I think it is absolutely genetic and metabolic...and I suspect related to diabetes and metabolic syndrome and the whole question of diet and nutrition and what particular types of bodies need. I suspect that with the right diet, probably a high protein, high fat, high vegetable, low starch diet, it would be way reduced..and that if people even ate the right food before drinking it would be way reduced. I suspect there are vitamin deficiencies involved, ethnicity of course is involved..through genetics and culture both probably..times of day of drinking, stress levels..it is a huge biological conundrum..but yes, people can avoid it by not ever drinking. That is basically what I did..first I grew up hearing you're Irish you can't drink..second..I never wanted to start on something I would have to give up later because I know I would not be good at that, and third, I suspected I might have a weakness there since I get severely hypoglycemic (using the term incorrectly). mg