Does Beer Before Liquor Actually Make You Sicker?

Question: I've been hearing this phrase for years: “Beer before liquor, never been so sick.” But is it true?

These are well-known mantras of students and anyone who wants to avoid a hangover: 'Beer before spirits, never been so sick'; “Grape or grain, but never both”; “Beer before wine and you will feel good.”

People have long tried to 'game' their drinking habits to ease morning pain. But while many swear these statements hold water, the evidence behind them is murky, experts say.

What does science suggest?

Few studies have examined whether these statements contain any truth, partly because such research is expensive, challenging and time-consuming to conduct, says Dr. Kai O. Hensel, a researcher at Helios University Hospital Wuppertal in Germany.

But in one of the most rigorous studies to date: published in 2019wanted Dr. Hensel and his colleagues do exactly that.

They recruited 90 students between the ages of 19 and 40 from a university in Germany and divided them into three groups. On the first day, the first group drank a lager with 5 percent alcohol (supplied by the beer company Carlsberg) until their breath alcohol concentration reached 0.05 percent, then they drank a white wine with 11 percent alcohol until their breath alcohol concentration reached 0.11 percent.

The second group did the same, but in reverse order. And people in the third group were instructed to drink only beer or only wine as a control.

While the participants drank, the researchers asked about their well-being and how drunk they felt. They also received standardized meals and water and then went to sleep at the study site. The next morning, participants rated the intensity of their hangover symptoms – including how tired, thirsty, dizzy and nauseous they felt – from 0 to 7.

A week or more later, the researchers repeated the entire process, but alternated the order of alcohol consumption between the groups: those who had drunk beer consumed wine first, and vice versa. And people in the control group who drank wine on the first day switched to beer, and those who drank beer switched to wine.

When the researchers compared participants' hangover scores across study days and groups, they found that drinking order did not uniformly affect their hangover symptoms, said Dr. Hensel.

There was no optimal drink order that applied to everyone, he said. The severity of people's hangovers depended more on how their bodies could process the alcohol.

“Our findings debunk age-old myths,” the researchers wrote in the study.

What actually reduces the chance of a hangover?

The easiest way to minimize the chance of a hangover is also the most obvious: drink less, says Emmert Roberts, senior clinical lecturer in addiction psychiatry at King's College London.

Some alcoholic drinks are more likely to make you feel sick the next morning than others, Dr. Roberts said. Darker liquors such as whiskey and cognac are associated with it more intense hangovers than lighter colored spirits such as vodka and gin. This is because dark liquors contain higher concentrations of congeners, compounds that are naturally produced during the distillation and fermentation process and contribute to the colors, flavors and aromas of the drinks.

Red wine is also known to cause headaches the next day, for reasons researchers don't fully understand.

Liquor generally has a higher alcohol concentration than beer or wine, so drinking equivalent amounts is more likely to make you feel worse, Dr. Roberts said.

There aren't many proven ways to prevent a hangover. Staying hydrated can help, said Dr. Sarah Andrews, assistant professor of psychiatry and behavioral sciences at Johns Hopkins Medicine. Alternating alcoholic drinks with water can also slow the rate at which you drink, allowing you to drink less overall. And making sure there is food in your stomach before drinking is also helpful, as drinking on an empty stomach can make you more drunk.

But if your only way to thwart a hangover is to follow the instructions of a cute saying, it won't work, Dr. Andrews said.

“There are so many myths about alcohol consumption that need to be debunked,” she said. “And this is certainly one of them.”