Alcoholic Beverages and Human Health: An Overview

*Oladipo Iyabo Christianah*

## **Abstract**

Production of alcohol is by fermentation of yeast, sugar, and starches. The consumption of which may be associated with some underlining risk factor depending on the quantity consumed per time. Alcohol can be consumed raw or by mixing in beverages, and whenever an alcoholic beverage is consumed, it can take about an hour for the body to metabolize one-eight of an imperial gallon. The level of the blood alcohol is increased when the quantity of alcohol consumed exceeds the normal dose which the body could metabolize, and then intoxication sets it. The higher the blood alcohol concentration, the higher the risk of diseases associated with the liver, kidney, and pancreas and the abundance of free radicals in the body system. Excessive use of alcohol can lead to alcoholism or alcohol dependence. Withdrawal from which can be life-threatening. Disulfiram, naltrexone, and acamprosate are the three approved oral medications for the treatment of alcoholism or alcohol dependence. On the other hand, moderate consumption of alcohol or red wines has been confirmed to be beneficial to human health particularly because of the antioxidant properties it confers.

**Keywords:** alcoholism, alcohol dependence, alcohol addiction, alcohol withdrawal, signs and symptoms

### **1. Introduction**

Alcohol are organic compounds identified by one or more hydroxyl (<sup>−</sup>OH) groups attached to a carbon atom of an alkyl group [1]. Alcohol is often considered as organic derivatives of water in which one of the hydrogen atoms has been replaced by an alkyl group, typically represented by R in organic structures. There are different types of alcohol: propyl, methyl, ethyl, and butyl alcohol, but for the production of alcoholic beverages, ethyl alcohol (ethanol) is the type used, while death or blindness could result if the other three are consumed at all [2]. Ethanol is normally produced from the fermentation of yeast, sugar, and starches [3]. It can also be consumed mixed in beverages or in its raw form, but the end product after digestion by the body is formaldehyde, which is deleterious to the body and also the cause of alcohol poisoning. Liver cirrhosis, gastric ulcers, gastritis, fatty liver, alcoholic hepatitis, and pancreatitis are examples of some disorders resulting from alcohol intoxication. Moderate consumption of alcohol may have some health benefits that could prolong life, but when taken in excess or as an escape route from problems, then abuse or alcoholism is inevitable.

Abuse of alcohol usually leads to alcohol use disorder also known as alcoholism or alcohol addiction which can lead to a violent behavior. Addiction to alcohol refers to physical and psychological dependency on alcohol to the point that tolerance is built up to alcohol [4]. Furthermore, once the body becomes adapted to excessive consumption of alcohol, an abrupt discontinuation leads to withdrawal symptoms which can be a threat to life and the symptoms normally includes hallucination, tremors, convulsions, anxiety, etc. Alcohol addiction may also result in the following: restlessness, depression, erratic behavior, decreased involvement in extracurricular activities, loss of interest in work or school, lack of interest in relationships, preoccupation with drinking, inability to control drinking, and violent behavior. While, nonalcoholic beverage refers to any drink that contains no alcohol or which contains less than 0.5% alcohol by volume and examples are fruit juices, mineral water, hot drinks etc.

## **2. Alcohol and alcoholic beverages**

There are different types of alcohol based on their uses; some are used as solvents, antifreeze solutions, e.g., isopropyl and methyl alcohol, paint removers in chemistry laboratories and chemical factories, and as nail polish remover and cleansing solvent, for example, methylated spirit for domestic use [5]. There are different types of alcohol depending on the number of carbon atoms present and the position of the OH bond in the formula, but the most common alcohol is ethanol (CH3CH2OH or C2H5OH). During the process called fermentation, alcohol is produced. Fermentation of yeast usually results into sugar breaking down into carbon dioxide and alcohol. But carbon dioxide is taking off the process through gas bubbles leaving a mixture of water and ethanol. Sugar fermentation to alcohol can be used in different applications especially in the production of alcoholic beverages, for example, the extracts of grapes and barley are fermented in the wine and beer industry to produce alcoholic beverages. Any drink or beverage that contains ethanol is normally referred to as alcoholic beverage and are either produced by fermentation or distillation. There are different types of alcoholic and nonalcoholic beverages. Alcoholic drinks can be classified into five categories: (i) Wine, i.e., still, sparkling, fortified, or aromatized; (ii) beer, i.e., ales, lagers, and stouts; (iii) cider and perry; (iv) distilled spirits, i.e., vodka, gin, rum, whiskey, brandy, and others; and (v) liqueurs, i.e., flavored with fruit, citrus, herb, kernel, flower, cream, and berry. And nonalcoholic drinks can be classified into four categories: (i) Hot drinks, i.e., tea, coffee, and chocolate; (ii) fruit juices; (iii) mineral waters; and (iv) cordials/syrups.

## **3. Alcohol and human health**

Alcohol has a complex mode of action and is majorly a depressant on the central nervous system, and the brain is affected in the process. It activates the release of the chief inhibitory neurotransmitter in the central nervous system by binding to GABA (gamma-aminobutyric acid) receptors in the brain. Absorption of alcohol which takes place from the intestine is reduced by fatty foods, and alcohol is distributed into body water. Alcoholic beverages contain ethyl alcohol, and research has shown that utilization of alcohol has here and now mental and physiological impacts on the consumer [6, 7]. Diverse absorption of alcohol in the human body affects a man, and the impacts of alcohol rely upon the quantity an individual has consumed, the level of alcohol in the mixed drinks and the time length that the utilization occurred, the measure of sustenance eaten and whether an individual has taken other remedies, and over-the-counter or road drugs, among different

**3**

*Alcoholic Beverages and Human Health: An Overview DOI: http://dx.doi.org/10.5772/intechopen.81054*

bonated drinks [6, 7].

elements. Alcohol in carbonated drinks is absorbed faster than alcohol in noncar-

Blood alcohol concentration (BAC) is dependent on amount and time range of alcohol utilization, muscle to fat ratio and weight, and nourishment impacts. Overabundance utilization of alcohol on an unfilled stomach over a brief timeframe range as a rule results to higher BAC. Drinking enough to cause a blood alcohol concentration (BAC) of 0.03–0.12% ordinarily causes a general perking up and conceivable happiness; expanded self-assurance and amiability; diminished nervousness; a flushed, red appearance in the face; impeded judgment; and fine muscle coordination. A BAC from 0.09 to 0.25% causes torpidity, sedation, adjust issues, and obscured vision. A BAC from 0.18 to 0.30% causes significant disarray, hindered discourse (e.g., slurred discourse), unsteadiness, and spewing [6, 7]. A BAC from 0.25 to 0.40% causes trance, obviousness, anterograde amnesia, retching (passing may happen because of inward breath of regurgitation (pneumonic goal) while oblivious), and respiratory melancholy (possibly dangerous). A BAC from 0.35 to 0.80% causes a state of unconsciousness (obliviousness), hazardous respiratory misery, and potentially deadly alcohol harming. Likewise with every mixed drink, drinking while at the same time driving, working an airship, or substantial hardware builds the danger of a mishap; numerous nations have punishments against driving while intoxicated [8]. Metabolization of 90% of consumed alcohol takes place in the liver; alcohol is converted to acetaldehyde by dehydrogenase (which is a sympathomimetic toxin responsible for "hangover"). Then, acetaldehyde is metabolized to acetic acid by aldehyde dehydrogenase and finally to carbon dioxide and water. Alcohol can then

be excreted from the body through the sweat, lungs, and urine.

feel high, and (v) the need to drink alcohol every day.

ism, mental ill health, and other addictions [10].

**3.1 Toxicity of alcohol**

The regular consumption of alcohol, despite the bad effects it has on human's life, is called addiction or alcoholism. The causes of alcoholism usually include one or more of the following: peer pressure, usage of alcohol as remedy for mental ill health, alcoholism gene, influence of an alcoholic parent, etc. The abuse of alcohol results in over a million deaths in teenagers and young adults due to accidents every year all over the world [9]. Alcohol abuse occurs when all or one of the following happens: (i) Excess alcohol consumption in a social gathering, (ii) drinking and driving, (iii) alcohol consumption throughout the day, (iv) alcohol consumption to

Cognitive ability is impaired due to alcohol consumption, for example, in occasional and moderate drinkers the following occurs: memory impairment, blackout, recklessness, and impaired decision-making. While the following results in heavy and/or chronic drinkers: diminished brain size, inability to think abstractly, loss of visuospatial abilities, Wernicke-Korsakoff syndrome, loss of memory, and poor attention span. There are five different types of alcoholics which are (i) young adult subtype which includes young adults whose family have no history of alcoholism or mental ill health; (ii) young antisocial subtype, also includes young adult with a family history of alcoholism, mental ill health, and other addictions; (iii) functional subtype, this includes gainfully employed and successful middle-aged with a supportive family; they have a family history of alcoholism while some of them may have a history of depression (iv) intermediate familial subtype, these are middleaged people with prior episode of depression and a family history of alcoholism, (v) chronic severe subtype are the middle-aged people with family histories of alcohol-

The toxic metabolic effects of alcohol are due both to its direct action when few percent of it enter the bloodstream from the stomach and that of its first metabolite *Frontiers and New Trends in the Science of Fermented Food and Beverages*

water, hot drinks etc.

and (iv) cordials/syrups.

**3. Alcohol and human health**

**2. Alcohol and alcoholic beverages**

to physical and psychological dependency on alcohol to the point that tolerance is built up to alcohol [4]. Furthermore, once the body becomes adapted to excessive consumption of alcohol, an abrupt discontinuation leads to withdrawal symptoms which can be a threat to life and the symptoms normally includes hallucination, tremors, convulsions, anxiety, etc. Alcohol addiction may also result in the following: restlessness, depression, erratic behavior, decreased involvement in extracurricular activities, loss of interest in work or school, lack of interest in relationships, preoccupation with drinking, inability to control drinking, and violent behavior. While, nonalcoholic beverage refers to any drink that contains no alcohol or which contains less than 0.5% alcohol by volume and examples are fruit juices, mineral

There are different types of alcohol based on their uses; some are used as solvents, antifreeze solutions, e.g., isopropyl and methyl alcohol, paint removers in chemistry laboratories and chemical factories, and as nail polish remover and cleansing solvent, for example, methylated spirit for domestic use [5]. There are different types of alcohol depending on the number of carbon atoms present and the position of the OH bond in the formula, but the most common alcohol is ethanol (CH3CH2OH or C2H5OH). During the process called fermentation, alcohol is produced. Fermentation of yeast usually results into sugar breaking down into carbon dioxide and alcohol. But carbon dioxide is taking off the process through gas bubbles leaving a mixture of water and ethanol. Sugar fermentation to alcohol can be used in different applications especially in the production of alcoholic beverages, for example, the extracts of grapes and barley are fermented in the wine and beer industry to produce alcoholic beverages. Any drink or beverage that contains ethanol is normally referred to as alcoholic beverage and are either produced by fermentation or distillation. There are different types of alcoholic and nonalcoholic beverages. Alcoholic drinks can be classified into five categories: (i) Wine, i.e., still, sparkling, fortified, or aromatized; (ii) beer, i.e., ales, lagers, and stouts; (iii) cider and perry; (iv) distilled spirits, i.e., vodka, gin, rum, whiskey, brandy, and others; and (v) liqueurs, i.e., flavored with fruit, citrus, herb, kernel, flower, cream, and berry. And nonalcoholic drinks can be classified into four categories: (i) Hot drinks, i.e., tea, coffee, and chocolate; (ii) fruit juices; (iii) mineral waters;

Alcohol has a complex mode of action and is majorly a depressant on the central nervous system, and the brain is affected in the process. It activates the release of the chief inhibitory neurotransmitter in the central nervous system by binding to GABA (gamma-aminobutyric acid) receptors in the brain. Absorption of alcohol which takes place from the intestine is reduced by fatty foods, and alcohol is

distributed into body water. Alcoholic beverages contain ethyl alcohol, and research has shown that utilization of alcohol has here and now mental and physiological impacts on the consumer [6, 7]. Diverse absorption of alcohol in the human body affects a man, and the impacts of alcohol rely upon the quantity an individual has consumed, the level of alcohol in the mixed drinks and the time length that the utilization occurred, the measure of sustenance eaten and whether an individual has taken other remedies, and over-the-counter or road drugs, among different

**2**

elements. Alcohol in carbonated drinks is absorbed faster than alcohol in noncarbonated drinks [6, 7].

Blood alcohol concentration (BAC) is dependent on amount and time range of alcohol utilization, muscle to fat ratio and weight, and nourishment impacts. Overabundance utilization of alcohol on an unfilled stomach over a brief timeframe range as a rule results to higher BAC. Drinking enough to cause a blood alcohol concentration (BAC) of 0.03–0.12% ordinarily causes a general perking up and conceivable happiness; expanded self-assurance and amiability; diminished nervousness; a flushed, red appearance in the face; impeded judgment; and fine muscle coordination. A BAC from 0.09 to 0.25% causes torpidity, sedation, adjust issues, and obscured vision. A BAC from 0.18 to 0.30% causes significant disarray, hindered discourse (e.g., slurred discourse), unsteadiness, and spewing [6, 7]. A BAC from 0.25 to 0.40% causes trance, obviousness, anterograde amnesia, retching (passing may happen because of inward breath of regurgitation (pneumonic goal) while oblivious), and respiratory melancholy (possibly dangerous). A BAC from 0.35 to 0.80% causes a state of unconsciousness (obliviousness), hazardous respiratory misery, and potentially deadly alcohol harming. Likewise with every mixed drink, drinking while at the same time driving, working an airship, or substantial hardware builds the danger of a mishap; numerous nations have punishments against driving while intoxicated [8].

Metabolization of 90% of consumed alcohol takes place in the liver; alcohol is converted to acetaldehyde by dehydrogenase (which is a sympathomimetic toxin responsible for "hangover"). Then, acetaldehyde is metabolized to acetic acid by aldehyde dehydrogenase and finally to carbon dioxide and water. Alcohol can then be excreted from the body through the sweat, lungs, and urine.

The regular consumption of alcohol, despite the bad effects it has on human's life, is called addiction or alcoholism. The causes of alcoholism usually include one or more of the following: peer pressure, usage of alcohol as remedy for mental ill health, alcoholism gene, influence of an alcoholic parent, etc. The abuse of alcohol results in over a million deaths in teenagers and young adults due to accidents every year all over the world [9]. Alcohol abuse occurs when all or one of the following happens: (i) Excess alcohol consumption in a social gathering, (ii) drinking and driving, (iii) alcohol consumption throughout the day, (iv) alcohol consumption to feel high, and (v) the need to drink alcohol every day.

Cognitive ability is impaired due to alcohol consumption, for example, in occasional and moderate drinkers the following occurs: memory impairment, blackout, recklessness, and impaired decision-making. While the following results in heavy and/or chronic drinkers: diminished brain size, inability to think abstractly, loss of visuospatial abilities, Wernicke-Korsakoff syndrome, loss of memory, and poor attention span. There are five different types of alcoholics which are (i) young adult subtype which includes young adults whose family have no history of alcoholism or mental ill health; (ii) young antisocial subtype, also includes young adult with a family history of alcoholism, mental ill health, and other addictions; (iii) functional subtype, this includes gainfully employed and successful middle-aged with a supportive family; they have a family history of alcoholism while some of them may have a history of depression (iv) intermediate familial subtype, these are middleaged people with prior episode of depression and a family history of alcoholism, (v) chronic severe subtype are the middle-aged people with family histories of alcoholism, mental ill health, and other addictions [10].

### **3.1 Toxicity of alcohol**

The toxic metabolic effects of alcohol are due both to its direct action when few percent of it enter the bloodstream from the stomach and that of its first metabolite called acetaldehyde (belongs to the same chemical family with formaldehyde) which is highly toxic to man [11]. Alcohol increases the rate of generation of free radicals in the body system and also inhibits the antioxidant levels thus inducing oxidative stress [6]. The excessive consumption of alcohol can also result in immunodeficiency and immunosuppressant thus exposing such individual to different kinds of infections. Research has shown that the consumption of alcohol is one of the causes of acute illness and chronic diseases throughout the world today [7].

## **3.2 Alcohol and pregnancy**

Consumption of alcohol during pregnancy can have deleterious effects on the fetus not only in the first trimester but also throughout pregnancy as alcohol can move by the umbilical cord and placenta from the mother's bloodstream to the fetus. Alcohol consumption can cause havoc on the pregnancy before a woman is aware of the pregnancy. The havoc that can be caused on pregnancy includes miscarriage, birth deformities, retarded growth, and mental defects [2]. Excessive consumption of alcohol in pregnant women results in fetal alcohol syndrome (FAS) or fetal alcohol spectrum disorders (FASD) characterized with irreversible mental and physical changes to the baby. Fetal alcohol syndrome (FAS) may cause skeletal and facial abnormalities, growth retardation, mental disorders, and heart defects, while in fetal alcohol spectrum disorders (FASD), hyperactivity, life-long learning disabilities, poor attention span, speech or language delays, poor memory, and other disorders may result [12–14]. It is generally advised that drinking should be completely avoided by pregnant women.

## **3.3 Alcohol's effects on the body**

Frequent alcohol consumption can be deleterious to human's health by affecting the following: (i) Brain: the communicative pathways of the brain are disrupted which may result in mood swing, lack of coordination, and coherence. (ii) Heart: it may also affect the heart by causing cardiomyopathy, arrhythmias, stroke, and high blood pressure. (iii) Liver: different types of problems may occur in the liver including liver inflammations, cirrhosis, alcoholic hepatitis, fibrosis and steatosis, or fatty liver [15]. (iv) Pancreas: heavy consumption of alcohol may cause the blood vessels in the pancreas to be swollen and inflamed thereby preventing proper digestion [16]. (v) Skin: abuse and consumption of alcohol can cause a variety of skin disorders [17]. Thermoregulation of the body also results in skin vasodilation and sweating [18]. (vi) Cancer: heavy drinkers stand the chance of developing cancers like cancer of the mouth, esophagus, throat, liver, and breast [16, 19]. Alcohol meddles with folate assimilation and function in the body, which may be one way alcohol can build danger of causing specific cancers. (vii) Immune system: alcoholism results in immune system being compromised, and the body is easily prone to diseases like pneumonia and tuberculosis.

## **4. Signs and symptoms of alcohol abuse and addiction**

Some of the signs and symptoms of alcoholism includes the following in most adults: stomach pains, vomiting or nausea, redness of the face during or after periods of consumption, delayed reflexes, loss of consciousness or blacking out, slurred or incoherent speech, poor balance, and clumsiness. Alcoholics reach a level that the breathing is affected due to depression of the respiratory system which sometimes results into death. Some alcoholics become dependent on alcohol

**5**

*Alcoholic Beverages and Human Health: An Overview DOI: http://dx.doi.org/10.5772/intechopen.81054*

**5. Side effects of alcohol withdrawal**

up to a point that their health, work, and relationship are neglected [20]. Signs of alcohol abuse include the following: insomnia, anger, loss of control and attention, etc. Alcoholism if untreated results in addiction identified by dependency. Signs of alcohol dependence are tolerance to increase in alcohol consumption, hangover, unsuccessful attempt to reduce consumption, alcohol withdrawal symptoms when alcohol is not consumed, etc. Seizures, extreme agitation or anxiety, hallucinations, nausea or vomiting, tremors, convulsions, uncontrolled shaking of the hands, persistent insomnia, and profuse sweating are some of the symptoms of withdrawal from alcohol indicative of advanced stage of addiction and should not be handled lightly [11]. Medical detoxification is usually the treatment given to alcoholism.

Withdrawal from alcohol normally kicks off between 6 and 24 hours after the last drink, and withdrawal has been categorized into three stages according to their severity: (i) stage one which is the mild stage involves tremors, abdominal pain and/or vomiting, foggy thinking, anxiety, insomnia, nausea, loss of appetite, fatigue, depression, mood swings, and heart palpitations; (ii) stage two which is the moderate stage also involves mental confusion; irregular heart rate; profuse sweating; irritability; increased blood pressure, body temperature, and respiration; and heightened mood disturbances; and (iii) stage three which is the severe stage is often called the delirium tremens. It is characterized by fever, agitation, severe confusion, hallucination, and seizures. Delirium tremens often occur in about 3–5% alcohol withdrawal individuals. It normally kicks off without warning at 24 or 48 hours after alcohol leaves the bloodstream. Withdrawal from alcohol is influenced by factors such as stress level, family history of addiction, co-occurring mental ill health, childhood trauma, drinking duration, and quantity consumed. It can also be influenced by combined use of alcohol and other drugs thereby increasing the potential for dangers and other side effects. Withdrawal from alcohol can in some cases cause the death of an addict as the central nervous system and the brain are normally affected

Withdrawal from alcohol has no definite timeline, but a general timeline has been detailed as follows: the first stage normally begins 8 hours after the first drink, while the second and third stages occur rapidly, and symptoms peak between 24 and 72 hours. Symptoms may then start to wear off 5–7 days later, but psychological

Physical symptoms are monitored and controlled up to a stable point during detoxification which is often achieved by medications. Restoration of the natural order to the overactivity of the central nervous system can be accomplished by using benzodiazepines during alcohol detoxification. Dangerous side effects of alcohol withdrawal can

Thought of suicide, anxiety, and depression can be controlled with medications alongside therapy and counseling. Disulfiram, naltrexone, and acamprosate are the three approved medications used to control alcohol cravings in the treatment of alcohol withdrawal. Naltrexone operates by blocking the opioid receptors in the brain, thereby reducing cravings for drinking, while long-term withdrawal symptoms are taken care of by acamprosate. Disulfiram makes drinking undesirable by making people sick if they drink. Another promising medication in the treatment of

by continuous suppression by alcohol for a long period of time.

be avoided by gradual and controlled weaning of alcohol out of the body.

symptoms may be prolonged for several weeks [21].

**5.1 Managing withdrawal symptoms**

alcohol use disorders is topiramate [2].

*Alcoholic Beverages and Human Health: An Overview DOI: http://dx.doi.org/10.5772/intechopen.81054*

*Frontiers and New Trends in the Science of Fermented Food and Beverages*

**3.2 Alcohol and pregnancy**

completely avoided by pregnant women.

diseases like pneumonia and tuberculosis.

**4. Signs and symptoms of alcohol abuse and addiction**

Some of the signs and symptoms of alcoholism includes the following in most adults: stomach pains, vomiting or nausea, redness of the face during or after periods of consumption, delayed reflexes, loss of consciousness or blacking out, slurred or incoherent speech, poor balance, and clumsiness. Alcoholics reach a level that the breathing is affected due to depression of the respiratory system which sometimes results into death. Some alcoholics become dependent on alcohol

**3.3 Alcohol's effects on the body**

called acetaldehyde (belongs to the same chemical family with formaldehyde) which is highly toxic to man [11]. Alcohol increases the rate of generation of free radicals in the body system and also inhibits the antioxidant levels thus inducing oxidative stress [6]. The excessive consumption of alcohol can also result in immunodeficiency and immunosuppressant thus exposing such individual to different kinds of infections. Research has shown that the consumption of alcohol is one of the causes of acute illness and chronic diseases throughout the world today [7].

Consumption of alcohol during pregnancy can have deleterious effects on the fetus not only in the first trimester but also throughout pregnancy as alcohol can move by the umbilical cord and placenta from the mother's bloodstream to the fetus. Alcohol consumption can cause havoc on the pregnancy before a woman is aware of the pregnancy. The havoc that can be caused on pregnancy includes miscarriage, birth deformities, retarded growth, and mental defects [2]. Excessive consumption of alcohol in pregnant women results in fetal alcohol syndrome (FAS) or fetal alcohol spectrum disorders (FASD) characterized with irreversible mental and physical changes to the baby. Fetal alcohol syndrome (FAS) may cause skeletal and facial abnormalities, growth retardation, mental disorders, and heart defects, while in fetal alcohol spectrum disorders (FASD), hyperactivity, life-long learning disabilities, poor attention span, speech or language delays, poor memory, and other disorders may result [12–14]. It is generally advised that drinking should be

Frequent alcohol consumption can be deleterious to human's health by affecting the following: (i) Brain: the communicative pathways of the brain are disrupted which may result in mood swing, lack of coordination, and coherence. (ii) Heart: it may also affect the heart by causing cardiomyopathy, arrhythmias, stroke, and high blood pressure. (iii) Liver: different types of problems may occur in the liver including liver inflammations, cirrhosis, alcoholic hepatitis, fibrosis and steatosis, or fatty liver [15]. (iv) Pancreas: heavy consumption of alcohol may cause the blood vessels in the pancreas to be swollen and inflamed thereby preventing proper digestion [16]. (v) Skin: abuse and consumption of alcohol can cause a variety of skin disorders [17]. Thermoregulation of the body also results in skin vasodilation and sweating [18]. (vi) Cancer: heavy drinkers stand the chance of developing cancers like cancer of the mouth, esophagus, throat, liver, and breast [16, 19]. Alcohol meddles with folate assimilation and function in the body, which may be one way alcohol can build danger of causing specific cancers. (vii) Immune system: alcoholism results in immune system being compromised, and the body is easily prone to

**4**

up to a point that their health, work, and relationship are neglected [20]. Signs of alcohol abuse include the following: insomnia, anger, loss of control and attention, etc. Alcoholism if untreated results in addiction identified by dependency. Signs of alcohol dependence are tolerance to increase in alcohol consumption, hangover, unsuccessful attempt to reduce consumption, alcohol withdrawal symptoms when alcohol is not consumed, etc. Seizures, extreme agitation or anxiety, hallucinations, nausea or vomiting, tremors, convulsions, uncontrolled shaking of the hands, persistent insomnia, and profuse sweating are some of the symptoms of withdrawal from alcohol indicative of advanced stage of addiction and should not be handled lightly [11]. Medical detoxification is usually the treatment given to alcoholism.

### **5. Side effects of alcohol withdrawal**

Withdrawal from alcohol normally kicks off between 6 and 24 hours after the last drink, and withdrawal has been categorized into three stages according to their severity: (i) stage one which is the mild stage involves tremors, abdominal pain and/or vomiting, foggy thinking, anxiety, insomnia, nausea, loss of appetite, fatigue, depression, mood swings, and heart palpitations; (ii) stage two which is the moderate stage also involves mental confusion; irregular heart rate; profuse sweating; irritability; increased blood pressure, body temperature, and respiration; and heightened mood disturbances; and (iii) stage three which is the severe stage is often called the delirium tremens. It is characterized by fever, agitation, severe confusion, hallucination, and seizures. Delirium tremens often occur in about 3–5% alcohol withdrawal individuals. It normally kicks off without warning at 24 or 48 hours after alcohol leaves the bloodstream. Withdrawal from alcohol is influenced by factors such as stress level, family history of addiction, co-occurring mental ill health, childhood trauma, drinking duration, and quantity consumed. It can also be influenced by combined use of alcohol and other drugs thereby increasing the potential for dangers and other side effects. Withdrawal from alcohol can in some cases cause the death of an addict as the central nervous system and the brain are normally affected by continuous suppression by alcohol for a long period of time.

Withdrawal from alcohol has no definite timeline, but a general timeline has been detailed as follows: the first stage normally begins 8 hours after the first drink, while the second and third stages occur rapidly, and symptoms peak between 24 and 72 hours. Symptoms may then start to wear off 5–7 days later, but psychological symptoms may be prolonged for several weeks [21].

Physical symptoms are monitored and controlled up to a stable point during detoxification which is often achieved by medications. Restoration of the natural order to the overactivity of the central nervous system can be accomplished by using benzodiazepines during alcohol detoxification. Dangerous side effects of alcohol withdrawal can be avoided by gradual and controlled weaning of alcohol out of the body.

#### **5.1 Managing withdrawal symptoms**

Thought of suicide, anxiety, and depression can be controlled with medications alongside therapy and counseling. Disulfiram, naltrexone, and acamprosate are the three approved medications used to control alcohol cravings in the treatment of alcohol withdrawal. Naltrexone operates by blocking the opioid receptors in the brain, thereby reducing cravings for drinking, while long-term withdrawal symptoms are taken care of by acamprosate. Disulfiram makes drinking undesirable by making people sick if they drink. Another promising medication in the treatment of alcohol use disorders is topiramate [2].

## **6. Beneficial effects of alcohol**

Red wines have been known to have antioxidant properties because they contain substances like resveratrol (polyphenol) and flavonoids which confer cardioprotective effects to the heart. Antioxidants also protect against artery damage by increasing levels of high density lipoprotein (HDL). So, moderate consumption of alcohol or red wines has been confirmed to be beneficial to human health. But it should not be used as an excuse to start drinking as it can be addictive or cause other health problems [2].

Also, it is generally known that red wine contains the most resveratrol, the antioxidant found in grape skin that may improve the health of the heart by counteracting blood vessel harm and also diminishing LDL cholesterol. Additionally, the flavonoids contained in red wine are another vital cancer prevention agent. It must then be noted that most research carried out have been on animals, and the measure of wine to be taken by an individual to level with a similar sum given to mice would neutralize any of the assumed advantages. Likewise, the 129 calories contained in a glass can accumulate, regardless of whether an individual is just drinking one daily [22]. Red wine also contains histamine that can cause headache assaults or different kinds of manifestations that happen from a histamine prejudice.

### **7. Treatment of alcohol abuse and alcoholism**

Alcoholism treatment involves serious medical, family, and social support, while interventions like group support, individual counseling, stepped therapy, and medications are usually advocated for alcohol dependence. Three approved medications for medical treatments of alcohol dependence are naltrexone (Depade, ReVia), disulfiram (Antabuse), and acamprosate (Campral) and an injectable long-acting form of naltrexone (Vivitrol). The medication may reduce relapses and drinking and may result to total recovery and abstinence from alcohol. Naltrexone and acamprosate have been recommended as treatment alternative for alcohol dependence together with behavioral therapy in a review, but disulfiram has not been recommended for routine use in primary care as proof of its ability to increase abstinence rates or decrease relapse rates or cravings compared with placebo as not been shown [4].

## **8. Alcohol detoxification**

Alcohol detoxification is the process by which the system of a heavy drinker is returned to normal after prolonged period of alcohol abuse. It normally involves medical treatment and counseling. The detoxification process involves three steps: (i) Step one (intake) involves a comprehensive review of drug, psychiatric, and medical histories of patients to fully understand the situation, (ii) step two (stabilization) which involves medical and psychological therapies to help a patient reach a balance of mind and body, and (iii) step three (medication) which involves medications that mimic the effects of alcohol to mitigate withdrawal symptoms. Some of the unpleasant side effects of detoxification may include nausea, insomnia, mood swing, muscle weakness, and nervousness, while kidney or liver dysfunction, seizures, extreme nausea, aspiration pneumonia, heart arrhythmias, fever, and hallucinations are examples of some of the severe side effects of alcohol detoxification. Medications are used to avoid physiological upsets and system imbalance during detoxification. Benzodiazepines are used to reduce alcohol withdrawal symptoms

**7**

*Alcoholic Beverages and Human Health: An Overview DOI: http://dx.doi.org/10.5772/intechopen.81054*

fatality in alcohol withdrawal [23].

the psychoactive nature of alcohol.

**10. Conclusions**

**9. Nonalcoholic drink**

and also prevent alcohol withdrawal seizures which are the most common causes of

Beverage without an alcohol is usually referred to as a nonalcoholic drink. There are different varieties of nonalcoholic beverages; examples are soft drinks, nonalcoholic beers like root beer, mineral water, aerated/carbonated, hot and cold drinks, mocktails, etc. These nonalcoholic beverages perform one or more of the following functions: (i) supply vitamins and nutrient required by the body, (ii) provide energy, (iii) hydrate, (iv) supply of the necessary calories and sugar required by the

Some beverages like soft drink, juice, and apple cider naturally may contain little amounts of alcohol. Distillation of ethanol is often to separate alcoholic drinks into what are commercially called spirit and nonalcoholic drinks. Purification of alcoholic drinks to 0.00% alcohol by volume by distillation is impossible. Furthermore, most drinks with the label nonalcoholic contain 0.5% ABV as it brings more profit than distilling it to 0.05% ABV normally found in products sold by companies specialized in nonalcoholic drinks [24]. It is said by some people that the sign nonalcoholic on drinks is misleading and therefore a threat to recovering alcoholics due to

Nonalcoholic beer may be beneficial to other people, but it is not advised to be consumed by a recovering alcoholic. According to a study which was conducted on some Spanish nuns who drank nonalcoholic beer for 45 days and had an increased antioxidant levels in their bloodstream, nonalcoholic beer could have positive impacts on the cardiovascular system. Among the disadvantages are (i) the perception of most people is that nonalcoholic beer does not have the rich flavor of normal alcoholic beer; (ii) most nonalcoholic beer contains a small amount of alcohol, which could result into relapse for recovering alcoholics; (iii) research has made it clear that the smell of any kind of beer may trigger cravings in the alcoholic's mind, and the level of dopamine in the brain may be raised; and (iv) there is a fear of being stigmatized as the only one not drinking alcohol in a social gathering.

Conclusively, drinks that contain ethanol are regularly alluded to as mixed refreshment and are either produced by fermentation or distillation. The utilization of which might be related with some underlining hazard factor contingent upon the amount devoured per time. The consistent utilization of alcohol, regardless of the terrible impacts it has on human's life, dependence, alcohol addiction, and withdrawal from which can be dangerous. Alcohol expands the rate of production of free radicals in the body framework and furthermore represses the antioxidant levels along these lines instigating oxidative stress. The unnecessary utilization of alcohol can likewise result in immunodeficiency and immunosuppressant subsequently presenting such individual to various types of infections. The causes of alcoholism range from alcoholism gene, peer pressure, to influence of an alcoholic parent, among others. The three affirmed oral pharmaceuticals for the treatment of alcohol addiction or dependence are disulfiram, naltrexone, and acamprosate. While, nonalcoholic beverages alludes to any drink that contains no alcohol or which contains under 0.5% alcohol by volume. Moderate consumption of alcohol or red wines has been affirmed to be gainful to human well-being especially on

body, and (iv) some can be used as aperitif or palate stimulant.

and also prevent alcohol withdrawal seizures which are the most common causes of fatality in alcohol withdrawal [23].

## **9. Nonalcoholic drink**

*Frontiers and New Trends in the Science of Fermented Food and Beverages*

kinds of manifestations that happen from a histamine prejudice.

**7. Treatment of alcohol abuse and alcoholism**

Red wines have been known to have antioxidant properties because they contain substances like resveratrol (polyphenol) and flavonoids which confer cardioprotective effects to the heart. Antioxidants also protect against artery damage by increasing levels of high density lipoprotein (HDL). So, moderate consumption of alcohol or red wines has been confirmed to be beneficial to human health. But it should not be used as an excuse to start drinking as it can be addictive or cause other health

Also, it is generally known that red wine contains the most resveratrol, the antioxidant found in grape skin that may improve the health of the heart by counteracting blood vessel harm and also diminishing LDL cholesterol. Additionally, the flavonoids contained in red wine are another vital cancer prevention agent. It must then be noted that most research carried out have been on animals, and the measure of wine to be taken by an individual to level with a similar sum given to mice would neutralize any of the assumed advantages. Likewise, the 129 calories contained in a glass can accumulate, regardless of whether an individual is just drinking one daily [22]. Red wine also contains histamine that can cause headache assaults or different

Alcoholism treatment involves serious medical, family, and social support, while interventions like group support, individual counseling, stepped therapy, and medications are usually advocated for alcohol dependence. Three approved medications for medical treatments of alcohol dependence are naltrexone (Depade, ReVia), disulfiram (Antabuse), and acamprosate (Campral) and an injectable long-acting form of naltrexone (Vivitrol). The medication may reduce relapses and drinking and may result to total recovery and abstinence from alcohol. Naltrexone and acamprosate have been recommended as treatment alternative for alcohol dependence together with behavioral therapy in a review, but disulfiram has not been recommended for routine use in primary care as proof of its ability to increase abstinence rates or decrease relapse rates or cravings compared with placebo as not

Alcohol detoxification is the process by which the system of a heavy drinker is returned to normal after prolonged period of alcohol abuse. It normally involves medical treatment and counseling. The detoxification process involves three steps: (i) Step one (intake) involves a comprehensive review of drug, psychiatric, and medical histories of patients to fully understand the situation, (ii) step two (stabilization) which involves medical and psychological therapies to help a patient reach a balance of mind and body, and (iii) step three (medication) which involves medications that mimic the effects of alcohol to mitigate withdrawal symptoms. Some of the unpleasant side effects of detoxification may include nausea, insomnia, mood swing, muscle weakness, and nervousness, while kidney or liver dysfunction, seizures, extreme nausea, aspiration pneumonia, heart arrhythmias, fever, and hallucinations are examples of some of the severe side effects of alcohol detoxification. Medications are used to avoid physiological upsets and system imbalance during detoxification. Benzodiazepines are used to reduce alcohol withdrawal symptoms

**6. Beneficial effects of alcohol**

problems [2].

been shown [4].

**8. Alcohol detoxification**

**6**

Beverage without an alcohol is usually referred to as a nonalcoholic drink. There are different varieties of nonalcoholic beverages; examples are soft drinks, nonalcoholic beers like root beer, mineral water, aerated/carbonated, hot and cold drinks, mocktails, etc. These nonalcoholic beverages perform one or more of the following functions: (i) supply vitamins and nutrient required by the body, (ii) provide energy, (iii) hydrate, (iv) supply of the necessary calories and sugar required by the body, and (iv) some can be used as aperitif or palate stimulant.

Some beverages like soft drink, juice, and apple cider naturally may contain little amounts of alcohol. Distillation of ethanol is often to separate alcoholic drinks into what are commercially called spirit and nonalcoholic drinks. Purification of alcoholic drinks to 0.00% alcohol by volume by distillation is impossible. Furthermore, most drinks with the label nonalcoholic contain 0.5% ABV as it brings more profit than distilling it to 0.05% ABV normally found in products sold by companies specialized in nonalcoholic drinks [24]. It is said by some people that the sign nonalcoholic on drinks is misleading and therefore a threat to recovering alcoholics due to the psychoactive nature of alcohol.

Nonalcoholic beer may be beneficial to other people, but it is not advised to be consumed by a recovering alcoholic. According to a study which was conducted on some Spanish nuns who drank nonalcoholic beer for 45 days and had an increased antioxidant levels in their bloodstream, nonalcoholic beer could have positive impacts on the cardiovascular system. Among the disadvantages are (i) the perception of most people is that nonalcoholic beer does not have the rich flavor of normal alcoholic beer; (ii) most nonalcoholic beer contains a small amount of alcohol, which could result into relapse for recovering alcoholics; (iii) research has made it clear that the smell of any kind of beer may trigger cravings in the alcoholic's mind, and the level of dopamine in the brain may be raised; and (iv) there is a fear of being stigmatized as the only one not drinking alcohol in a social gathering.

## **10. Conclusions**

Conclusively, drinks that contain ethanol are regularly alluded to as mixed refreshment and are either produced by fermentation or distillation. The utilization of which might be related with some underlining hazard factor contingent upon the amount devoured per time. The consistent utilization of alcohol, regardless of the terrible impacts it has on human's life, dependence, alcohol addiction, and withdrawal from which can be dangerous. Alcohol expands the rate of production of free radicals in the body framework and furthermore represses the antioxidant levels along these lines instigating oxidative stress. The unnecessary utilization of alcohol can likewise result in immunodeficiency and immunosuppressant subsequently presenting such individual to various types of infections. The causes of alcoholism range from alcoholism gene, peer pressure, to influence of an alcoholic parent, among others. The three affirmed oral pharmaceuticals for the treatment of alcohol addiction or dependence are disulfiram, naltrexone, and acamprosate. While, nonalcoholic beverages alludes to any drink that contains no alcohol or which contains under 0.5% alcohol by volume. Moderate consumption of alcohol or red wines has been affirmed to be gainful to human well-being especially on

account of the cancer prevention agent properties it gives. Some other positive effects like reduction of diabetes, stroke, and coronary heart disease have been associated with moderate consumption of alcohol particularly among middle-aged and older men and women.

## **Conflict of interest**

The authors hereby declare that there is no conflict of interest.

## **Author details**

Oladipo Iyabo Christianah Department of Science Laboratory Technology, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria

\*Address all correspondence to<EMAIL_ADDRESS>
© 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

**9**

*Alcoholic Beverages and Human Health: An Overview DOI: http://dx.doi.org/10.5772/intechopen.81054*

> Statistics [Internet]. Available from: https://www.niaaa.nih.gov/alcoholhealth/overview-alcohol-consumption/ alcohol-facts-and-statistics [Accessed:

[10] American Addiction centers. Alcoholism Addiction Treatment. [Internet]. Available from: https:// Americanaddictioncenters.org/ alcoholism-treatment/ [Accessed:

[11] Vaillant GE, Keller M. Alcoholism [Internet]. 2018. Available from: www. britannica.com/science/alcoholism

[12] Office of the Surgeon General. U.S. Department of Health and Human Services. News release. U.S. Surgeon General Releases Advisory on Alcohol Use in Pregnancy. Available from: http://www.surgeongeneral.gov/ pressreleases/sg02222005.html

[13] Centers for Disease Control and Prevention. Fetal Alcohol Spectrum Disorders (FASDs) Alcohol Use in Pregnancy [Internet]. Available from: http://www.cdc.gov/n cbddd/fasd/ alcohol-use.html [Accessed: 24-5-2018]

[14] Mayo Clinic. Heart Disease; Red Wine and Resveratrol: Good for your heart? [Internet]. March 4, 2011. Available from: http://www.mayoclinic.

com/health/red-wine/HB00089

[15] Naimi TS, Brewer RD, Mokdad A, Denny C, Serdula MK, Marks JS. Binge drinking among US adults. JAMA.

[16] Buckman JF, Eddie D, Vaschillo EG, Vaschillo B, Garcia A, Bates ME. Immediate and complex cardiovascular adaptation to an

[Accessed: 24-5-2018]

2003;**289**:70-75

2-6-2018]

2-6-2018]

[Accessed: 2-6-2018]

[Accessed: 24-5-2018]

[1] Leroy GW. Alcohol Encyclopædia Britannica [Internet]. 2018. Available from: https://www.britannica.com/ science/alcohol [Accessed: 27-5-2018]

**References**

[2] Drugs.com. Alcohol. [Internet]. Available from: https://www.drugs.com/ alcohol.html [Accessed: 26-5-2018]

[3] National Institutes of Health (NIH). National Institute on Drug Abuse (NIDA). Drugs of Abuse: Alcohol. [Internet]. Available from: http://www. drugabuse.gov/drugsabus e/alcohol

[4] Drugabuse.com. Alcohol Abuse. [Internet]. Available from: https:// drugabuse.com/library/alcohol-abuse/

[5] Tarek IK. A round in alcohols world between: Production, properties, uses, applications, fuel, and compounds chemistry. Chemical Science and Engineering. 2009;**14**:25. Available from: http://tarek.kakhia.org/books\_ eng/Alcohol.Tarek\_Kakhia.pdf

[6] Nordmann R, Riviere C, Rouach H. Implication of free radical

[7] Kevin DS, Charles P, Jürgen R. Chronic diseases and conditions related to alcohol use. Alcohol Research: Current Reviews. 2014;**35**(2):155-171

[8] Horowitz M, Maddox A, Bochner M. Relationships between gastric emptying of solid and caloric liquid meals and alcohol absorption. American Journal of Physiology. 1989;**257**(92 Pt 1):

[9] National Institute of Alcohol Abuse and Alcoholism. Overview of Alcohol Consumption; Alcohol Facts and

G291-G298. PMID 2764113

mechanisms in ethanol-induced cellular injury. Free Radical Biology & Medicine.

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1992;**12**:219-240

*Alcoholic Beverages and Human Health: An Overview DOI: http://dx.doi.org/10.5772/intechopen.81054*

## **References**

*Frontiers and New Trends in the Science of Fermented Food and Beverages*

and older men and women.

**Conflict of interest**

account of the cancer prevention agent properties it gives. Some other positive effects like reduction of diabetes, stroke, and coronary heart disease have been associated with moderate consumption of alcohol particularly among middle-aged

The authors hereby declare that there is no conflict of interest.

© 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium,

Department of Science Laboratory Technology, Ladoke Akintola University of

**8**

**Author details**

Oladipo Iyabo Christianah

provided the original work is properly cited.

Technology, Ogbomoso, Oyo State, Nigeria

\*Address all correspondence to<EMAIL_ADDRESS>
[1] Leroy GW. Alcohol Encyclopædia Britannica [Internet]. 2018. Available from: https://www.britannica.com/ science/alcohol [Accessed: 27-5-2018]

[2] Drugs.com. Alcohol. [Internet]. Available from: https://www.drugs.com/ alcohol.html [Accessed: 26-5-2018]

[3] National Institutes of Health (NIH). National Institute on Drug Abuse (NIDA). Drugs of Abuse: Alcohol. [Internet]. Available from: http://www. drugabuse.gov/drugsabus e/alcohol [Accessed: 24-5-2018]

[4] Drugabuse.com. Alcohol Abuse. [Internet]. Available from: https:// drugabuse.com/library/alcohol-abuse/ [Accessed: 2-6-2018]

[5] Tarek IK. A round in alcohols world between: Production, properties, uses, applications, fuel, and compounds chemistry. Chemical Science and Engineering. 2009;**14**:25. Available from: http://tarek.kakhia.org/books\_ eng/Alcohol.Tarek\_Kakhia.pdf

[6] Nordmann R, Riviere C, Rouach H. Implication of free radical mechanisms in ethanol-induced cellular injury. Free Radical Biology & Medicine. 1992;**12**:219-240

[7] Kevin DS, Charles P, Jürgen R. Chronic diseases and conditions related to alcohol use. Alcohol Research: Current Reviews. 2014;**35**(2):155-171

[8] Horowitz M, Maddox A, Bochner M. Relationships between gastric emptying of solid and caloric liquid meals and alcohol absorption. American Journal of Physiology. 1989;**257**(92 Pt 1): G291-G298. PMID 2764113

[9] National Institute of Alcohol Abuse and Alcoholism. Overview of Alcohol Consumption; Alcohol Facts and

Statistics [Internet]. Available from: https://www.niaaa.nih.gov/alcoholhealth/overview-alcohol-consumption/ alcohol-facts-and-statistics [Accessed: 2-6-2018]

[10] American Addiction centers. Alcoholism Addiction Treatment. [Internet]. Available from: https:// Americanaddictioncenters.org/ alcoholism-treatment/ [Accessed: 2-6-2018]

[11] Vaillant GE, Keller M. Alcoholism [Internet]. 2018. Available from: www. britannica.com/science/alcoholism [Accessed: 2-6-2018]

[12] Office of the Surgeon General. U.S. Department of Health and Human Services. News release. U.S. Surgeon General Releases Advisory on Alcohol Use in Pregnancy. Available from: http://www.surgeongeneral.gov/ pressreleases/sg02222005.html [Accessed: 24-5-2018]

[13] Centers for Disease Control and Prevention. Fetal Alcohol Spectrum Disorders (FASDs) Alcohol Use in Pregnancy [Internet]. Available from: http://www.cdc.gov/n cbddd/fasd/ alcohol-use.html [Accessed: 24-5-2018]

[14] Mayo Clinic. Heart Disease; Red Wine and Resveratrol: Good for your heart? [Internet]. March 4, 2011. Available from: http://www.mayoclinic. com/health/red-wine/HB00089 [Accessed: 24-5-2018]

[15] Naimi TS, Brewer RD, Mokdad A, Denny C, Serdula MK, Marks JS. Binge drinking among US adults. JAMA. 2003;**289**:70-75

[16] Buckman JF, Eddie D, Vaschillo EG, Vaschillo B, Garcia A, Bates ME. Immediate and complex cardiovascular adaptation to an

acute alcohol dose. Alcoholism: Clinical and Experimental Research. 2015;**39**(12):2334-2344. DOI: 10.1111/ acer.12912

[17] Smith KE, Fenske NA. Cutaneous manifestations of alcohol abuse. Journal of the American Academy of Dermatology. 2000;**43**:1-16

[18] Yoda T, Crawshaw LI, Nakamura M, Saito K, Konishi A, Nagashima K, et al. Effects of alcohol on thermoregulation during mild heat exposure in humans. Alcohol. 2005;**36**:195-200

[19] Shi P, Chen Y, Guo M, Yu H. Acute effects of alcohol on heart rate variability: Time-related changes and gender difference. Biomedical Engineering Applications, Basis and Communications. 2014;(26, 3). DOI: 10.4015/S1016237214500483

[20] Timberline Knolls Residential Treatment Center. Alcohol Addiction Treatment. Alcohol Addiction Signs, Symptoms and Effects [Internet]. Available from: http:// www.timberlineknolls.com/alcoholaddiction/signs-effects/ [Accessed: 12-6-2018]

[21] American Addiction Centers. Alcohol Withdrawal Treatment, Symptoms, and Time- line. [Internet]. Available from: https:// americanaddictioncenters.org/ withdrawal-timelines-treatments/ alcohol/ [Accessed: 15-6-2018]

[22] Popsugar. Fitness. [Internet]. Available from: https://www. popsugar.com/fitness/Pros-ConsDrinking-Red-Wine-White-Wine-Champagne-14656661/ [Accessed: 18-8-2018]

[23] Addiction Centers. Alcohol Detoxification. [Internet]. Available from: https://www.addictioncenter. com/alcohol/detox/ [Accessed: 13-6-2018]

[24] Wikipedia Non Alcoholic Drinks [Internet]. Available from: https:// en.wikipedia.org/wiki/Non-alcoholic\_ drink. [Accessed: 12-6-2018]

**11**

**Chapter 2**

**Abstract**

Usage of Kombucha 'Tea Fungus'

The following herbal teas were fermented with the Kombucha "tea fungus" for 7 days: *Acacia arabica*, *Aegle marmelos* root bark, *Aerva lanata*, *Asteracantha longifolia*, *Cassia auriculata*, *Hemidesmus indicus*, *Hordeum vulgare*, *Phyllanthus emblica*, *Tinospora cordifolia*. Microbial enumerations of the bacteria and fungi present in the broth and the tea fungal mats were carried out. At the end of the period of fermentation, the pH values ranged from 4.0 to 6.0, while the titratable acidity (TA) ranging from 2.5 to 5.0 g/mL. The TA was within the acceptable limits of consumption for all beverages. The Oxygen radical absorbance capacity (ORAC) assay indicated 5 of the fermented beverages to have statistically significant increases (P < 0.05) by the end of the period of fermentation. By day 7, the IC50 values of the α-amylase inhibitory activities ranged from 52.5 to 67.2 μg/mL, while the α-glucosidase inhibitory activity values ranged from 95.2 to 196.1 μg/mL by this time point. Overall, an enhancement of the antioxidant and starch hydrolase inhibitory potential of the seven herbal teas was observed as a result of the fermentation by addition of the tea fungus. Thus, this fermentation process could be highlighted as a novel and versa-

**Keywords:** antioxidant activity, ORAC, Kombucha, starch hydrolase inhibitory

Kombucha or "tea fungus" is a fermented beverage which is believed to have its origins in northeast China, and has recently gained rapid popularity among the rest of the world [1]. The beverage is produced through the symbiotic growth of bacteria and osmophilic yeast strains in a thick jelly-like membrane which is cultured in sugared black tea (**Figure 1**) [2]. While the term "Kombucha" is the most commonly used name for the beverage on a commercial basis, it is also known by other names such as Chainii grib, Chainii kvass Champignon de longue vie, Ling zhi, kocha kinoko and red tea fungus [3]. For the production of the beverage, the substrate is incubated with the tea fungal mat statically under aerobic conditions, usually for a minimum of 7 days at 20–28**°**C [4]. However, to obtain a pleasantly sour beverage with palatability and acceptable sensory properties, the fermentation should terminate when the titratable acidity (TA) reaches 4.0–4.5 g/L**—**a level which has been confirmed as acceptable by longtime consumers of the Kombucha beverage

for Enhancement of Functional

Properties of Herbal Beverages

*Viduranga Yashasvi Waisundara*

tile methodology to obtain functional beverages.

and is known as the optimal consumable acidity [5].

activity, total phenolic content

**1. Introduction**

## **Chapter 2**


*Supporting open minds since 2005*

Stainless Steels http://dx.doi.org/10.5772/intechopen.96827 Edited by Ambrish Singh

### Contributors

Temitope Olumide Olugbade, Maruthasalam Sowrirajan, Selvaraj Vijayan, Munusamy Arulraj, André Paulo Tschiptschin, Carlos Eduardo Pinedo, Selma Attabi, Abdelaziz Himour, Lakhdar Laouar, Amir Motallebzadeh, Swarup Kumar Ghosh, Indrajit Dey, Pallabi Manna, Muralidhar Yadav, Nisith Kumar Tewary, Jayanta Kumar Saha, Tomomi Shiratori, Tatsuhiko Aizawa, Tomoaki Yoshino, Yohei Suzuki, Takafumi Komatsu, Gennadii Snizhnoi, Duduzile Zamavezi Nkomo, Nomsombuluko Masia, Ambrish Singh

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**3.2 Standard thermocouple types**

472 Solar Radiation

Iron, Chromel) and the other as the negative (Constantan, Alumel). Basic system suitable for the application of thermoelectricity in power generation is that of several thermocouples connected in series to form a thermopile (a device with increased output relative to a single thermocouple). The junctions forming one end of the thermocouple are at the same low

The thermopile is connected to a device in which the temperature TL is fixed when connected to a heat sink. The temperature TH is determined by the output of the heat source and the thermal output of the thermopile. The load is run by the charges generated. With a thermopile, the multiplication of thermocouple involves a corresponding increase of resistance, hence it follows that one thermocouple can be better than another at one temperature but less effective at a second temperature. In order to take maximum advantage of the different materials, the thermocouples are cascaded, producing power in stages and

A primary consideration in choosing which thermocouple type to use in a given circumstance is the range of temperatures over which the device is to be used. Some of the

Suitability for conditions of use, expected service life and compactable installation

 Adequate sensitivity S over a wide range of temperature, stability against physical and chemical changes under various conditions of use and over extended periods of times,

Thermocouples can either be sheathed or beaded with bare thermoelements (Figure 8).

Sheathed thermocouple probes are available with one of the three junction types:

**Grounded Junction Type**: This is recommended for gas and liquid temperatures and for high-pressure applications. It has faster response than the ungrounded junction type.

**Ungrounded Junction Type:** This is recommended for measurements in corrosive environments where it is desirable to have the thermocouple electronically isolated from

temperature TL and the other junctions at the hot temperature TH.

other selection factors among others to be addressed include:

Availability, moderate costs, abrasion and vibration resistance.

increase power output.

requirements

Fig. 8. Thermocouple materials

and shielded by the sheath.

**3.1 The choice of thermocouple**

ASTM and ANST standards explicitly stated that the letter designations identifying only the reference tables might be applied to any thermocouple with a temperature-emf relationship that complies with the table within the specified tolerances, regardless of the chemical composition of the thermocouple (Quinn, 1983). Any randomly chosen pair of dissimilar wires will produce some kind of thermal emf when subjected to a temperature difference from end to end, however, the emf so produced may be unpredictable and of little use. Hence certain thermoelement combinations have been commercially developed over the years that have proved to be useful, reproducible, and readily available.

Eight of the most widely used of these combinations have been assigned letter-designations for ease of reference, Base metal thermocouples types designated as E, J, K, and T. The rear (Noble) metal thermocouple types are S, R, and B types.


**Author details**

Prashant Kaushik1,2\*, Opinder Singh Sandhu3 , Navjot Singh Brar4 , Vivek Kumar5 , Gurdeep Singh Malhi5 , Hari Kesh6 and Ishan Saini7

1 Instituto de Conservación y Mejora de la Agrodiversidad Valenciana, Universitat Politècnica de València, Valencia, Spain

2 Nagano University, Nagano, Japan

3 Department of Soil Science, Punjab Agricultural University, Ludhiana, India

4 Department of Vegetable Science, Punjab Agricultural University, Ludhiana, India

5 Department of Agronomy, Punjab Agricultural University, Ludhiana, India

6 Department of Plant Breeding, CCS Haryana Agricultural University, Hisar, India

7 Department of Botany, Kurukshetra University, Kurukshetra, Haryana, India

\*Address all correspondence to<EMAIL_ADDRESS>
© 2020 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

**11**

*Soil Metagenomics: Prospects and Challenges DOI: http://dx.doi.org/10.5772/intechopen.93306*

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[5] Uroz S, Buée M, Deveau A, Mieszkin S, Martin F. Ecology of the forest microbiome: Highlights of temperate and boreal ecosystems. Soil Biology and Biochemistry.

[6] Fierer N, Leff JW, Adams BJ, Nielsen UN, Bates ST, Lauber CL, et al. Cross-biome metagenomic analyses of soil microbial communities and their functional attributes. Proceedings of the National Academy of Sciences of the United States of America.

[7] Saini I, Aggarwal A. Kaushik P, Influence of biostimulants on important traits of *Zinnia elegans* Jacq. Under open field conditions. International Journal of Agronomy. 2019;**2019**:3082967

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*Soil Metagenomics: Prospects and Challenges DOI: http://dx.doi.org/10.5772/intechopen.93306*


**6. Conclusion**

In this chapter, I have covered some new directions of exploration of two major areas in psychoanalysis: free association and its link to science and primal repression, an area recognized by Freud but little referred to in recent writings. Gentile [63] has previously pointed to the relationship between free association and democracy. She posits that:

*Free Association, Synchrony, and Neural Networks as Evolutionary Exponents in Psychoanalysis DOI: http://dx.doi.org/10.5772/intechopen.107964*

*The ironic definitional "rule" of free association was that there was no rule to follow and no one's rule. If free association was to prevail, the patient had to bypass conventional rules of conventional censorship, ceding herself to the impetus yet also imperial authority to desirous voice, her unconscious desire (p. 21).*

Likewise, exploring some of the aspects of the primal repressed systematically may provide access to a variety of sources of intergenerational transmission of traits and information, an area that has been of particular interest in the study of traumatic stress. It is my contention that the only way of promoting an open field of psychoanalysis is by partnering with the investigative and research methodology of other fields and promoting "joint ventures" that would give further legitimacy to a new psychoanalysis. This shall open our field to new generations of psychoanalytic researchers and clinicians alike.


**Marfan Syndrome – Advances in Diagnosis and Management**

Miguel Angel Ramirez-Marrero, Beatriz Perez-Villardon, Ricardo Vivancos-Delgado and Manuel de Mora-Martin

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/48482


**1. Introduction**

Non-*Saccharomyces* yeasts have attracted increasing attention in recent years, with several studies providing evidence of their impact on the organoleptic characteristics and chemical-physical stability of wines. Despite their large intraspecific biodiversity, non-*Saccharomyces* yeasts often show species-specific metabolic features that contribute to the specific imprint of the resulting wines, when inoculated in mixed fermentation with *Saccharomyces cerevisiae* [1]. For instance, among the non-*Saccharomyces* yeasts, those belonging to the species *Torulaspora delbrueckii* result in the production of low volatile acidity, high terpenols, and 2-phenylethanol when utilized in mixed culture with *S*. *cerevisiae* [2–7]. In addition, the release of higher concentrations of thiols, with consequent increase of varietal

> 67

characters, was reported for *T. delbrueckii*/*S*. *cerevisiae* mixed starters [8,9]. *Starmerella bacillaris* (synonym *Candida zemplinina*) contributes to reduce the amount of acetic acid in mixed fermentation with *S*. *cerevisiae* [5,10–12]. Moreover, this yeast is usually characterized by high glycerol production [11,13–17] and low ethanol yield [16,18–20] making it an interesting tool to increase the wine sweetness and modulate the ethanol content. *Lachancea thermotolerans* strains produce lactic acid during the alcoholic fermentation causing a decrease of wine pH while reducing its volatile acidity [4,21–24]. Moreover, an increase of 2-phenylethanol, glycerol, and polysaccharides in mixed fermentation *L. thermotolerans*/*S*. *cerevisiae* was reported [4,21,22,25]. Regarding *Metschnikowia pulcherrima*, some studies showed its high β-glucosidase activity [26–28] with consequent increase of volatile terpene content from glycosylated flavorless precursors present in grapes. Moreover, because of a high β-lyase activity, yeasts belonging to the species *M*. *pulcherrima* release high quantity of varietal thiols from grape precursors conjugated to cysteine or glutathione [29,30]. In the last few years there has been also a renewed interest in yeasts belonging to the genus *Schizosaccharomyces*. Indeed, besides reducing malic acid in grape juice and/or wine, these yeasts produce high quantities of pyruvic acid [31,32] and polysaccharides during the course of alcoholic fermentation [33–36], positively contributing to the chemical-physical stability of wines. Finally, among yeasts typically considered as potential spoilage, those belonging to the genus *Zygosaccharomyces* have also started to attract attention [37,38]. In particular, the species *Z. florentina* contributes to increase esters and glycerol concentration when used in co-culture with *S*. *cerevisiae*, thus producing wines with higher floral notes and lower perception of astringency [39].

A Scopus database search with the combination of terms "wine and non-*Saccharomyces*" as query statement to highlight the relevant literature in the last decade, indicates that an increasing number of peer-reviewed publications have considered the use of non-*Saccharomyces* yeasts as starters together with *S*. *cerevisiae*. In particular, of a total of 458 peer reviewed scientific articles published from 2010 to 2019, the average number of publications/year on this topic was 26 during the period in between 2010 and 2014, and reached 65 in the following years (2015–2019). It is worth pointing out that most of these publications refer to laboratory scale fermentations. In particular, considering publications starting from 2015, 76% of the fermentations were carried out at the laboratory scale (50% in up to 1 L, 15% in 1.2–5 L and 11% in 10–20 L). Instead, pilot plant and industrial scale fermentations, that regarded 24% of the trials, are still quite limited. Of these, 18% were carried out in grape must volumes ranging from 30 to 200 L (pilot plant fermentations) and 5% in 700 to 1000 L (industrial scale fermentations). One fermentation was performed in a 100,000 L vessel.

Moreover, while 12% of the publications starting from 2015 describe fermentations carried out in synthetic media, the majority of works report on the utilization of different grape varieties to evaluate the impact of the non-*Saccharomyces* yeasts on the chemical and physical characteristics of the relevant wine. Among these, Shiraz, Sauvignon Blanc, Barbera, Cabernet Sauvignon, Chardonnay and Merlot were the most frequently utilized. Few articles (4%) describe mixed fermentations in Sangiovese grape must despite the importance of this grape variety that in Italy represents 90% of total world Sangiovese vineyard area (http://www.oiv.int/public/medias/5888/en-distribution-of-theworlds-grapevine-varieties.pdf). In order to avoid any metabolic interference by other microorganisms, half of the studies evaluated the impact of pure and mixed starters on the final wine by using sterile grape juice.

Indeed, laboratory scale fermentation and synthetic media or sterile grape juice are important conditions to evaluate the specific metabolic traits of the non-*Saccharomyces* yeasts included in the mixed starter and also to establish their possible interactions with *S*. *cerevisiae*. However, the results obtained under these conditions are likely far away from those obtainable under technological conditions, also due to the unpredictability of the interactions that the inoculated starters may establish with wild grape must microflora.

Based on these observations, in the present work seven different non-*Saccharomyces*/*S*. *cerevisiae* mixed starters were inoculated in Sangiovese grape must at the pilot plant scale and their impact on the final product was evaluated through chemical and sensory analyses of the resulting wines after stabilization. Sangiovese is the most widely planted red grape variety in Italy, particularly in Tuscany where it represents the obligatory variety in the production of wines with a protected and guaranteed designation of origin (DOCG) such as Chianti Classico and Brunello di Montalcino.

#### **2. Material and Methods**

## *2.1. Yeast Strains*

Seven non-*Saccharomyces* strains from the yeast culture collection of the Department of Agriculture, Food, Environment and Forestry (DAGRI, University of Florence, Italy) and of the Department of Life and Environmental Sciences (DiSVA, Polytechnic University of Marche, Ancona, Italy) were used (Table 1). The yeast strains were sub-cultured on YPD (1% yeast extract, 2% peptone, 2% glucose, 2% agar) at six months intervals, and maintained at 4 ◦C.

**Table 1.** Origin of the seven non-*Saccharomyces* strains and the commercial strain of *S. cerevisiae* used in this study.

a Department of Life and Environmental Sciences of the Polytechnic University of Marche (Italy), b Department of Agriculture, Food, Environment and Forestry, University of Florence (Italy). c Lallemand Inc. (Montreal, QC, Canada).

The strains reported in Table 1 were isolated from grapes and musts of different origins and characterized for their enological performances in mixed fermentations carried out in grape juice at laboratory scale [4,37,38]. A commercial *S*. *cerevisiae* starter, Lalvin EC1118 (Lallemand Inc., Montreal, QC, Canada), was used as reference strain and for comparison determination.

#### *2.2. Pilot Scale Fermentation*

The fermentation trials were carried out in 100 L steel tanks containing 70 L of Sangiovese grape must with the following characteristics: pH 3.66, 234 ±7 g/L sugars, 4.0 g/L total acidity (as tartaric acid), 1.2 g/L malic acid. Non-*Saccharomyces* yeasts were inoculated in 12 L filtered sterilized commercial red grape must, aliquoted within 2 L flasks, each containing 1.5 L and grown for 48-h at 25 ◦C under shaking conditions (150 rpm). Cell concentration was determined by microscope counting. Each tank was inoculated with 107 cell/mL of the non-*Saccharomyces* yeast strain. After 3 days of fermentation, *S*. *cerevisiae* EC1118 was inoculated as active dry yeast (ADY) at the final concentration of 107 cell/mL. Control trials were inoculated with 107 cell/mL of *S*. *cerevisiae* EC1118. Skin cap was punched down twice a day and fermenting must was sampled during the fermentation process immediately after inoculation (T0) and 3, 5, and 10 days after inoculation (T3, T5, T10, respectively) to evaluate the evolution of the yeast populations as viable cell counts and to determine the residual sugars. Alcoholic fermentation was monitored by periodically measuring the density by a double scale hydrometer (density and Baumé). All trials were fermented at 25 ◦C, in duplicate. After completion of fermentation, the wines were naturally fined by three successive rackings over a month at 16–18 ◦C and added with SO2 up to 100 mg/L before bottling (0.75 L cork-capped glass bottles).