Mixing alcohol with artificially sweetened beverages: Prevalence and correlates among college students

Effects of voluntary adolescent intermittent alcohol exposure and social isolation on adult alcohol intake in male rats

Initiating alcohol use in adolescence significantly increases the likelihood of developing adult alcohol use disorder (AUD). However, it has been difficult to replicate adolescent alcohol exposure leading to increased adult alcohol intake across differing preclinical models. In the present study, differentially housed male rats (group vs. single cages) were used to determine the effects of voluntary intermittent exposure of saccharin-sweetened ethanol during adolescence on adult intake of unsweetened 20% ethanol. Adolescent male rats were assigned to group- or isolated-housing conditions and underwent an intermittent 2-bottle choice in adolescence (water only or water vs. 0.2% saccharin/20% ethanol), and again in adulthood (water vs. 20% ethanol). Intermittent 2-bottle choice sessions lasted for 24 h, and occurred three days per week, for five weeks. Rats were moved from group or isolated housing to single-housing cages for 2-bottle choice tests and returned to their original housing condition on off days. During adolescence, rats raised in isolated-housing conditions consumed significantly more sweetened ethanol than rats raised in group-housing conditions, an effect that was enhanced across repeated exposures. In adulthood, rats raised in isolated-housing conditions and exposed to sweetened ethanol during adolescence also consumed significantly higher levels of unsweetened 20% ethanol compared to group-housed rats. The effect was most pronounced over the first five re-exposure sessions. Housing conditions alone had little effect on adult ethanol intake. These preclinical results suggest that social isolation stress, combined with adolescent ethanol exposure, may play a key role in adult AUD risk.

Effects of Consuming a Low Dose of Alcohol with Mixers Containing Carbohydrate or Artificial Sweetener on Simulated Driving Performance

The Australian National Drug and Alcohol Research Centre (NDARC) devised gender-based drinking recommendations to ensure blood or equivalized breath alcohol concentrations (BrAC) remain <0.050%. However, these may be inappropriate for individuals consuming alcohol without carbohydrate (CHO), which results in higher BrACs. This study investigated the effects of ingesting alcohol with and without CHO on BrACs and simulated driving performance. Thirty-two participants (16 males; age: 23 ± 6 years) completed two randomized single-blinded trials. Participants performed a baseline drive (Drive 1), then an experimental drive (Drive 2), following alcohol consumption (males: 20 g; females: 10 g). Alcoholic beverages contained either 25 g sucrose or aspartame (AS). Driving performance was assessed using lateral control (standard deviation of lane position [SDLP] and number of lane departures) and risk-taking (number of overtaking maneuvers and maximum overtaking speed). BrAC and subjective ratings (e.g., intoxication) were also assessed. BrAC was significantly lower as Drive 2 commenced with CHO compared to AS (0.022 ± 0.008% vs. 0.030 ± 0.011%). Two males provided BrACs >0.050% with AS. Neither beverage influenced changes to simulated driving performance. Ingesting alcohol in quantities advised by the NDARC results in no detectable simulated driving impairment. However, the likelihood of exceeding the legal drink-driving BrAC is increased when alcohol is consumed with artificially-sweetened mixers.

The Influence of Mixers Containing Artificial Sweetener or Different Doses of Carbohydrate on Breath Alcohol Responses in Females

BACKGROUND

Breath alcohol responses may be affected by the presence of carbohydrate (CHO) in a beverage. This study investigated the impact of consuming alcohol with mixers containing various doses of CHO or an artificial sweetener on breath alcohol concentration (BrAC), ratings of intoxication and impairment, and cognitive performance in females.

METHODS

Twenty-six females (age 25.1 ± 0.7 years, mean ± standard deviation) completed a crossover study involving 4 trials. A dose of alcohol was consumed in each trial mixed with water (W), artificial sweetener (150 ± 1 mg aspartame [AS]), or CHO (15 g sucrose [15CHO] and 50 g sucrose [50CHO]). BrAC was sampled for 210 minutes following beverage ingestion and analyzed for peak BrAC and other parameters using WinNonlin noncompartmental pharmacokinetic modeling (c_max , t_max , area under the curve to the last measured time point [AUC_last ]). An objective measure of cognitive performance was assessed using a 4-choice reaction time (CRT) task. Estimation of BrAC, self-reported ratings of intoxication, and willingness to drive were recorded.

RESULTS

Mean peak BrAC was reduced in a dose-response manner when alcohol was consumed with CHO compared to both W and AS treatments (W: 0.054 ± 0.015%, AS: 0.052 ± 0.011%, 15CHO: 0.049 ± 0.008%, 50CHO: 0.038 ± 0.007%). No difference in peak BrAC was observed between W and AS treatments. WinNonlin parameters revealed significant differences in c_max and AUC_last (W: 4.80 ± 1.12 g/dl/h, AS: 4.61 ± 0.92 g/dl/h, 15CHO: 4.10 ± 0.86 g/dl/h, 50CHO: 3.11 ± 0.58 g/dL/h) when CHO-containing beverages were consumed compared to W and AS treatments. No difference in t_max or CRT was observed between treatments. Participants were able to detect subtle differences in peak BrAC and reported greater ability to drive after consuming 50CHO compared to W. However, participant's willingness to drive and CRT did not differ between treatments.

CONCLUSIONS

Consuming alcohol with CHO-containing mixers attenuates peak BrAC and reduces total alcohol exposure in a dose-response manner compared to drinks containing artificial sweetener or no additives. The effect of adding CHO to alcoholic beverages may translate to reduced risk of alcohol-related harms.