Grape or grain but never the twain? A randomized controlled multiarm matched-triplet crossover trial of beer and wine

Abstract

Background Alcohol-induced hangover constitutes a significant, yet understudied, global hazard and a large socio-economic burden. Old folk wisdoms such as “Beer before wine and you'll feel fine; wine before beer and you'll feel queer” exist in many languages. However, whether these concepts in fact reduce hangover severity is unclear. Objectives The aim of this study was to investigate the influence of the combination and order of beer and wine consumption on hangover intensity. Methods In this multiarm, parallel randomized controlled matched-triplet crossover open-label interventional trial, participants were matched into triplets and randomly assigned according to age, gender, body composition, alcohol drinking habits, and hangover frequency. Study group 1 consumed beer up to a breath alcohol concentration (BrAC) ≥0.05% and then wine to BrAC ≥0.11% (vice versa for study group 2). Control group subjects consumed either only beer or only wine. On a second intervention day (crossover) ≥1 wk later, study-group subjects were switched to the opposite drinking order. Control-group subjects who drank only beer on the first intervention received only wine on the second study day (and vice versa). Primary endpoint was hangover severity assessed by Acute Hangover Scale rating on the day following each intervention. Secondary endpoints were factors associated with hangover intensity. Results Ninety participants aged 19–40 y (mean age 23.9), 50% female, were included (study group 1 n = 31, study group 2 n = 31, controls n = 28). Neither type nor order of consumed alcoholic beverages significantly affected hangover intensity (P > 0.05). Multivariate regression analyses revealed perceived drunkenness and vomiting as the strongest predictors for hangover intensity. Conclusions Our findings dispel the traditional myths “Grape or grain but never the twain” and “Beer before wine and you'll feel fine; wine before beer and you'll feel queer” regarding moderate-to-severe alcohol intoxication, whereas subjective signs of progressive intoxication were confirmed as accurate predictors of hangover severity. This trial was prospectively registered at the Witten/Herdecke University Ethics Committee as 140/2016 and retrospectively registered at the German Clinical Trials Register as DRKS00015285.

Effects of Alcohol Hangover on Cognitive Performance: Findings from a Field/Internet Mixed Methodology Study

“…AMEDs were the least consumed beverages ( N = 30, truex¯ = 2.87), and although wine was consumed by a similar number of people ( N = 31), on average it was consumed at a higher level (truex¯ = 7.16 drinks). Thus, our data confirm other findings using other methodology [50] showing that irrespective of the type of alcoholic drink or mixer, the most meaningful association was between the number of drinks consumed and BAC.…”

Effects of Alcohol Hangover on Cognitive Performance: Findings from a Field/Internet Mixed Methodology Study

“…AMEDs were the least consumed beverages (N = 30, = 2.87), and although wine was consumed by a similar number of people (N = 31), on average it was consumed at a higher level ( = 7.16 drinks). Thus, our data confirm other findings using other methodology [50] showing that irrespective of the type of alcoholic drink or mixer, the most meaningful association was between the number of drinks consumed and BAC.…”

Sensitivity to Experiencing Alcohol Hangovers: Reconsideration of the 0.11% Blood Alcohol Concentration (BAC) Threshold for Having a Hangover

“…When looking at their unique contributions to the variance explained, the strongest predictor was subjective intoxication (48.5%), followed by sleep quality (7.2%), estimated BAC (1.2%), and body mass index (BMI; 1.1%). These findings are in line with two other recent regression analyses [17,18]. Both studies showed that subjective intoxication (perceived drunkenness), and not BAC, was the strongest predictor of hangover severity.…”