爲何人到40歲後喝酒宿醉更厲害

When you're in your 40s, it's pretty common to need reading glasses. You might need smaller wine glasses, too.
到了40歲，需要佩戴老花鏡是很常見的。與此同時，你可能也需要換更小的酒杯了。

That's because alcohol hits people harder in their 40s and 50s than it did during their 20s and 30s. The reasons for this include changes in body composition to brain sensitivity and liver functioning. Lifestyle factors are at play, too. And since people tend to take more medications -- both prescription and over-the-counter -- as they age, there are more chances for uncomfortable and even dangerous booze-drug mixing.
這是因爲人到了四五十歲時，酒精的影響比二三十歲的時候更厲害。原因包括身體組成、大腦敏感度和肝功能等各方面的變化。生活方式也有影響。另外，由於人們年紀增大時會服用更多藥物――包括處方藥和非處方藥――酒精和藥物混合的機率就會更大，從而造成身體不舒服甚至出現危險。

'All of the effects of alcohol are sort of amplified with age,' says David W. Oslin, a professor of psychiatry at the Perelman School of Medicine at the University of Pennsylvania. 'Withdrawal is a little bit more complicated. Hangovers are a little bit more complicated.'
賓夕法尼亞大學佩雷爾曼醫學院(Perelman School of Medicine at the University of Pennsylvania)精神病學教授大衛・奧斯林(David W. Oslin)說：“酒精的作用會隨着年齡的增長而放大。戒酒變得更復雜了，宿醉也變得更復雜了。”

Part of the issue is that people in their 40s and older simply tend not to drink as much or as often as those in their 20s and 30s, which lowers tolerance. 'You're becoming more work-oriented, more family-oriented,' says Robert Pandina, director of the Center of Alcohol Studies at Rutgers University.
一個原因在於40歲以上的人往往不會像二三十歲時那樣喝得那麼多和那麼頻繁了，這樣會降低酒量。羅格斯大學(Rutgers University)酒精研究中心(Center of Alcohol Studies)主任羅伯特・潘迪納(Robert Pandina)說：“人會變得更以工作和家庭爲重。”

So when you do drink 'you might have a more sensitive response to alcohol because you've lowered your exposure to alcohol over all.'
所以當你喝酒的時候，“你可能會對酒精的反應更敏感，因爲你已經整個降低了酒精消耗量”。

Some people swear that only certain types of alcohol -- red wine, tequila -- are a problem. Generally, doctors say there's little science indicating that some drinks make people drunker or lead to more miserable hangovers. It is true, however, that people at any age can develop sensitivities to sulfites and tannins in wine, which can cause headaches and an upset stomach, Dr. Pandina says. And the carbonation in sparkling wines or even in mixed drinks like whiskey and Coke 'seems to increase how rapidly alcohol is absorbed,' says Reid Blackwelder, president of the American Academy of Family Physicians and a practicing family doctor in Kingsport, Tenn.
有人斷定只有某些種類的酒會有問題，比如葡萄酒和龍舌蘭酒。醫生普遍表示，鮮有科學依據表明某些種類的酒會讓人更容易醉或者導致更嚴重的宿醉。不過潘迪納博士說，人在任何年紀確實都會對葡萄酒裏的亞硫酸鹽和單寧酸形成敏感性，這兩種物質會造成頭痛以及胃部不適。美國家庭醫生學會(American Academy of Family Physicians)主席、田納西州金斯波特(Kingsport)執業家庭醫生瑞德・布萊克韋爾德(Reid Blackwelder)說，起泡酒甚至威士忌和可樂等混合飲料中的碳酸“似乎會增加酒精吸收的速度”。

About 52% of people age 45 to 64 are 'regular' drinkers, meaning they had at least 12 drinks in the previous year, according to the Centers for Disease Control and Prevention's 2011 National Health Interview Survey.
美國疾病控制與預防中心(Centers for Disease Control and Prevention，簡稱CDC)2011年全國健康採訪調查(National Health Interview Survey)的結果顯示，45歲至64歲的人羣中，約52%是“經常性”飲酒者，也就是他們上一年至少喝過12杯酒。

Body composition starts to change as early as the 30s. As people age, they tend to lose muscle mass, while fat content increases. Alcohol isn't distributed in fat. People also have less total body water as they get older. So if several people have the same amount to drink, those with more fat and less muscle and body water will have more alcohol circulating in their bloodstream. (This is also partly why women of any age tend to feel alcohol's effects more than men.)
身體組成早在人30多歲的時候就開始改變。隨着年齡增長，肌肉往往會開始減少，而脂肪含量會增加。酒精不能溶於脂肪。身體所含水分也會隨着年齡增長而減少，因此如果幾個人喝同量的酒，脂肪多而肌肉和身體水分少的人就會有更多的酒精在血液中循環。（這也是爲何各個年齡段的女性通常比男性更容易感受到酒精的影響。）

'A lot of older people are borderline dehydrated. They have less body water just from the natural effects of aging,' Dr. Blackwelder says. It helps to drink water and have a full stomach when knocking one back.
布萊克韋爾德博士說：“很多年紀大的人都處於瀕臨脫水狀態。由於衰老的自然效應，他們體內的水分會減少。”喝酒的時候大量飲水以及保持飽腹狀態會有幫助。

The majority of alcohol is metabolized by the liver, which changes when people hit their 50s. (A small amount is metabolized in the stomach and mouth.) The liver gets bigger as people get older, but the organ becomes less efficient. Blood flow decreases, as do the number of hepatocytes, the liver's functional cells, says Gary Murray, acting director of the Division of Metabolism and Health Effects at the National Institute on Alcohol Abuse and Alcoholism at the National Institutes of Health.
酒精大部分由肝臟代謝（小部分在胃和口腔代謝），而人到了50歲的時候就會不一樣。年紀越大，肝臟就會越大，但功能卻越來越弱。美國國立衛生研究院(National Institutes of Health)國家酒精濫用及酗酒問題研究所(National Institute on Alcohol Abuse and Alcoholism)代謝和健康影響部門代理主任加里・穆雷(Gary Murray)說，血液流動會減緩，肝細胞的數量也會減少。

Certain enzyme levels dip, too, including one type of the enzyme alcohol dehydrogenase, which breaks down alcohol. Women of all ages tend to have lower levels of this enzyme in the stomach. But between the ages of 50 and 60, men see their levels slide, too. All these changes mean 'you have a prolonged exposure to alcohol and possibly a little bit bigger buzz,' when you drink, Dr. Murray says. There's also some evidence that hormonal changes around menopause can increase women's sensitivity to alcohol. Healthy young people tend to metabolize about one drink per hour, Dr. Murray says.
某些酶的水平也會降低，包括一種降解酒精的脫氫酶。各個年齡段女性胃裏的脫氫酶水平都較低，但男性到了50歲和60歲，脫氫酶水平也會降低。穆雷博士說，所有這些變化都意味着，在你喝酒的時候“消耗酒精的時間會延長，可能酒勁兒也會更大一點”。穆雷說，還有證據表明，更年期前後荷爾蒙水平的改變會增加女性對酒精的敏感度。健康的年輕人通常大概一小時代謝掉一杯酒。

Stephanie Draeken used to enjoy a glass or two of wine several nights a week. 'I have four kids. I need my wine,' says the stay-at-home mother in Austin, Texas. But since turning 40 nearly two years ago, Ms. Draeken says if she has even one glass of wine now she'll 'wake up in the middle of the night with a horrible headache and the next day is like a college-style hangover without the college-style fun,' she says.
得克薩斯州奧斯汀(Austin)的全職母親斯蒂芬妮・德雷肯(Stephanie Draeken)以前喜歡每週有幾天晚上喝一兩杯葡萄酒。她說：“我有四個孩子，我需要喝酒。”但近兩年前快40的時候，她說即使只喝一杯酒，她都會“在半夜醒來，頭疼得厲害，而且第二天感覺就像大學時的宿醉一樣，只不過沒有大學時的那種樂趣”。

She tried switching to higher-priced wine, then stuck with white wine. She tried champagne. 'It didn't matter,' she says. She says she now rarely drinks wine and limits herself to an occasional vodka and soda.
她嘗試過換成更高價格的葡萄酒，然後老是喝白葡萄酒。她嘗試過香檳。她說：“不起作用。”她說她現在很少喝葡萄酒，只偶爾喝伏特加或蘇打飲料。Alcohol-drug interactions can become more of a problem, too, since older people are more likely to take medications. Alcohol and many medications are metabolized by the same enzymes in the liver, which can enhance the effects of alcohol or the medications. Heartburn drugs like Zantac interfere with the metabolism of alcohol, thus raising blood-alcohol levels.
酒精和藥物的互相作用也是一個問題，因爲年紀較大的人更有可能服用藥物。酒精和許多藥物都是由肝臟中同樣的酶代謝的，這就會加強酒精或藥物的作用。善衛得(Zantac等緩解胃灼熱的藥物會干擾酒精的代謝，從而增加血液中的酒精濃度。

Acetaminophen (Tylenol) poses another problem because, combined with alcohol, it can damage the liver.
對乙酰氨基酚（商品名“泰諾”(Tylenol)）會造成另外一個問題，因爲它和酒精混合後會損傷肝臟。

Mixing alcohol with blood thinners like Coumadin can be particularly dangerous, causing bleeding. 'People on Coumadin shouldn't really drink at all,' says Dr. Oslin. And taking alcohol with some pain medications and benzodiazepines (antianxiety drugs) can make you 'more prone to sedation, more prone to cardiovascular risk and more prone to overdose,' Dr. Oslin says.
酒精和可密定(Coumadin)等抗凝血藥物混合尤其危險，會導致出血。奧斯林博士說：“服用可密定的人其實一點酒都不應該喝。”他說，酒精和某些止痛藥及苯二氮平類藥物（抗焦慮藥物）一起服用會讓人“更容易進入鎮靜狀態，更易患心血管病，更容易服藥過量”。

People with certain medical conditions should also be cautious with alcohol, doctors say. Long-term alcohol use can raise blood pressure. And alcohol tends to irritate the stomach.
醫生們表示，身患某些疾病的人也應在喝酒上多加註意。長期飲酒會使血壓升高，酒精還會刺激胃部。

Barring health problems and medication interactions, doctors generally become concerned when people drink more than a moderate amount of alcohol. That is defined as up to two drinks per day for men and up to one drink per day for women, according to the latest federal Dietary Guidelines for Americans. (A standard drink is about 12 ounces of beer, 5 ounces of wine or 1.5 ounces of liquor, according to the CDC.)
除健康問題和藥物作用以外，醫生通常還擔心飲酒過量的問題。根據聯邦政府最新的美國人膳食指南(Dietary Guidelines for Americans)，適度飲酒的定義是男性每天最多兩杯，女性每天最多一杯。（根據CDC標準，標準的一杯酒約爲12盎司的啤酒、五盎司的葡萄酒或1.5盎司的烈酒。）

In fact, there's some evidence that a moderate amount of alcohol can have health benefits. Studies have linked moderate alcohol consumption with a reduced risk of cardiovascular problems and death overall. Excessive alcohol consumption increases the risks of liver disease, stroke, high blood pressure, certain types of cancer and dementia, beyond the obvious accidents and injuries.
事實上，有證據顯示適量飲酒有益健康。有研究表明適量飲酒可降低心血管疾病和死亡的風險。過量飲酒除了會導致顯而易見的事故和受傷之外，還會增加肝臟疾病、中風、高血壓、某些種類的癌症和癡呆的風險。

Particularly beginning in the 50s and 60s, the brain is more sensitive to alcohol. Booze basically enhances normal age-related cognitive decline. Neurons lose speed. Specifically, the insulating myelin sheaths around the axons of neurons -- the parts responsible for transmitting information to other neurons -- get smaller. As people age, 'neurons are not as efficient. So you impair them with a little bit of alcohol, they are that much more inefficient,' says Dr. Oslin. 'Somebody who goes to a cocktail party at 65 can have one or two drinks and be really impaired.'
尤其是從50和60多歲開始，人的大腦就會對酒精更敏感。酒精基本上會加重正常的衰老引起的認知功能衰退。神經元傳播速度也會降低。具體來說，神經元軸突周圍的絕緣性髓鞘――負責將信息傳送至其他神經元的部分――變小了。奧斯林博士說，隨着年紀增加，“神經元的效率會不如以前，所以你用一點酒精損害它們後，它們就會變得更沒有效率。65歲的人去雞尾酒會時喝一兩杯酒就會損害很大”。

Older people are also more affected by alcohol's impact on sleep, a fact that can turn a mild hangover into a must-stay-in-bed-all-day affair. 'Alcohol in all ages wrecks our REM sleep,' says Alison A. Moore, professor of medicine and psychiatry at the David Geffen School of Medicine at the University of California, Los Angeles. 'Older adults are more likely to have poor sleep. [Alcohol] can make sleep even more fragmented.'
年紀大的人的睡眠也會更容易受到酒精的影響，輕微宿醉會變成全天都得躺在牀上。加州大學洛杉磯分校(University of California, Los Angeles)大衛格芬醫學院(David Geffen School of Medicine)醫藥及精神病學教授艾莉森・摩爾(Alison A. Moore)說：“無論任何年齡，酒精都會破壞快速眼球運動睡眠，年長的人更有可能睡眠不好。（酒精）會導致睡眠更分散。”