Fit and Tipsy?

The Interrelationship Between Cardiorespiratory Fitness and Alcohol Consumption and Dependence

Kerem Shuval; David Leonard; Karen G. Chartier; Carolyn E. Barlow; Bob M. Fennis; David L. Katz; Katelyn Abel; Stephen W. Farrell; Andjelka Pavlovic; Laura F. Defina

Disclosures

Med Sci Sports Exerc. 2022;54(1):113-119. 

In This Article

Results

Participants' mean age was 45.9 yr (SD = 9.5) with their age ranging from 20 to 86 yr. In addition, more than two thirds (71.7%) were men, 85.5% were married, and 82.4% were either Baby Boomers or Generation X. In addition, 43.1% of participants were in the low or moderate fitness category, whereas 47.8% were moderate and 10.5% were heavy alcohol drinkers. A total of 13.1% of participants received a CAGE score of 2 or higher, indicating suggested alcohol dependence. Furthermore, although, on average, participants were overweight (BMI: mean = 26.4 kg·m−2, SD = 4.3), BMI differed by sex. That is, women on average were of normal weight (BMI: mean, 24.1 kg·m−2; SD, 4.3), whereas men on average were overweight (BMI: mean, 27.3 kg·m−2; SD, 4.0). Finally, descriptive characteristics of participants stratified by sex appear in Table 1.

The prevalence of alcohol consumption by fitness category among women and men is depicted in Figure 1. In women, light drinking decreased whereas moderate drinking increased according to increasing fitness categories. Specifically, 69.8%, 56.4%, and 47.6% of women were light drinkers within the low, moderate, and high fitness categories, respectively. Conversely, 26.1%, 39.2%, and 47.8% of women were moderate drinkers within the low, moderate, and high fitness categories, respectively. In comparison, the prevalence of heavy drinking in women appeared similar across fitness categories, that is, 4.2%, 4.4%, 4.6% were heavy drinkers within the low, moderate, and high fitness categories, respectively. In men, similar trends were observed; that is, light drinking decreased (45.4%, 37.9%, 36.2%), moderate drinking increased (41.8%, 48.4%, 51.5%), and heavy drinking was similar across ordered fitness categories (12.8%, 13.8%, 12.2%), respectively. Trends for light and moderate drinking were statistically significant across fitness categories for both sexes (unadjusted P for trend <0.001).

Figure 1.

Prevalence of alcohol consumption by cardiorespiratory fitness among women and men: Cooper Center Longitudinal Study 1988–2019. Current drinking was grouped into three categories for participants age 18–64 yr: 1) light drinking: ≤3 drinks per week; 2) moderate drinking: >3–7 drinks per week (women) and >3–14 drinks per week (men); and 3) heavy drinking: >7 drinks per week (women) and >14 drinks per week (men). Among participants age ≥65 yr, moderate drinking was regarded as >3–7 weekly drinks for both women and men, whereas heavy drinking was considered >7 drinks a week for both sexes; light drinking remained the same as above. Treadmill times were categorized into age- and sex-specific quintiles and then grouped into low, moderate, and high fitness. Total participants, N = 38,653; women, n = 10,922; men, n = 27,731.

The relationship between fitness (moderate and high vs low category) and alcohol consumption while adjusting for covariates, appears in Table 2. Ordinal logistic regression was used to distinguish higher from lower levels of alcohol consumption at the two possible breakpoints: 1) light versus moderate/heavy drinking, and 2) light/moderate versus heavy drinking. In women, participants within the moderate and high fitness categories had 1.58 (95% confidence interval [CI], 1.32–1.91) and 2.14 (95% CI, 1.77–2.58) times greater odds of moderate/heavy versus light drinking, respectively, in comparison to their low fitness counterparts. No significant relationships between fitness and alcohol consumption were observed when comparing heavy to light/moderate drinking levels in women. In men, individuals within the moderate and high fitness category had 1.42 (95% CI, 1.30–1.55) and 1.63 (95% CI, 1.49–1.80) times greater odds of moderate/heavy versus light alcohol consumption, respectively, in comparison to their low fitness counterparts. In addition, men within the moderate (but not high) fitness category had significantly greater odds of heavy (in comparison to light/moderate) drinking (OR, 1.15; 95% CI, 1.01–1.31). When examining the physical activity-alcohol relationship, as with fitness, meeting or exceeding activity guidelines was related to higher odds of moderate/heavy versus light drinking; however, findings differed somewhat when comparing heavy to light/moderate drinking (see Table, Supplemental Digital Content, Physical Activity and Alcohol Consumption among Women and Men, http://links.lww.com/MSS/C421).

In addition, the prevalence of a CAGE score of ≥2, by fitness and drinking categories among men and women, appear in Figure 2. In women, the prevalence of suggested alcohol dependence in heavy drinkers did not differ significantly across fitness levels. Specifically, the prevalence of suggested alcohol dependence in women who were heavy drinkers was 46.7%, 49.2%, and 47.6% across low, moderate, and high fitness categories, respectively (adjusted P for trend = 0.532). In comparison, in men who were heavy drinkers, there was significantly less suggested alcohol dependence across fitness categories. Specifically, the prevalence of suggested alcohol dependence was 45.7%, 41.7%, and 34.9% for low, moderate, and high fitness categories, respectively (adjusted p for trend <0.001).

Figure 2.

Prevalence of Suggested Alcohol Dependence by Cardiorespiratory Fitness and alcohol consumption among Women and Men: Cooper Center Longitudinal Study 1988–2019. A CAGE score ≥2 was regarded as suggested alcohol dependence. Among heavy drinkers, the CAGE score trends across fitness are significant for men (P < 0.001) but not women (P = 0.358). Current drinking was grouped into three categories for participants age 18–64 yr: 1) light drinking: ≤3 drinks per week; 2) moderate drinking: >3–7 drinks per week (women) and >3–14 drinks per week (men); and 3) heavy drinking: >7 drinks per week (women) and >14 drinks per week (men). Among participants age ≥65 yr, moderate drinking was regarded as >3–7 weekly drinks for both women and men, whereas heavy drinking was considered >7 drinks a week for both sexes; light drinking remained the same as above. Treadmill times were categorized into age- and sex-specific quintiles and then grouped into Low, Moderate and High Fitness. Total participants: n = 38,653; women: n = 10,922; men: n = 27,731.

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