Fitness and Training

Do Hitting the Gym and Hitting the Bottle Go Hand in Hand?

Do Hitting the Gym and Hitting the Bottle Go Hand in Hand? If you work out regularly to improve your overall health, you may want to pay extra attention to how much alcohol you’re drinking. New research finds that physically fit men and women are more than twice as likely to be moderate or heavy drinkers compared with people who don’t exercise regularly.

The study, published in January 2022 in Medicine & Science in Sports & Exercise, not only found a robust relationship between physical activity and alcohol consumption but also between cardiorespiratory fitness and alcohol, according to lead author Kerem Shuval, PhD, MPH, assistant professor at the school of public health at the University of Texas in Dallas. “It is important to note that these behaviors — physical activity and alcohol — tend to go ‘hand in hand.’

Therefore, when trying to change one behavior, it is important to take into account the other,” says Dr. Shuval.

What Is Excessive Drinking? It Might Surprise You
The 2020–2025 Dietary Guidelines for Americans recommends that adult men limit intake to two drinks or less in a day and that women have one drink or less a day.

What, exactly, is “one drink”? In the United States, a standard drink contains 0.6 ounces (oz) or 1.2 tablespoons of pure alcohol. That’s the amount typically found in a 12-oz beer with 5 percent alcohol content, a 5-oz glass of wine with 12 percent alcohol content, or a mixed drink with 1.5 oz of 80 proof liquor (such as vodka, tequila, or whiskey).

In health terms, excessive drinking includes binge drinking and heavy drinking. Binge drinking is when you consume more than four (for women) or five (for men) drinks at a single occasion, and heavy drinking is defined as eight or more drinks per week for women, and 15 or more drinks per week for men. Drinking excessively doesn’t mean you are abusing alcohol — most people who drink excessively are not alcoholics or alcohol dependent, per the Centers for Disease Control and Prevention (CDC).

However, there are long-term health risks of excessive drinking that can include high blood pressure, heart disease, liver disease, digestive problems, certain types of cancer, dementia, and a weakening of the immune system, per the agency.

Men And Women Absorb Alcohol Differently
Why are the recommendations around alcohol different for men and women? Research has shown that women develop alcohol-related health problems sooner and at lower drinking levels than men.

One reason is that alcohol resides mostly in body water, and pound for pound, women have less water in their bodies than men. Water dilutes alcohol — that means that even if a man and a woman weigh the same and drink the same amount of alcohol, the woman’s blood alcohol concentration (BAC) will tend to be higher, putting her at greater risk for harm, according to the National Institute on Alcohol Abuse and Alcoholism.

Males and females also have variations in the amount and activity of alcohol dehydrogenase (ADH), the enzyme that metabolizes alcohol, according to the Alcohol Pharmacology Education Partnership at Duke University.

Men have highly active forms of ADH in the stomach and liver, which can reduce the absorption of alcohol in the bloodstream by as much as 30 percent, whereas women have almost no ADH in their stomach, and the ADH in their liver is much less active. The bottom line is that more alcohol is absorbed into women’s bloodstream as compared with men, making it easier for them to become intoxicated.

Fit People More Likely to Drink Unhealthy Amounts of Alcohol
This study examined data from 38,653 healthy people between 20 to 86 years old (the average age was 46) who were enrolled in the Cooper Center Longitudinal Study (CCLS). Alcohol intake was assessed by a questionnaire, and cardiorespiratory fitness was classified as low, moderate, or highly fit based on a treadmill test and the participants’ age and sex.

For alcohol consumption, those consuming three or fewer drinks per week were considered light drinkers; up to seven for women and 14 for men was moderate; and above that was heavy for patients aged 18 to 64 years.

Key findings of the study included:

  • Adults who exercise enough to be moderately or very fit also tend to drink more alcohol.
  • Women with moderate fitness levels were 1.6 times as likely to consume moderate or heavy amounts of alcohol, and women with high fitness levels were 2.1 times more likely to do so.
  • Men with moderate fitness levels were 1.4 more likely to consume moderate or heavy amounts of alcohol, and men with high fitness levels were 1.6 times more likely to do so.
  • Somewhat surprisingly, among men who were heavy drinkers, higher fitness levels were related to lower rates of suggested alcohol dependence. For example, men who drank heavily within the low fitness category had an estimated 1.3 times higher risk of suggested alcohol dependence compared with men who were highly fit, a finding that the authors suggest warrants further examination.

According to the researchers, these findings support previous research on physical activity and drinking, including a systematic review published in 2017 in the American Journal of Health Promotion that concluded that 75 percent of studies in nonstudent adults found that higher levels of physical activity were related to increased alcohol consumption.

One aspect that makes this study unique is that fitness was objectively measured and is a direct consequence of physical activity, says Shuval. “The finding linking fitness and alcohol intake strengthens the literature of this topic,” he adds.

The study authors acknowledge a few limitations of their research. As with other studies of this type, the alcohol use was self-reported by participants. This is significant because often people underreport habits that may be perceived as negative because of social desirability.

Participants in the research were predominately white, highly educated, and had good access to medical care, and so the conclusions may not be applicable to a multi-ethnic and more economically diverse population.

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