Do I Really Have to Cut Out Alcohol?

 

Written by: Hailey Wegner, SLU Dietetic Intern

When the word “dietitian” slips into conversation with any friend or passerby – I often know what is going to come next... a question regarding nutritional intake that this person wants to know about.

Friends: “What’s with this keto diet... Anyway?”

Stranger at the grocery store: “So...should I be eating more super foods?”

But when I am among young adults... there is one question that almost always comes up.

Everyone: “Do I really have to cut out alcohol?”

This question especially comes up when the young adult wishes to see physique changes. This is especially, especially true when the young adult is a competitive athlete... and especially, especially, especially true when the young adult is a competitive collegiate athlete.

_______________________

There is no question that drinking alcohol is written into the culture of almost every college attendee. First year students of traditional college often drink irresponsibly, and believe drinking to be integral to the college experience with over 40% of college students endorse heavy episodic or “binge” drinking (generally defined as 5 + drinks in one sitting for men and 4 + drinks in one sitting for women)^{(1, 2)}.

This is not untrue for athletes. While some may believe that the collegiate athlete is at a lower risk of engaging in binge drinking due to scheduling constraints or the physical demand of peak performance; studies show that students involved in sports have a higher tendency to drink/get drunk/binge on alcohol more often than those students with no involvement in sports⁽³⁾.

So what DO I tell athletes when the question of: “so what about alcohol...” comes up?

_______________________

Me: “I’m glad you asked... because it indicates that you care about your body performing the BEST that it can...”

Depending on the circumstances that apply to the athlete in front of me... I can choose from the LARGE array of evidence that shows the detrimental effects of alcohol on athletic performance.

Me: “Alcohol consumption disrupts our metabolism of nutrients... so your body and performance will suffer.”

And its true! Research has shown that: Alcohol consumption has been shown to inhibit liver glucose output during exercise; which can cause low blood sugar while exercising, and alcohol will decrease muscle glucose uptake – so tissues cannot get the fuel that they need. It also suppresses the breakdown of fatty acids—and is therefore regarded as a risk factor for weight gain ^{(5) .} Alcohol consumption prevents your body from absorbing important nutrients like thiamin, vitamin B12, folic acid and zinc⁽⁴⁾. (These nutrients help in the formation of new cells, boost your immune system, and aid in the metabolism of proteins and fats).

Me: “Most importantly to athletes, though, is that large amounts of alcohol can shut off muscle repair, growth, and even has been shown to produce muscle wasting.” ⁽⁷⁾

Which is ALSO true. AND... Athletes tend to consume the most alcohol in the 1-2 hours after exercise, which is the timeframe that is the most critical for optimal nutrient uptake. ⁽⁶⁾

Me: “Not surprisingly then... Athletes who drink alcohol at least once per week have an elevated risk of injury as compared to athletes who do not drink”

This is for a variety of reasons... Alcohol is shown to increase fatigue during high-intensity exercise, ⁽⁶⁾ which can lead to poor concentration and sloppy performance. Alcohol increases production of anti-inflammatory molecules; and inflammation is a key part of the muscle repair process, and alcohol consumption induces dehydration and loss of blood flow to active tissue. ⁽⁶⁾

Me: “There are even some detriments that most people wouldn’t think about... such as impaired temperature regulation, depressed immune functioning, low testosterone production, and decreased quality and duration of sleep.” ^{(10, 6)}

I am sure we can all imagine how those could negatively impact performance.

Me: “And I know you think you can hang... but even mild hangover symptoms have direct impact on performance; such as: headache, nausea, hypersensitivity to light or sound, diarrhea, fatigue, dehydration, and body aches” ⁽⁴⁾

Athlete: “Okay... so I will avoid alcohol in-season... but it’ll be fine in off season.. right?

Me: “Well... actually, no. Studies have shown “chronic” detrimental effects of alcohol can accumulate in as little as as 6-weeks.”

Some well-researched chronic detriments include increased whole-body protein breakdown and long-term compromises to the immune system... which makes an athlete more susceptible to career-delaying illnesses  ^{(6, 8)}

Me: “But... Don’t worry! Everything in moderation, including moderation... there is evidence that low doses of alcohol can be safely consumed without an impact on performance”

That’s right! As long as the athlete is of legal drinking age, low-to moderate doses of alcohol have been shown to have no effect on certain subsets of athletic performance. 

Studies show that low doses of alcohol are unlikely to be detrimental to repletion of glycogen, rehydration and muscle injury and have little to no effect on muscle protein balance or muscle growth ⁽¹¹⁾

Notably, low doses of alcohol would be less than 1-2 drinks per day for men, and less than ½-1 drink per day for women; and that “stacking” these drinking events to 1-2 days per week is still considered binge drinking. ⁽¹²⁾ These drinks would be measured using a “1 drink” equivalent of 5 oz of wine, 12 oz of beer, or 1 shot (1.5 oz) of liquor ⁽¹³⁾ .

_______________________

All in all, the evidence AGAINST consuming alcohol while participating in athletics is overwhelming. However, much like a human-relationship to food, the human-relationship to alcohol can be seen written into many aspects of collegiate culture. My overarching recommendation for athletes always encompasses these two ideas.

Me: “It is best to avoid any alcohol consumption to ensure top-notch athletic performance. But for athletes who choose to drink, you should become fiercely aware with the AMOUNTS that are shown to cause no affect... drinking to achieve social acceptance should not be a priority over your physical performance in your sport, especially since there IS an amount of alcohol that is considered safe to consume. With this in mind, avoid alcohol 48 hours prior to any athletic event and rehydrate/ consume food BEFORE celebratory drinking to slow alcohol absorption.”

Love,

Your Sports Dietitian

 

References:

1) Crawford, L. A., Novak, K. B., & Jayasekare, R. R. (2019). Volunteerism, Alcohol        Beliefs, and First-Year College Students’ Drinking Behaviors: Implications for       Prevention. The Journal of Primary Prevention, 40(4), 429-448.             doi:10.1007/s10935-019-00558-z

2) D.A. Dawson, B.F. Grant, F.S. Stinson, P.S. Chou, Another look at heavy episodic       drinking and alcohol use disorders among college and noncollege youth,        Journal of Studies on Alcohol, 65 (2004), pp. 477-488

3) Ford JA. Alcohol use among college students: a comparison of athletes and nonathletes. Subst Use Misuse. 2007;42(9):1367–77.

4) Alcohol and Athletic Performance. (n.d.). Retrieved from        https://alcohol.stanford.edu/alcohol-drug-info/staying-safe/alcohol-and-          athletic-performance

5) Suter, P., Schutz, Y. The effect of exercise, alcohol or both combined on health and physical performance. Int J Obes 32, S48–S52 (2008).         https://doi.org/10.1038/ijo.2008.206

6) Barnes MJ. Alcohol: impact on sports performance and recovery in male athletes. Sports Med. 2014 Jul;44(7):909-19. doi: 10.1007/s40279-014-0192-8. PMID:        24748461)

7) Steiner JL, Lang CH. Dysregulation of skeletal muscle protein metabolism by           alcohol. Am J Physiol Endocrinol Metab. 2015 May 1;308(9):E699-712. doi:   10.1152/ajpendo.00006.2015. Epub 2015 Mar 10. PMID: 25759394; PMCID:     PMC4420901.

8) Hong-Brown LQ, Frost RA, Lang CH. Alcohol impairs protein synthesis and degradation in cultured skeletal muscle cells. Alcohol Clin Exp Res.            2001;25(9):1373–82.

9) Cameron C. et al, Sport-related achievement  motivation and alcohol outcomes:     An athlete-specific risk factor among  intercollegiate athletes, Addictive       Behaviors, Volume 38, Issue 12, 2013,  Pages 2930-2936, ISSN 0306-4603,

10) Yoda T, et al,. Effects of alcohol on thermoregulation during mild heat exposure   in humans. Alcohol. 2005 Jul;36(3):195-200. doi:         10.1016/j.alcohol.2005.09.002. PMID: 16377461.

11) Kimball, S. R., & Lang, C. H. (2018). Mechanisms Underlying Muscle Protein          Imbalance Induced by Alcohol. Annual review of nutrition, 38, 197–217.       https://doi.org/10.1146/annurev-nutr-071816-064642)

12) Maraldi, C., et al,. (2009). Moderate Alcohol Intake and Risk of Functional Decline: The Health, Aging, and Body Composition Study. Journal of the           American Geriatrics Society, 57(10), 1767-1775. doi:10.1111/j.1532-   5415.2009.02479.x

13) National Institute on Alcohol Abuse and Alcoholism. (NIH Publication No. 07-      3769).Helping patients who drink too much: a clinician’s guide   (updated) 2007