We often talk about it, engaging in regular physical activity of sufficient intensity (at least 150 min per week at moderate intensity or 75 min per week at high intensity) allows us to reduce the risk of certain chronic diseases such as type 2 diabetes, cardiovascular diseases or certain cancers, but it also reduces the risk of mortality from all cause. In addition, this regular practice often leads to an increase in our level of cardiorespiratory fitness (often represented by VO2MAX in athletes or VO2PEAK in sedentary people), which is itself positively and strongly correlated with our life expectancy.
Conversely, the relationship between alcohol consumption and mortality is not so clear. Some studies suggest that light drinking (less than 3 drinks per week) is associated with a lower risk of cardiovascular mortality, whereas heavy drinking (>7 and >14 drinks per week, in women and men, respectively) increases the risk of cardiovascular disease and death. Nevertheless, some cancers could be caused by regular, even light, alcohol consumption.
Positive healthy behaviours usually lead to others in their wake. For example, taking up sport again often leads to a more balanced diet and healthier eating habits. However, alcohol consumption does not necessarily follow the same trajectory. And the relationship between physical activity and alcohol consumption is not as obvious as it seems.
In an attempt to find out more, an international team of researchers led by the Cooper Institute in Dallas, USA, studied the relationship between cardiorespiratory fitness and alcohol consumption in 55 082 people. Rather than utilizing self-reported measures of physical activity to try to guess their fitness level, the researchers gave each participant a treadmill exercise test to objectively assess their cardiovarespiratory fitness. In addition to this test, each participant completed a questionnaire that included questions about their physical activity level and alcohol consumption. People who were pregnant, had an abnormal electrocardiogram, a history of heart problems, diabetes, were underweight or did not reach 85% maximum heart rate during the treadmill test were excluded from the analysis. Thus, the data of 38 653 people (45.9 ± 9.5 years old, from 20 to 86 years old) were processed.
Based on the results of the treadmill test, the researchers divided the participants into 5 quintiles (for the analysis, the 1st quintile was the reference quintile):
Regarding alcohol consumption, participants indicated how many drinks they consumed per week. A "drink" was defined as either a 330 ml beer, a glass of wine (150 ml) or a hard liquor (50 ml). This is a standard measure, since in all three cases one glass corresponds to about 20 g of alcohol. Based on this information, they were classified into 3 categories: light (≤ 3 glasses/week), moderate (3-7 glasses for women and 3-14 glasses for men) and heavy (> 7 glasses for women and > 14 glasses for men) consumption. Note that for people over 65, more than 7 drinks per week is considered heavy drinking.
Finally, alcohol dependence was assessed by the CAGE (Cut down, Annoyed, Guilty, Eye opener) questionnaire. This questionnaire consists of 4 questions that indicate whether the patient: 1) ever felt the urge to cut down on his or her drinking; 2) ever felt annoyed about criticism of his or her drinking; 3) ever felt guilty about drinking; and 4) drinks first thing in the morning (eye opener). The questionnaire score can range from 0 to 4, with 2 points being the threshold for suggested alcohol dependence.
The main results of this study show that relatively high levels of cardiorespiratory fitness are associated with higher alcohol consumption, both in men and women. Thus, women with moderate and high fitness levels were 1.58 and 2.14 times more likely to drink moderately/highly than women with low fitness levels. For men, those with moderate and high levels of fitness were 1.42 and 1.63 times more likely to be moderate/strong drinkers compared to those with low fitness.
More specifically, for both women and men, light drinking seems to decrease with increasing fitness level, while moderate drinking increases. In comparison, irrespective of fitness level, the percentage of women and men with heavy drinking remained broadly the same, (with men having a higher percentage than women). However, men with a moderate fitness level were significantly more likely to drink heavily than others.
The concept of "licensing effect" could partly explain these results. This psychological concept helps to explain the ability of people to indulge in (negatively connoted, "immoral") deviations after having accomplished something positive. For example, after running a half-marathon (seen as a positive, healthy, "moral" choice), a runner will feel that he or she has earned that pizza and beer(s) (seen as a bad diet, "immoral" choice). Regularly engaging in strenuous physical activity would give people a wild card to consume more alcohol. A 2015 study showed that over a 3-week period, people consumed more alcohol on the days when they were most active.
This study shows that people (men or women) who are physically active are more likely to consume alcohol, although not necessarily at levels higher than those recommended by the official guidelines. It also confirms the results of interventions aimed at reducing alcohol consumption through increased physical activity, which are not necessarily successful. While low alcohol consumption is not in itself a problem for the vast majority of individuals, it is very important to be wary of its addictive nature and the consequences that this can have not only on one's health, but also on one's family, social, professional relationships, etc. Thus, for some audiences, promoting physical activity should be accompanied by an awareness of alcohol consumption and its consequences.
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