Alcohol and Athletic Performance

How alcohol affects a person depends on the amount consumed, the environmental context, and individual differences in tolerance. While a small amount of alcohol consumed daily may have a protective effect on the cardiovascular system, chronic heavy alcohol use is associated with a wide range of physiological and societal negative outcomes, which account for approximately 100,000 deaths yearly in the United States.

The fitness-oriented individual should be aware of the acute and chronic effects of alcohol on physical performance. Acutely, alcohol can cause negative effects on motor skills and physical performance. Chronically, alcohol abuse may eventually impede physical performance; individuals diagnosed with alcohol dependence have displayed varying degrees of muscle damage and weakness.

Alcohol abuse is at least as prevalent in the athletic community as it is in the general population; in fact, the majority of athletes have begun drinking by the end of high school. Both male and female college students have higher rates of binge drinking than non-athletes, and drinking five or more drinks on any one occasion affects the brain and body for several days.

How Could Drinking Affect My Athletic Performance?

Alcohol has been described as a performance impairing drug. Exercise is a complex activity utilizing many of the body's organ systems; alcohol exerts an effect on most of these systems, including the central nervous system, muscle energy stores and the cardiovascular system.

What Happens if I Exercise With an Elevated Blood Alcohol Level?

Alcohol has acute effects on motor skills, strength and power, and aerobic performance.

Alcohol and motor skills	Low amounts of alcohol (0.02-0.05g/dL) result in: decreased hand tremors slowed reaction time decreased hand-eye coordination Moderate amounts of alcohol (0.06-0.10 g/dL) result in: further slowed reaction time decreased hand-eye coordination decreased accuracy and balance impaired tracking, visual search, recognition and response skills
Alcohol and strength, power, and short-term performances	Alcohol will not improve muscular work capacity and results in: a decrease in overall performance levels slowed running and cycling times weakening of the pumping force of the heart impaired temperature regulation during exercise decreased grip strength, decreased jump height, and decreased 200- and 400-meter run performance faster fatigue during high-intensity exercise
Alcohol and aerobic performance	Adequate hydration is crucial to optimal aerobic performance. The diuretic property of alcohol can result in: dehydration and significantly reduced aerobic performance impaired 800- and 1500-meter run times increased health risks during prolonged exercise in hot environments

Medical Concerns:

Alcohol has been linked to exercise-induced anaphylaxis and asthma.
Acute ingestion may cause myocardial irritability, resulting in arrhythmias.
Consumption before water activities increases the risk of injury.

What Happens if I Exercise With a Hangover?

Hangovers are caused by alcohol toxicity, dehydration, and the toxic effects of congeners in alcoholic drinks. Hangovers are commonly characterized by a depressed mood, headache, and hypersensitivity to outside stimuli, such as light and sound. These lingering effects of alcohol may lead to decreased athletic performance.

Drinking on the day or night before athletic activity hinders physical conditioning progress, and exercising with a hangover has been shown to significantly decrease aerobic performance capacity - by as much as 11%. Regardless of the type of activity, conditioning progress will be impeded. Teammates who do not drink the day before competition will be ahead of the game.

What About Chronic (Long-Term) Effects of on Athletic Performance?

While low-dose (meaning no more than 2 drinks daily) chronic alcohol consumption may offer some cardio-protective element in the exerciser by increasing HDL-cholesterol or decreasing coronary spasm, alcohol affects the body's every system and is also linked to several pathologies.

Heavy, chronic alcohol consumption impairs exercise performance by:

impairing the cardiovascular response to exercise
causing nutritional deficiencies from alterations in nutrient intake, digestion, absorption, metabolism, physiological effects, turnover, and excretion of nutrients
causing myopathy, or muscle damage, wasting, and weakness, in various muscles, including the heart
changing the body's hormonal environment, making it less conducive to increasing muscle mass and strength
compromising cardiovascular and muscular performance in people with alcoholism

Special concerns for women:

Women's muscular strength is inversely correlated with total life-time doses of alcohol
Women may be more sensitive than men to the toxic effects of alcohol on the heart

Athletes are not immune later in life from the potentially serious consequences of chronic alcohol abuse, including liver toxicity, endocrine dysfunction, decreased serum testosterone, seizures, altered lipid metabolism, ulcers, heart disease, diabetes, and bone disorders.

Nutritional Aspects of Alcohol and Sports: Alcohol as a Nutrient

Each gram of alcohol provides seven kilocalories compared to nine for fat and four each for carbohydrate and protein. Other nutrients may be present, depending on the type of beverage. Beer, for example, has been seen as a good source of many nutrients and has sometimes been used in preparation for endurance events or to replenish nutrients following competition. Many athletes and sports administrators name beer as their preferred alcoholic beverage, and some athletes may still believe that beer is an effective beverage for replacing fluid and supplying high energy.

However, beer will actually worsen dehydration due to the diuretic effect of alcohol on the renal system. Beer is inappropriate as a carbohydrate replacement; the 7g of energy per gram of alcohol (ethanol) provides "empty calories" and does not provide available glucose.

Acute ingestion of alcohol provides no benefits relative to the energy sources for exercise and in fact may reduce muscle glycogen at rest, impair gluconeogenesis, cause hypoglycemia and decrease leg-muscle glucose uptake. Exercise will not increase alcohol metabolism.

In the chronic alcoholic, alcohol replaces the normal macronutrient intake (protein, carbohydrates, and fats) and nutritional deficiency diseases can develop. In fact, alcohol ingestion lowers muscle glycogen levels and will decrease the available fuel for normal aerobic energy production.

Alcohol and Injury

Athletes who drink alcohol at least once per week have an elevated risk of injury as compared to athletes who do not drink.
Consuming alcohol regularly depresses immune functioning and slows the healing process for sports-related injuries.
Alcohol-related injuries in sports like cycling, boating, ice skating, snow skiing and swimming are likely related to a decrease in psychomotor functioning and impaired judgment.
Nearly 1/3 of college students consume alcohol during participation in recreational boating or swimming, while greater than 50% of young adult drowning victims have detectable post-mortem blood alcohol levels.

ACSM Position Statement on Alcohol and Athletic Performance

The American College of Sports Medicine emphasizes that

there is no benefit from alcohol use for sport performance
use of alcohol may be detrimental to the athlete

For athletes who choose to drink, the ACSM recommends

Pre-event: Avoid alcohol beyond low-amount social drinking for 48 hours.
Post-exercise: Rehydrate first and consume before drinking to slow alcohol absorption.

The Big Idea

When active people make decisions about drinking, they may want to consider.

How important is my sport to me?
How important is drinking or partying to me?
How important is it that I perform to the best of my ability?
How will drinking affect my ability to perform?
How will my body feel if I drink? How will I feel if I don't drink?
How will I benefit from my decision to drink or not to drink?
How motivated am I to drink in a low-risk way?
How confident am I that I can make low-risk choices around alcohol?
Will I violate team, University, or state laws and regulations if I choose to drink?
Will I put myself or others at risk of impairment, health, or legal problems if I drink?

Active people who want to make low-risk choices may want to consider.

What can I do instead of drinking heavily?
Who around me will support my decision?
How can I stay motivated to stick with my decision?

References

Berning, J. (1996). Coaches' Corner: Alcohol and Athletic Performance. Gatorage Sports Science Institute, www. gssiweb.com

Current Comment from the ACSM, Alcohol and Athletic Performance. April 2000.

Dowdall, G., Grossman, S., Zanakis, S., Davnport, A., & Weschler, H. (2001). Binge drinking, tobacco, and illicit drug use and involvement in college athletics. Boston, MA: Harvard School of Public Health

Green, G., Uryasz, F., Petr, T., and Bray, C. (2001). NCAA study of substance use and abuse habits of college student-athletes. Clinical Journal of Sport Medicine, 11, 51-56.

Gutgesell, M. and Canterbury, R. (1999). Alcohol usage in sport and exercise. Addiction Biology, 4, 373-383.

Nelson, TF and Wechsler, H. (2001). Alcohol and college athletes. Medicine and Science in Sports and Exercise, 33(1), 43-47.

O'Brien, C. and Lyons, F. (2000). Alcohol and the athlete. Sports Medicine, 29(5), 295- 301.

Wilson, G., Pritchard, M., & Scchaffer, J. (2004). Athletic status and drinking behavior in college students: The influence of gender and coping styles. Journal of American College Health, 52(6), 269-273.