Drinking alcohol at or above recommended levels has been linked to an increased likelihood of disease and early death—but a new study says that getting regular exercise may offset some of these risks. The paper, published online yesterday in the British Journal of Sports Medicine, is the first to examine the opposite influences that physical activity and alcohol intake seem to have on mortality due to cancer, heart disease, and other causes.
Alcohol consumption is an “integral part” of western culture, the study authors write. In 2013, 88% of American adults said they’d had alcohol at some point in their lifetime, while 56% had imbibed in the past month. That’s true despite some troublesome statistics. While low to moderate levels of drinking may provide some health benefits, it has also been shown to raise the risk of certain cancers.
The consequences of heavy drinking are clearer, still: Many studies have shown that drinking in higher-than-moderate amounts (in the United States, that’s considered more than 7 servings a week for women and more than 14 for men) increases the risk of heart disease, stroke, several types of cancer, and death from all causes.
Exercise, on the other hand, is known to help people stay healthy and live longer. In fact, the study authors write, physical activity and alcohol consumption “may be linked to chronic disease through shared pathways but acting in the opposite directions.”
So they set out to see whether staying active might help cancel out the harmful effects of alcohol consumption over the years. To test their hypothesis, they looked at survey responses about health and drinking from more than 36,000 adults in England and Scotland, recorded between 1994 and 2006.
Over the next several years, nearly 6,000 of those adults died. After accounting for other factors that could potentially influence their results, the researchers found that drinking any amounts (compared to lifelong abstinence) was associated with a heightened risk of death from cancer—and the more people drank, the higher that risk was.
Heavy drinking (defined in this study as more than 14 servings a week for women and more than 21 a week for men, a now-outdated British guideline) was also associated with increased risk of death from all causes.
But when they factored in physical activity, they saw a more nuanced picture. The links between drinking and death—from all causes as well as from cancer—remained for people who got less than the recommended 7.5 MET hours, which is equal to 150 minutes of moderate physical activity, a week. For those who moved at least that much, however, those risks were lessened or canceled out.
In fact, people who were physically active and drank occasionally (not every week) seemed to have lower risk for cardiovascular death than those who were complete teetotalers.
Occasional drinkers who were sedentary didn’t reap the same benefits. “This suggests that low and irregular alcohol consumption has cardioprotective effects, but these effects need some physical activity to ignite,” says study co-author Emmanuel Stamatakis, PhD, associate professor of exercise, health and physical activity sport sciences at the University of Sydney in Australia.
Because this was an observational study, and because it didn’t look at specific drinking or dietary patterns, the authors can’t draw any definite conclusions about cause and effect. But the findings do indicate that physical activity has the potential to curb some of the harmful effects of drinking, they say. What’s more, these benefits start at relatively low levels—just 150 minutes a week of moderate exercise, the minimum amount recommended for overall health by the U.S. government.
That doesn’t mean, though, that people who exercise regularly shouldn’t worry about drinking in excess. “Our study examined specific long-term health outcomes in relation to alcohol drinking, and it says nothing for all other alcohol harms such as liver disease, mental health conditions, brain damage, or car accidents and alcohol-fueled violence,” says Stamatakis.
Given that drinking is so prevalent in society, it doesn't make sense to recommend abstinence, he adds. But he does suggest limiting consumption to moderate levels at most. (Taking into account differences in serving sizes and recent changes to British guidelines, the definition of “moderate” varies only slightly between the U.S. and the United Kingdom.)
“As long as people remain physically active, consumption within these guidelines would be wise advice,” he says. “And it may be a good idea to take a break from alcohol for a week or a few weeks from time to time.”
Overall, Stamatakis says, the findings highlight what we already know: how important it is to stay active. “Exercise is such a powerful influence that may even offset some of the damage done by other unhealthy behaviors,” he says. “If we were to interpret our results causally, it looks like physical inactivity and alcohol drinking is a very toxic combination.”