In Part 1 I discussed how alcohol affects the body and can degrade the liver. Let’s look at what it does to other organs and muscle as well as how it reacts with cigarettes and in women in comparison to men.
Good for the Heart?
Low blood alcohol produces a temporary increase in blood pressure and an elevated pulse, but larger amounts interfere with heart contraction, causing arrhythmia, or abnormal heart rhythms, by affecting the ebb and flow of calcium into the heart. Even a single bout of heavy drinking can bring on arrhythmia. Heavy drinking directly damages the heart muscle, leading to cardiomyopathy. A possible result is heart failure. Excess alcohol also raises blood pressure and nullifies the blood-pressure-lowering effect of exercise. Alcoholic binges—defined as five or more drinks at a time—can cause a type of heart disturbance called atrial fibrillation. Because it often occurs during holiday celebrations, the condition is designated as the “holiday heart syndrome.” Estimates indicate that drinking 80 grams of alcohol daily for 10 years results in heart enlargement, which predisposes to eventual heart failure.
Controversy surrounds the beneficial effects of alcohol in preventing cardiovascular disease. Many studies show that two drinks a day increases levels of high-density-lipoprotein cholesterol. That’s good because HDL ferries excess cholesterol out of the body—indeed, it is the only mechanism the body uses to rid itself of excess cholesterol, which can’t be burned like fat. Other studies show that alcohol increases only an inert form of HDL called HDL-3. The active form is HDL-2. On the other hand, more recent studies show that both kinds of HDL offer equal protection against cardiovascular disease.1
To further confuse the issue, a Johns Hopkins University study that looked at beer’s effects on HDL found that it had little or no effect on the HDL of beer drinkers. Beer did, however, raise apolipoprotein A-1, another beneficial protein considered protective against heart disease.
Still other studies show that alcohol raises HDL only in people with mildly elevated blood cholesterol. It does nothing for those with high cholesterol. A British study of 8,000 men found that while moderate drinking did indeed boost HDL, it didn’t significantly decrease the risk of heart attack. Other well-known risk factors, such as smoking and high blood pressure, are considered far more important.
A 1997 study published in the Proceedings of the National Academy of Sciences found that drinking moderate levels of alcohol preconditions the heart to deal with a lack of blood flow that occurs during a typical heart attack. The net effect is that heart cell death is reduced by half in the event of an actual heart attack, and the recovery rate of the heart doubles.
For athletes, including bodybuilders, the whole argument is moot. The research involved only sedentary people. Athletes’ bodies are often high in HDL, and drinking booze doesn’t increase HDL in people like that.
Alcohol and Cigarettes: Partners in Death
Alcohol potently supresses the immune system through several mechanisms. One way is by increasing cortisol, an adrenal hormone known to suppress the immune system. Bodybuilders who consistently overtrain also have elevated cortisol, making them more prone to infection and disease. Alcohol may work with overtraining in lowering immune response.
Alcohol is also synergistic with smoking in encouraging cancer. That combination greatly increases the chance of developing cancers of the tongue, mouth, throat, larynx and liver. The risk of head and neck cancers is six to 15 times greater in smokers who also drink. For throat cancer, the risk is 44 times greater. A recent study implicated commercial mouthwashes with high alcohol content in mouth cancer. Heavy beer drinkers show increased incidence of rectal and colon cancers, although some research disputes that finding.
Women: At Special Risk?
Given the same amount of alcohol, women get drunker faster than men. The effect was formerly attributed to women’s greater fat mass and smaller size. More recent evidence, however, shows that women produce less gastric alcohol dehydrogenase, a stomach enzyme that metabolizes alcohol. It causes them to absorb an average of 30 percent more alcohol into the bloodstream. One drink raises a woman’s blood alcohol as much as two drinks for a man. Oral contraceptives interfere with liver alcohol metabolism, and a woman gets drunker just before her period because liver metabolism of alcohol slows at that time. One researcher remarks that alcoholic women “might as well be shooting up alcohol.” The finding explains why female alcoholics develop medical complications sooner in life than their male counterparts. Interestingly, although women make up over half the population, they account for just one third of the nation’s alcoholics.
A 1989 study involving 87,000 nurses implicated alcohol in breast cancer. It suggested that having more than one drink a day increased the risk. The National Cancer Institute found a similar link for women who had only three drinks a week, and subsequent studies related the risk to increased alcohol consumption in women. Those who drank one to four drinks a day had a 20 percent greater risk than nondrinkers; five drinks a day raised the risk to 89 percent.
Drinking during pregnancy, especially in the first trimester, can cause fetal alcohol syndrome. Babies born with this syndrome have lower birth weight, height and head circumference. They also often have irreversible defects, such as facial abnormalities and mental retardation. The syndrome shows up in 30 to 50 percent of babies born to alcoholic mothers. It’s one of three major causes of infant mental retardation worldwide.
Less severe effects of maternal alcohol intake during pregnancy are found in 36,000 infants each year. A study of 31,000 pregnancies shows that having one to two drinks a day while pregnant substantially increases the risk of a growth-retarded infant. When a pregnant woman drinks alcohol, her unborn child is drinking it too—within 15 minutes. Alcohol is often detected in the amniotic fluid of alcoholic mothers and on the baby’s breath at birth. Alcohol remains in the fetus twice as long as it does in the mother’s metabolic system because the baby’s system metabolizes alcohol at half the adult rate. A recent study involving lab rats showed that much of the brain damage induced in fetuses by maternal alcohol ingestion is caused by oxidation.4 It found that vitamin E, a dietary antioxidant, blocked most of the fetal brain damage. As yet there’s no evidence that the protective effect occurs in humans.
No one yet knows how much of alcohol—if any—is safe for a pregnant woman to drink. Some evidence shows that just one ounce of alcohol a week increases the risk for spontaneous abortion. A recent study found that breast-feeding moms who drank alcohol gave infants 22 percent less milk. Alcohol apparently affects the odor of milk, which infants can detect, and it hampers women’s let-down reflex, which initiates breast feeding.
Alcohol and Muscles
Bodybuilders who like to drink should consider the effects of alcohol on both muscles and hormones. A 1989 study of alcoholics found that heavy alcohol intake damages the heart muscle in one third of alcoholics and skeletal muscles in half of them. Chronic alcoholics can lose as much as 30 percent of their muscle. Pathologist Emanuel Rubin, of Philadelphia’s Jefferson Medical College and one of the study’s authors, commented, “It’s very clear that alcohol’s toxic effects on muscles are significant and far more widespread than anyone thought.”
In fact, alcoholic myopathy, or muscle disease, occurs in 40 to 60 percent of chronic alcoholics, making it five times more common than cirrhosis. The study also found that muscle weakness is proportionate to the amount somebody drinks. The study also noted, however, that detrimental effects occurred over a sustained period of heavy drinking. Nonetheless, the study concluded that alcohol “is a toxin for striated muscle, regardless of where it is.”
A 1983 British study found that three years of heavy alcohol drinking negatively affected type 2B muscle fibers. That’s significant because 2Bs are most subject to hypertrophy. The study further noted that the myopathy was reversible when people stopped drinking. Another British study found that alcohol directly inhibited protein synthesis in the quadriceps. It also interferes with the interaction of muscle contractile proteins and the enzyme that controls the sodium pump mechanism in muscle, causing localized swelling, or edema, in muscle tissue.
Alcohol and Body Systems
You may be thinking by now that research proves that long-term heavy alcohol use causes degenerative muscle changes. Well, what about people who just drink moderately?
Consider the effects of alcohol on the endocrine system. Large amounts of alcohol increase the liver breakdown of testosterone two- to fivefold over normal. Alcohol also prevents the conversion of vitamin A into an active form in the testes. That may cause sterility. Even a single bout of heavy drinking raises counts of cortisol, enough to cause a significant drop in blood testosterone. Large amounts of alcohol decrease the binding of luteinizing hormone to its receptors in the testes. Luteinizing hormone normally stimulates the testes to synthesize testosterone. Chronic alcohol intake, however, decreases LH receptors in the testes, thereby making them insensitive to LH and lowering testosterone production.
Alcohol also interferes with several enzymes in the testes that manufacture testosterone. By-products of alcohol metabolism, such as acetaldehyde, may exert direct toxic effects on the structure of the testes. In 20 percent of severe male alcoholics, booze lowers testosterone production enough to cause gynecomastia—a.k.a. enlarged breasts. Booze also causes impotence in 70 to 80 percent of alcoholic men. While both wine and beer contain small amounts of phytoestrogens, or weak plant estrogens, it’s not enough to spike estrogen in men.5 On the other hand, high alcohol intake directly stimulates the aromatase enzyme, found throughout the body, which converts testosterone into estrogen.6 In young women alcohol increases testosterone, helping in the conversion of the adrenal androgen androstenedione to testosterone in the liver.7 In a study of middle-aged men and women, moderate alcohol consumption increased plasma DHEA-S by 16.5 percent in both sexes. Plasma testosterone in the men dropped by 6.8 percent, although levels of estrogen weren’t affected.8
Alcohol lowers growth hormone and blunts the normal GH response to decreased blood sugar. That may contribute to the higher incidence of hypoglycemia in people who drink, as growth hormone is a safeguard against hypoglycemia. Heavy alcohol intake helps release prolactin, a pituitary hormone linked to male impotence. Alcohol also interferes with the activity of insulinlike growth factor 1, which is considered a primary anabolic hormone. A high alcohol intake not only depresses IGF-1 synthesis but also increases the binding protein that circulates with IGF-1 in the blood, thus lowering the amount of biologically active IGF-1. That would adversely affect muscle recovery and repair and may contribute to the toxic effects of alcohol metabolites in muscle.
While alcohol consists of “empty” calories, booze itself cuts the rate of fat burning. In a recent Swiss study, eight healthy young men drank 96 grams of pure alcohol a day—about seven cans of beer. That made up 25 percent of their calories. In the first part of the study the alcohol was added to the men’s usual calorie intake. Later, it replaced fat and carbohydrate in the men’s diets, equaling the same number of calories. In both instances alcohol reduced the rate of fat burning in the men by one-third. Another study linked bodyfat and weight gain to a heavy alcohol intake of more than 30 grams daily in men aged 40 to 59.9
In addition, the researchers found that large quantities of alcohol increase the body’s acetate pool. Excess acetate by-product is shunted to peripheral body tissues, where it often suppresses fat burning and triggers fat deposition instead. Acetate also circulates to muscle but is a poor energy source, contributing only about 6.5 percent of available energy. So excess alcohol takes a direct route to the body’s fat pathway. It also stimulates a large output of insulin, which brings on bodyfat synthesis.
An Exercise Option?
We’ve seen that drinking alcohol under conditions of low-carbohydrate intake can quickly lead to hypoglycemia. That relates to alcohol’s effects on preventing conversion of noncarbohydrate energy sources into glucose in the liver. Alcohol cannot be used as a direct source of energy by muscle and doesn’t contribute to synthesis of muscle glycogen, the primary energy source for anaerobic exercise such as weight training. In fact, recent studies show that alcohol intake directly blunts muscle glucose uptake, as well as glycogen synthesis, adversely affecting muscle repair and recovery.10 On the other hand, taking in moderate amounts of alcohol alone, away from meals, appears to offer anticatabolic effects by lowering protein oxidation, particularly that of leucine, a branched-chain amino acid that is the single most potent amino acid involved in protein synthesis. Eating any additional protein, fat or carbs, however, cancels out the anticatabolic effect.11
Several studies found that moderate alcohol intake increases insulin sensitivity, which would favor bodyfat loss.12 Another theory suggests that rather than triggering bodyfat gain, the metabolism of acetate in peripheral tissues stimuates higher levels of AMP, which in turn, stimulates AMPK release. AMPK favors increased fat burning in muscle. A recent study found that moderate alcohol intake increased adiponectin and ghrelin while decreasing acylation-stimulating protein, which encourages fat storage. The net effect was increased insulin sensitivity.13 Drinking 15 grams of white wine after a meal decreases insulin and plasma glucose.14 Another recent study also found that moderate alcohol intake reduced the risk of type 2 diabetes in middle-aged women. The effect was the result of a drop in insulin resistance produced by a greater production of adiponectin.15
Although alcohol is cleared from the body at a set rate, some rat studies show that exercise may help clear alcohol through increased body temperature, which seems to up liver enzyme activity. Exercise also speeds alcohol elimination through increased breathing and sweat loss, although only 2 to 10 percent of alcohol exits through sweat and breathing; 90 percent still must be metabolized by the liver.
As an ergogenic, alcohol falls short. While it appears to decrease anxiety, it actually slows reaction time and impairs coordination. By depressing antidiuretic hormone from the pituitary gland, booze causes a loss of fluid that can lead to dehydration. Each 10 grams of alcohol causes a four-ounce loss of body fluid; put another way, metabolizing an ounce of alcohol requires eight ounces of water. To prevent dehydration from alcohol, drink one glass of water for every two alcoholic drinks—a 12-ounce beer, a four-ounce glass of wine or 1.5 ounces of 80-proof liquor.
From the standpoint of sports, small doses of alcohol steady the nerves, thus aiding sports such as pistol shooting. Two pistol shooters were disqualified from the 1968 Olympic games after they were found to have used alcohol to improve their accuracy. A 1978 study comparing an ounce of 40 percent alcohol with a placebo and a tranquilizer, however, found improved effects in pistol shooters from all three. That suggests a placebo effect that works because the shooter believes it’ll work. The lower heart rate caused by alcohol, though, is a definite disadvantage in sports. Alcohol constricts blood vessels in muscle, leading to increased production of fatigue by-products, such as lactic acid. It also adversely affects hand-eye coordination, reaction time, balance and other factors due to its effect on central brain processing capacity. In addition, alcohol does you no favors where strength is concerned.
In cold weather alcohol makes blood flow to the skin, leading to a decrease in core body temperature. That may lead to complications caused by hypothermia, or excessive loss of body heat. One study found a severe drop in blood sugar in very fit subjects who exercised for two hours at high intensity, then drank alcohol while recovering in a cold room. Taking in some sugar, such as an energy-replacement drink, appears to prevent that effect. Conversely, the hotter your body, the drunker you get. A rise in body temperature evidently increases the brain’s sensitivity to alcohol. That may explain the occasional drowning fatality in hot tubs after somebody has a few relaxing drinks.
As with all things, moderation is the key when it comes to alcohol. The National Institute of Alcohol Abuse and Alcoholism suggests following the advice offered by English physician Francis Anstie in 1877: Drink no more than 0.5 ounces of alcohol a day per 50 pounds of bodyweight; only with food; and only in dilute form. Pregnant women shouldn’t drink at all. Sir Walter Raleigh put it more poetically nearly 400 years ago: “The first draught serveth for health, the second for pleasure, the third for shame, the fourth for madness.”
Editor’s note: For more positive effects of alcohol see “Wine: A Healthful Exception” in Part 1, which appeared in the March ’09 issue.
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