[The Physician and Sportsmedicine]


In High Spirits?: Alcohol and Your Health

Susan M. Kleiner, PhD, RD

Table 1. Where to Turn for Help

Alcoholics Anonymous
475 Riverside Dr
New York, NY 10115
(212) 870-3400
Local offices will be listed in your phone book

Al-Anon Family Group Headquarters
Box 862 Midtown Station
New York, NY 10018
(800) 356-9996
Local offices will be listed in your phone book

The BACCHUS and GAMMA Peer Education Network
Box 100430
Denver, CO 80250-0430
(303) 871-3068
Materials and programs geared toward college students

National Clearinghouse for Alcohol and Drug Information
Box 2345
Rockville, MD 20847-2345
(800) 729-6686

National Collegiate Athletic Association Committee on Competitive Safeguards and Medical Aspects of Sports
6201 College Blvd
Overland Park, KS 66211-2422
(913) 339-1906

National Institute on Alcohol Abuse and Alcoholism
National Institutes of Health
US Department of Health and Human Services
6000 Executive Blvd
Bethesda, MD 20892-7003
(301) 443-3860

It has been a long time since anyone has seriously asked me whether drinking beer is a good way to replenish carbohydrates. But people do ask whether drinking a beer or two before exercise will hurt exercise performance. And even more frequently, clients have questions about whether drinking a little bit of alcohol may actually be heart-healthy.

Thanks to an ever-growing body of research on the topic, we now have more answers to those questions, as well as more information on the problems related to alcohol abuse.

What's in Alcohol?

Pure alcohol (200 proof) supplies 7 calories per gram, and nothing else. In practical terms, a shot (1.5 ounces) of 90-proof gin contains 110 calories, and 100-proof gin contains 124 calories.

Beer has a little more to offer, but not much. On average, a 12-ounce can of beer contains 146 calories, 13 grams of carbohydrate, traces of several B vitamins, and, depending on the brand, varying amounts of minerals. Light beer and nonalcoholic beer are lower in calories and sometimes carbohydrates. The caloric contents of table wines are all similar. A 3 1/2-ounce serving of table wine contains about 72 calories, 1 gram of carbohydrate, and very small amounts of several vitamins and minerals. Sweet or dessert wines contain about 90 calories per 2-ounce serving.

How Alcohol Hurts

Alcohol is a central nervous system depressant, which means that it slows down various functions--like memory, visual perception, and speech production--and reduces your ability to function at your best. Also, the difference between the amount of alcohol that will get you drunk and the amount that will kill you is very small. The reason more people don't die of alcohol intoxication is that your stomach is very sensitive to alcohol and rejects it by causing you to vomit.

Acute (sudden and severe) alcohol intoxication results in tremor, anxiety, irritability, nausea and vomiting, decreased mental function, vertigo, coma, and death. Chronic (ongoing) alcoholism harms every organ in the body, particularly the liver, heart, brain, and muscles. Chronic alcohol use causes loss of many nutrients from the body, including thiamine, vitamin B6, and calcium.

Today, alcohol is the most abused drug in the United States (1). Ten percent of users are addicted (alcoholics), and another 10% to 20% are abusers or problem drinkers. Problem drinkers differ from alcoholics in that they are not physically addicted to alcohol and can often drink with control, but they have negative experiences associated with their drinking. Problem drinkers place themselves and others at risk by having health problems, injuries, academic or job performance problems, relationship problems, memory loss, traffic accidents, and legal or financial problems (2). Young people are significant abusers of alcohol: 85% of high school seniors have used alcohol in the past year, and 3 million problem drinkers are under the age of 16. (See table 1 for resource groups.)

Under the Influence

Since alcohol depresses the central nervous system, it impairs mental and physical skills and decreases athletic performance. Even social use of alcohol the day before an event may affect performance. Skills that are especially affected by alcohol are accuracy, balance, steadiness, reaction time, complex and fine motor coordination, visual tracking, and information processing. Strength and power, muscle endurance, and aerobic endurance are also diminished with alcohol use (3). A study (4) found that runners who drank alcohol before a treadmill run had higher heart rates, lower blood sugar levels, and more trouble finishing their runs compared with runners who had nonalcoholic drinks.

It has been thought that in low doses alcohol can help reduce anxiety and tremors, which is why some athletes competing in such sports as archery and riflery, where a steady hand is helpful, have used alcohol as a performance aid. But they are actually hurting their performance because alcohol decreases hand-eye coordination, judgment, and tracking. The National Collegiate Athletic Association and the International Olympic Committee have banned alcohol use in these events.

A Heart-Healthy Habit?

It is clear that excessive alcohol intake increases your chances of developing heart disease because alcohol consumption can lead to obesity, and obesity is a major risk factor in developing heart disease.

But current evidence (5) suggests that moderate drinking is associated with a lower risk for heart disease in some people (see "What Is Moderation?," below). Daily consumption of one drink per day, it was found, can increase the level of high-density lipoprotein cholesterol (HDL-C), also known as the "good cholesterol," in your blood. The higher your HDL-C levels, the lower your risk of heart disease.

What Is Moderation?*

Guidelines from the US Department of Agriculture define moderation in drinking alcohol as no more than one drink per day for women and no more than two drinks per day for men. Count as a drink:

  • 12 ounces of regular beer
  • 5 ounces of wine
  • 1.5 ounces of 80-proof distilled spirits
  • 1 ounce of 100-proof distilled spirits.

It's important to remember that you should not "save up" skipped drinks and drink them all at once. This is considered binge drinking and indicates that you have a problem with alcohol.

The guidelines also recommend that the following people should not drink alcohol:

  • Children and adolescents,
  • People of any age who cannot drink moderately,
  • Women who are either pregnant or trying to conceive,
  • People who plan to drive or do other activities that require skill and attention, and
  • People who are taking medications.

*Adapted from Nutrition and Your Health: Dietary Guidelines for Americans, ed 4. Washington DC, US Department of Agriculture and US Dept of Health and Human Services, 1995.

So, should you start drinking a little bit of alcohol? Because of all the possible negative effects of higher alcohol consumption, such as high blood pressure, stroke, heart disease, certain cancers, accidents, violence, suicides, birth defects, and death, if you don't drink, don't start drinking just to help prevent heart disease.

If you drink alcoholic beverages, do so in moderation, with meals, and when consumption does not put you or others at risk. Remember: Exercise, quitting smoking, and lowering your blood cholesterol through a healthy diet are better ways to prevent heart disease, without any added risks.


  1. Dimeff RJ: Drugs and sports: prescription and non-prescription. Read before Sports Medicine for the Rheumatologist, American College of Rheumatology, Phoenix, May 19, 1996
  2. Sobel L, Sobel M: Problem Drinkers. New York City, Guilford Press, 1993
  3. Dimeff RJ: Steroids and other performance enhancers, in Matzen RN, Lang RS (eds): Clinical Preventive Medicine. St Louis, CV Mosby Co, 1993, p 367
  4. Kendrick ZV, Affrime MB, Lowenthal DT: Effect of ethanol on metabolic responses to treadmill running in well-trained men. J Clin Pharmacol 1993;33 (2):136-139
  5. Hartung GH, Foreyt JP, Reeves RS, et al: Effect of alcohol dose on plasma lipoprotein subfractions and lipolytic enzyme activity in active and inactive men. Metabolism 1990;39(1):81-86

Remember: You, your physician, and your nutritionist need to work together to discuss nutrition concerns. The above information is not intended as a substitute for appropriate medical treatment.

Dr Kleiner is a private nutrition consultant to athletes in the Seattle area. She is a member of the American College of Sports Medicine and of the American Dietetic Association and its practice group, Sports and Cardiovascular Nutritionists (SCAN), and a fellow of the American College of Nutrition.




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