The tendency to become dependent on alcohol has long been known to run in families, which for some only added to the social stigma attached to this complicated condition. Decades ago researchers began investigating the widely observed tendency of persons from Chinese, Japanese or other East Asian backgrounds to become “flushed” when they drank an alcoholic beverage. Blood tests on subjects displaying this effect showed increased levels of acetaldehyde, a breakdown product of alcohol, which resulted in an uncomfortable sensation of warmth in the skin, palpitations and weakness. By the 1980s investigators traced the reaction to an enzyme involved in alcohol metabolism, aldehyde dehydrogenase, and eventually to the gene that encodes it, ALDH1.
This ALDH1 gene variant has since been found to be common in Asian populations–seen in 44 percent of Japanese, 53 percent of Vietnamese, 27 percent of Koreans and 30 percent of Chinese (including 45 percent of Han Chinese)–yet it is rare in people of European descent. As might be expected, people with this slow-metabolizing gene variant also have a decreased risk, by up to sixfold, for alcoholism, so it is an example of a genetic variation that can protect against developing the disorder.