• Cassie Smith, Peter John Herzig, Andrew Davey, Ben Desbrow, and Christopher Irwin.
• Menzies Health Institute Queensland, Gold Coast, Queensland, Australia.
• Alcohol. Clin. Exp. Res. 2017 Jan 1; 41 (1): 38-45.

BackgroundBreath 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.MethodsTwenty-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 (cmax , tmax , area under the curve to the last measured time point [AUClast ]). 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.ResultsMean 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 cmax and AUClast (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 tmax 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.ConclusionsConsuming 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.Copyright © 2016 by the Research Society on Alcoholism.

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