Asian or Oriental Flushing Reflex: Alcohol is Racist

Alcohol is racist. It doesn’t treat people of different races equally. In particular, it discriminates against Asians. It’s often called the Asian or Oriental flushing reflex.

Oriental flushing reflex

Example of Asian flushing reaction.

A genetic intolerance to alcohol occurs most often among Asians. It’s generally known as the Oriental flushing reflex. The term “flushing” refers to the bright reddening of the skin or flushing, This is from the dilation of the capillaries of the face, neck, shoulder, and sometimes the entire body.

The condition is also called Oriental flushing reaction. Today, the term “Oriental” is no longer politically correct. Therefore, newer terms include Asian flushing reflex, Asian flushing reaction, Asian flush syndrome, Asian flush, and Asian glow.

Those who suffer this condition quickly experience various unpleasant physical reactions after drinking even small amounts of alcohol. In addition to flushing, they can include rapid breathing, nausea, itching, drowsiness, strange sensations in the ears, and other symptoms.

The Asian flushing reflex is caused by poor metabolism or breakdown of alcohol in the body. This is because of a buildup of acetaldehyde. That, in turn, results from low production an ALDH2 enzyme. The root cause is a variant of the ALDH2 gene (ALDH2*2).

The proportion of Asians who suffer the condition depends on their racial background. It can be as high as over 36% among Chinese, Japanese, and Koreans. The condition is less frequent among Indians and other Asians. It is about 3% among Caucasians.  The Chinese expression “to be red faced” for being slightly intoxicated has a basis in fact.

Those with Asian or Oriental flushing reflex have up to a 10-fold increased risk of oesophageal cancer. This is thought to result from the accumulation of acetaldehyde.

The prevalence of the reaction among Asians is often suggested as an explanation for the low rates of alcoholism among Asians. But there is no relationship between flushing and reported drinking patterns. Nor can it explain changes in drinking patterns over time or between generations.

More about the Asian or Oriental flushing reflex

Greaves, M. and Burova, E. Flushing: causes, investigation and clinical consequences.  J Euro Acad Dermat Venereol, 1997, 8(2),   91’“100.

Johnson, R.C. The Flushing Response and Alcohol Use Among U.S. Minorities. In: Spieler, D. (Ed.) Alcohol Use Among U.S. Ethnic Minorities. Rockville: NIAAA, 1989.

Kitano, H. Alcohol and the Asian-American. In: Watts, T. and Wright, R. (Eds.) Alcoholism in Minority Populations. Springfield, IL: Thomas, 1989.