THE EFFECTS OF ALCOHOL ON ATHLETIC PERFORMANCE
CLAIRE SIEKANIEC, MS, RD, CSSD
A
lcohol use is widespread in the realm of sports.
Consumption ranges from the weekend warrior guzzling a
beer after completing a 5-k run to elite athletes popping
champagne in the locker room after a championship win. Alcohol
is often used as a means of celebration or relaxation, and athletes
frequently consume drinks without much thought of the acute
and chronic effects on performance and health. Alcohol’s path
to oxidation is complex, and both short- and long-term use
affects most systems of the body. Factors such as genetics,
gender, amount of alcohol ingested, body mass, and nutrition
status help explain the large variance in effects that alcohol has
within and across individuals (1,4). From an athletic performance
standpoint, the acute use of alcohol can influence motor skills,
hydration status, aerobic performance, as well as aspects of
the recovery process; consequently, influencing subsequent
training and competitions (2,9). Chronic alcohol use can lead to
difficulty in managing body composition, nutritional deficiencies,
and depressed immune function, resulting in increased risk of
injury and prolonged healing and return-to-play (2,17). While the
acute and chronic effects of alcohol are largely dose-dependent,
chronic and heavy intake can increase one’s risk of long-term
health effects such as cardiovascular disease, liver disease,
and cancer (4). The drinking habits of athletes, as well as the
effects of alcohol, are highly variable, making a one-size-fits-all
recommendation difficult and impractical. Furthermore, current
research on the effects of alcohol on athletic performance is
limited due to ethical concerns. This article will discuss the
available evidence related to alcohol and athletic performance.
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ALCOHOL INGESTION PRIOR TO EXERCISE
Blood alcohol concentration increases upon ingestion of alcohol.
Soon after, the acute side effects begin to take place, which can
result in depression of central nervous system activity. While the
effects are dose-dependent, this can lead to compromised motor
skills, decreased coordination, delayed reactions, diminished
judgment, and impaired balance (3,9). These effects on the body
may not only contribute negatively to athletic performance,
but may also increase an athlete’s risk for injury. The effects of
low to moderate doses of alcohol on anaerobic performance
and strength are equivocal, but an aid to performance is not
evident (9). Conversely, research has shown that even small
doses of alcohol ingested prior to exercise led to a decrease in
endurance performance (10). It appears that alcohol may affect
aerobic performance by slowing the citric acid cycle, inhibiting
gluconeogenesis, and increasing levels of lactate (12). Additionally,
the body preferentially metabolizes alcohol, thereby altering the
metabolism of carbohydrates and lipids, which are the preferred
energy sources during endurance exercise (12). Although alcohol
may have been viewed as an ergogenic aid in the past (likely
for psychological reasons), the scientific evidence shows that
alcohol hinders athletic performance, and ingestion prior to
training or competition should be avoided. Alcohol is currently
a banned substance for National Collegiate Athletic Association
(NCAA) rifle competitions, and the World Anti-Doping Agency
(WADA) prohibits alcohol consumption during air sports, archery,
powerboating, and automobile competitions on the basis of it
being considered an ergogenic aid (11,18).
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ALCOHOL INGESTION AFTER EXERCISE
The ingestion of alcohol prior to or during exercise is not very
common. However, the intake of alcohol following an event is
a much more likely scenario. To recover properly from exercise,
it is important to replenish glycogen, stimulate muscle protein
synthesis (MPS), and restore fluid balance. Alcohol and the
behaviors associated with intoxication can interfere with many
aspects of the recovery process. Beverages containing greater
than or equal to 4% alcohol can increase urine output, ultimately
delaying recovery from a dehydrated state (15). Beer has been
plugged as a post-workout recovery beverage because it
contains carbohydrates and electrolytes, but in actuality, the
typical beer does not contain nearly enough carbohydrates or
electrolytes for proper recovery from a long workout with a
large sweat loss. It is reasonable to conclude that the negative
effects of alcohol consumption after a workout outweigh any
potential beneficial effects. To adequately replace lost fluids, it
is important for athletes to drink rehydrating beverages such as
sports drinks, or consume water with salty foods, prior to alcohol
consumption. If immediate alcohol intake is inevitable, athletes
should strive to only consume small volumes of alcohol.
Replenishing glycogen stores is another essential component to
recovery, especially when the turnaround between training and
competition is short. It is unclear if alcohol consumption after
exercise directly affects glycogen synthesis; however, alcohol can
indirectly displace carbohydrate and protein intake (5). When
protein-rich foods are displaced with alcohol during the postexercise recovery period, MPS is not optimally stimulated, which
can potentially inhibit muscle growth and repair. Furthermore,
there is evidence for a direct effect of alcohol on MPS. Researchers
have found that alcohol significantly decreases MPS even
when adequate protein is consumed (13). This effect has been
investigated on resistance exercises, as well as exercises commonly
carried out in team sport training (6). Overall, when an athlete
chooses to fill up on alcoholic beverages during the recovery
period they are less likely to follow optimal nutrition guidelines
for recovery, resulting in a prolonged recovery period, inadequate
recovery before the next training session or competition, or lack of
desired muscular adaptations.
ALCOHOL’S EFFECT ON SLEEP, INJURY,
AND HORMONES
Beyond the energy storage and MPS implications, alcohol
can also negatively affect sleep, recovery from injury, and the
production of hormones associated with muscular growth (2).
Athletes need adequate sleep to aid in recovery and to be able
to perform at their best, both physically and mentally. Ingestion
of alcohol before going to bed may help induce sleep, but has
been shown to disrupt restorative sleep cycles throughout the
night, decreasing quality of sleep (7). To compound this, when
athletes enjoy a night out drinking, they may stay out later than
normal, reducing their duration of sleep. These two factors
combined may impact recovery, energy levels, and performance
in upcoming training and competitions.
When athletes experience soft tissue injuries, the body employs
an inflammatory response. Alcohol has been shown to limit the
inflammatory response via an increase in the production of antiinflammatory molecules and a decrease in pro-inflammatory
molecules (2). In addition to an imbalance of the inflammatory
response, alcohol also acts as a vasodilator, increasing blood
flow to the injured area, which could possibly increase the
severity of the injury and prolong the recovery (2). Therefore,
consumption of alcohol is generally not recommended if an
injury has recently occurred.
There are a number of hormones that affect muscle growth. For
example, cortisol stimulates protein breakdown while testosterone
increases protein synthesis. In recreationally trained athletes,
research has found that high doses of alcohol intake after
resistance exercise increased cortisol levels and decreased the
testosterone-to-cortisol ratio, which can interfere with the adaptive
process of long-term resistance training (8). Additionally, alcohol
decreases testosterone secretion; therefore, excessive intake during
the recovery period should be avoided for athletes striving for
muscular hypertrophy or for those with hormonal imbalances (4).
EXERCISE AND HANGOVERS
The effects of alcohol do not simply wear off when signs of
intoxication are gone. Heavy drinking can lead to an array of
symptoms commonly referred to as a hangover. Athletes are not
immune to hangovers, which can influence their training and
competitions. The hangover symptoms produced by alcohol have
many intra-individual variances. However, the main effects of
hangovers include electrolyte imbalance, hypoglycemia, gastric
irritation, vasodilation, and sleep disturbances (14). These effects
cause an array of physical symptoms, which may leave an athlete
feeling drained and unable to train as hard as normal. Research
has shown an approximate 11% decrease in aerobic capacity in
those exercising with a hangover (12). Effects of a hangover on
anaerobic performance remain unclear, but overall it is probable
that athletes training or competing without a hangover will enjoy a
competitive edge over their hungover opponents.
CHRONIC EFFECTS OF ALCOHOL
There is evidence supporting health benefits from moderate
alcohol consumption, but regular heavy consumption and binge
drinking can take a toll on the body. Athletes are susceptible to
the health effects associated with excessive alcohol consumption,
which can also affect performance. Alcohol is calorically dense,
providing seven calories per gram, with a standard drink in
the United States containing 14 grams of alcohol (16). If other
substances are present, such as soft drinks and sugar-based
beverages, the caloric value of an alcoholic drink rises even higher.
As a general reference, the following are common drink sizes and
their average alcohol content: 12 oz of beer (5% alcohol), 5 oz of
wine (12% alcohol), and 1.5 oz of 80-proof distilled spirits (40%
alcohol) (16). The calories from alcoholic beverages can add up
fast and contribute a significant amount of calories to an athlete’s
overall caloric intake. Additionally, behaviors associated with
heavy drinking, such as irregular eating patterns and increased
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THE EFFECTS OF ALCOHOL ON ATHLETIC PERFORMANCE
consumption of unhealthy foods, may lead to increased caloric
intake. Over time, this combination can affect an athlete’s body
composition.
Heavy intake of alcohol can also lead to nutritional deficiencies.
Athletes require a sound nutrition plan to promote optimal athletic
performance, and may already be at a higher risk of nutritional
deficiencies than their non-athlete counterparts due to the
physical demands of training. Alcohol affects absorption and
utilization of many nutrients. Excessive alcohol intake can reduce
the intestine’s ability to absorb nutrients such as vitamin B12,
thiamin, and folate. Additionally, liver cells can become inefficient
at activating vitamin D and the metabolism of alcohol can destroy
vitamin B6 (4). Nutritional deficiencies present many different
problems to athletes and can have serious health and performance
implications. In addition, long-term misuse of alcohol is associated
with a higher risk of developing cardiovascular disease, liver
disease, and cancer (4). It can also compromise the immune
system and increase susceptibility to illness (2).
CONCLUSION
Overall, the effects of alcohol vary dramatically from person to
person with many different contributing factors. The effects of
alcohol on athletic performance vary depending on quantity,
demographics, and type of exercise. Therefore, it is difficult to
determine specific recommendations, but it is suggested that
athletes follow the same recommended guidelines for safe and
responsible drinking as the general public. Binge drinking is
never recommended due to the side effects that interfere with
desired athletic adaptations. The cumulative effects of binge
drinking episodes may leave an athlete unable to perform at the
expected or desired level. After an athletic event, athletes should
be encouraged to follow recommended nutrition and hydration
guidelines for recovery prior to alcohol consumption.
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ABOUT THE AUTHOR
Claire Siekaniec is a Sports Dietitian at the Orthopedic Specialty
Hospital (TOSH) in Murray, UT. She is a Registered Dietitian and
Certified Specialist in Sports Dietetics. She completed a Bachelor
of Science degree in Nutrition and Dietetics from the University
of New Haven and a Master of Science degree in Sports Nutrition
from the University of Colorado Colorado Springs. She has spent
time working as a Clinical Dietitian at the Alaska Native Medical
Center and as a Sports Nutrition Intern for the University of Virginia
Athletic Department.
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al. Effect of acute alcohol ingestion on resistance exercise induced
mTORC1 signaling in human muscle. Journal of Strength and
Conditioning Research Published Ahead of Print, 2016.
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