgitate backwards, increasing stomach and pancreas secretions, and causing fat to accumulate in the liver.
Alcohol is also a potent diuretic (which means it increases the amount of urine produced) through inhibiting the production of a hormone called Anti Diuretic Hormone (or ADH). Consuming 50g alcohol (around 6 units) diluted in 250ml of water, causes elimination of 600-1000mL of water over several hours. There are probably additional mechanisms at work mucking around with the body’s salt (electrolytes) and acid balance which may, in part at least, explain the thirst, dry mouth and dizziness you experience. The severity of a hangover does somewhat correlate with the concentration of ADH. The good and bad news is that whilst hydration can reduce the severity of a hangover, it cannot cure it.
Glucose is the brain’s main form of energy. Alcohol prevents its production in the liver, which may account for some of the fatigue, weakness and mood disturbance you experience. And yet the body is actually rather good at regulating our blood sugar level, and there is usually a good supply of glucose in the liver. Normally one only sees true hypoglycaemica (low blood sugar) in alcohol-dependent persons who’ve been on a bender for several days, not eaten, and consequently exhausted their liver’s supply of glucose. It is uncommon to be truly hypoglycaemic after a big night out, and frustratingly, in two small studies, administration of glucose at the time of alcohol ingestion has not been shown to reduce the intensity of a hangover. Because of the ways alcohol interacts with sugars individuals with diabetes are especially vulnerable to alcohol-induced alternation in their blood sugar level.
How alcohol affects your sleep
Alcohol has numerous effects on sleep. The sedative effect induces sleep, but the sleep is usually of shorter duration and of reduced quality. Alcohol reduces the amount of dream sleep (called REM sleep) and increases deep-sleep. The balance between these states is really important for good quality sleep. Most boozing occurs in the evening and night and competes with normal sleep time, so further reducing the duration of sleep. It has been suggested that acute intoxication muddles with the body’s circadian rhythm (the sunlight-dependent natural 24 hour clock that regulates almost every automatic bodily function) therefore inducing a jet-lag-like state. Also, alcohol relaxes the back of the throat (which is why you may snore when you go to bed intoxicated), and the floppy back of the throat could block your airway, causing or worsening a condition called sleep apnoea. All of which culminates in understandable fatigue.
We are not too sure what causes headaches in hangovers. It may partially result from dehydration. Other explanations include alcohol-induced dilatation of the blood vessels in the brain (called vasodilation), alcohol’s effects on chemicals in the brain called neurotransmitters, or the ways alcohol interacts with our immune system. Who knows for sure?
We do know that alcohol is broken down in the liver to a product called acetaldehyde. When you give animals acetaldehyde or drugs to humans that makes acetaldehyde accumulate (the basis of a drug called disulfiram (or “Antabuse”), sometimes given to patients’ with alcohol addiction. It is also the reason you really mustn’t drink alcohol when taking the antibiotic metronidazole.), it causes flushing, nausea, vomiting, and fast pulse – effects not dissimilar to a hangover. Because of these similarities, it is attractive to think that small concentrations of the stuff may play a role in hangovers. However, acetaldehyde’s role remains frustratingly elusive since it is usually broken down quickly in the liver.
There is considerable individual difference in hangover severity so it seems likely that genetics plays an important role as well. More enigmatically, people who experience shame or guilt during a hangover may experience a worse one.
The role of congeners
When you drink alcohol (unless for some inexplicable reason you’ve chosen to drink pure alcohol) there are other biologically active compounds in the glass called congeners, which account for most of the drink’s smell and taste. Drinks will vary widely in congener content. It has been shown that alcohol low in congeners can lessen the severity of hangovers. Vodka usually has the lowest congener content, bourbon whiskey the highest.
The presence of congeners might explain the theory behind the hair of the dog. Methanol is a congener. Methanol and its breakdown products may cause some hangover symptoms. Alcohol inhibits the breakdown of methanol, so it can stay around in the body longer than one would normally expect. The morning after, as BAC has dropped, methanol is then broken down. Consuming more alcohol would once again inhibit methanol’s breakdown, delaying the effect methanol and its breakdown products may have. Personally I wouldn’t recommend it. Virgin Mary anyone?
So what’s the best way to prevent a hangover?
This may sound obvious, but hangover symptoms are much less likely to occur if you drink small non-intoxicating amounts of alcohol. If you do drink to excess the stronger the drink, the greater the chance of a hangover.
Drinking alcohol low in congeners (good news if you like gin, less good if you’re a fan of red wines) may reduce the severity.
Other things that have been shown to worsen hangovers include: lack of food, not enough sleep, increased physical activity whilst intoxicated, dehydration and poor physical health. It stands to reason that the opposites may improve hangovers. Avoid strenuous physical activity when drunk, try and be in general good-shape, drink plenty of water, and have some food with your drink.
Eating fatty food when ingesting alcohol may be helpful in reducing the severity of a hangover. Fat delays the absorption of alcohol from the gut into the bloodstream, thereby reducing the peak BAC. Peak BAC correlates with the severity of a hangover.
As we have seen, alcohol has an effect on glucose, so it may be pragmatic to ingest some long-acting carbohydrates such as fruits and non-starchy vegetables, nuts, and minimally processed grains whist imbibing alcohol.
If you are unfortunate enough to experience a hangover, what’s the best way to cure it?
There are only a few randomized control trials (the standard to try and determine if an intervention is effective) looking at hangover cures. None have shown any clear benefit I’m afraid.
Sorry.
So what may help? Drinking lots of water. Perhaps a light easily digestible meal, if it doesn’t exacerbate the gastric effects of your hangover. If you can, sleep for longer.
If you are used to a coffee in the morning, going without may induce a caffeine withdrawal headache, and perhaps make the hangover headache worse. So it may be sensible to have one - if you are the morning-coffee type. Otherwise, it’s probably of no benefit.
As with tablets and supplements, there are no proven effective hangover meals. Despite the popularity of the Full English Breakfast as a cure, there is no systematic evidence it works. Pragmatically ingestion of fresh juice (which contains water, salts and fructose – a sugar) may help tackle to diuretic effects of last night’s alcohol. Eating other forms of long-acting carbohydrates, like oats, may be of some benefit given what we have seen of alcohol’s effect on the body’s sugars so a bowl of porridge might be beneficial.
Be careful if taking Ibuprofen or other anti-inflammatory medication. Whilst they may improve some hangover symptoms, they can cause stomach irritation and may well worsen your gastric symptoms. Paracetamol is also harmful in overdose to the liver. We have already seen alcohol has a direct damaging effect on the liver so I would caution the use of paracetamol, especially if you have a history of liver problems. (Then again, if you have a history of liver problems you should not be drinking alcohol, certainly not to excess). In small doses in usually well people, paracetamol may alleviate some of the symptoms.
I’m afraid, as with so much about hangovers, the paucity of studies means we move swiftly from evidence to opinion. So, for what it’s worth, this is what I would pragmatically recommend in a hangover situation, appreciating there is no clear evidence basis:
My advice in a nutshell
Whilst out of an evening drink plenty of water. (And I do mean plenty -- like 1 pint water for every 2 units of alcohol). Enjoy your alcohol with delicious food. When you get in, drink a pint of squash or water. Make sure there’s another by your bed. Take ranitidine (a drug that reduces the amount of acid in the stomach, it is available over the counter, sometimes branded as Zantac) before going out or before bed. When you wake up, drink more water, perhaps some tea and maybe 2 paracetamol. If your stomach can manage, try a light breakfast of juice, toast with honey, or porridge. Then go back to sleep. And sleep and sleep. Until you feel better.
Dr Jonathan Tricker is a practising GP. You may also find his piece on how much you should drink useful.
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