When at the Bar, Understand Red Faces & the 'Asian Flush'

By Erik Lief — Jul 13, 2016
The Asian Flush, also known as the Asian Glow, or Alcohol Flush Reaction, can be pretty debilitating. The condition is usually associated with red faces, and flushing of the neck area. But for some of Asian descent, it also results in symptoms such as heightened heart rate, headache, and nausea -- from consuming as little as one alcoholic drink.

Depending on who's consuming it, alcohol affects different people in very different ways. And to go along with that, drinking stereotypes are never in short supply. Too many of us are quick to roll out generalities like, "The Irish know really how to drink," or a pack of 20-something men, regardless of their demeanor, are just "former frat boys looking to get loud and loaded."

And then there are Asians, a large percentage of whom are also painted with an unfair brush, but one of a far different sort. Basically many believe they are, "lightweight drinkers who can't hold their liquor, and get drunk easily."

But the problem with that oversimplified and misleading idea is that there's a scientific explanation being ignored: It has do with the liver and how it processes alcohol. In short, for those of Asian descent, it’s all in the genes.

First off, those afflicted with this condition have a name for it: "The Asian Flush." It has other monikers as well -- Asian Glow, or Alcohol Flush Reaction (AFR) -- and from a physiological standpoint, it's pretty debilitating. Yale Scientific, the nation's oldest college science publication, says "AFR is usually associated with flushing of the neck and face, but the condition also results in symptoms such as heightened heart rate, headache, and nausea, even after consuming as little as one alcoholic drink."

It's believed that those of Korean, Japanese and Chinese descent (mostly from the northeastern part of the country), roughly 40-50 percent lack a key enzyme that causes the disorder. Research has established that the flush come from the "genetic inability to properly metabolize alcohol (or ethanol) which, thanks to enzymes in the liver, is normally metabolized first into the toxic chemical acetaldehyde – a carcinogen, and then into the harmless substance acetic acid (vinegar), aka acetate," as described in a report on nbcnews.com, which added that "[those afflicted] have a genetic deficiency in the alcohol-metabolizing enzyme ALDH2, which can lead to an accumulation of the toxic substance acetaldehyde."

The article quotes Philip J. Brooks, from the National Institute on Alcohol Abuse and Alcoholism, who says, "Individuals with this particular genetic disposition can’t metabolize [acetaldehyde] to the acetate. So it builds up in their body and causes vasodilation, which causes the flushing response.”

For those of you interested in seeing an engaging, visual explanation of the Asian Flush phenomenon, here's an easy-to-follow video, courtesy of Vox media. For the unaware, unfortunately they believe that the "flushing" can be overcome by attempting to raise one's tolerance for alcohol -- by drinking more. But that's a foolish concept; it can greatly worsen the condition. What's more, according to a study published by PLoS Medicine, from the Public Library of Science, doing so can increase the risk of esophageal cancer.

On the lighter side, there are those affected by the Asian Flush who, instead of focusing on the drawbacks, choose to highlight its advantages. When out with friends, they say a lower bar bill is welcome, as is that less drinking can lead to more dancing, and greater aerobic activity. Asian optimists will also point out that they're prone to experience fewer hangovers, and in the long run, a reduced chance of developing alcoholism.

So not everyone thinks it's all bad -- especially this blogger writing for ChopstickLounge.com, whose post is titled "4 Reasons Why Asian Glow is Awesome." It's quirky, but interesting. So, the next time you're out with a friend or acquaintance of Asian origin, and they're nursing a drink or savoring soda while you're sucking down Gin and Tonics, give 'em a break if you feel they're not keeping up. Because, after all, it's not their fault -- it's science calling the shots.