ALDH2 and hyperinsulinemic hypoglycemia, familial, 4: ALDH2 deficiency is one of the most common hereditary disorders affecting ~8% of the world population and 35% to 45% of individuals of East Asian heritage.(1, 2, 3) There are 67 million individuals worldwide with ALDH2 deficiency who are >50 years old and are at increased risk of osteoporosis that is further accelerated by chronic alcohol consumption.(2, 3, 34, 35, 36) ALDH2 serves in the ethanol metabolism pathway to convert acetaldehyde to acetate predominantly in the liver.