Tuesday, June 17, 2014

True or False: The Occasional Weekend Alcohol Binge Does not Hamper Skeletal Muscle Hypertrophy, Will Not Decrease Testosterone and Cannot Impair Your Strength & Recovery

Brain & muscle get along astonishingly well. Booze & muscle don't.
A glass of wine from time to time. That's not a proper rhyme and probably less beneficial for your health than the rave press-released about "French Paradoxes" and the potent health effects of the negligible amounts of resveratrol in red wine would suggest, but it's certainly not as bad as a regular weekend binge - a habit with health consequences that go far beyond the well-known damaging effects on the liver. It has also been associated with reductions in brain volume (Liesdahl. 2013) and acute reductions in grey matter blood supply (Serrador. 2013).

Regular alcohol consumption will also increases the risk of stroke (Rantakömi. 2014), messes with cardiovascular health (Ryu. 2014) and disturbs your sleep (Canham. 2014).
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I could probably extend this list by another 10 items, but I intend to focus on only one. The effects of alcohol consumption and hormonal alterations related to muscle hypertrophy, as they have recently been reviewed by Antnio Bianco in the peer-reviewed journal Nutrition & Metabolism (Bianco. 2014). 
As Bianci et al. point out, alcohol consumption in Western countries is on the rise and that in spite of the fact that most people know about the negative effects of regular ethanol intake on organ tissue.

What most people don't take into account are the many far-reaching changes that occur way before the first liver cells die. Hormonal changes like the catabolic increase in adrenal gland secretion of steroid hormones with profound effects on glucose, bone and muscle metabolism. No wonder
"[a]cute alcohol consumption also impacts on neural function, cardiovascular function, thermoregulatory function and can cause skeletal muscle myopathyes such as the alcoholic myopathy" (Bianco. 2014)
Yep, muscular diseases, myopathies, are in fact a very common consequence of alcohol consumption and the fact that they occur in response to impairments of skeletal muscle hypertrophy makes them relevant even for those of us whose alcohol consumption is a dozen of Tequilas away from qualifying as an alcoholic.

Even the occasional weekend binge can ruin the results you've been working for in the gym

Figure 1: The threshold intake for acute hormonal effects, here increases in cortisol, appears to be >1.5g ethanol per kg body weight (Bianco. 2014)
It's true, the hormonal downstream effects of ethanol are significant enough to impair the training induced increase in protein synthesis. As it turns out the "big" and "fast" type II fibers, you're trying to build, when you're hitting the weights are particularly susceptible to the negative effects of ethanol (Preedy. 1994; Vary 2008) - a decrease in basal protein synthesis by 15% to 20% even 24 hr after a weekend binge is nothing out of the ordinary (Hong-Brown. 2001). 

Against that background it's no wonder that the average alcoholic has sticks, where other have legs and arms. The amount of muscle you are carrying around is after all determined by the difference between protein synthesis and degradation.

Both, synthesis and degradation are obviously affected by the presence of alcohol, which increases the expression of the "muscle growth break" myostatin and inhibits the ability of IGF-I or insulin
  • to stimulate protein synthesis (-30-60%) for 72h
  • to slow proteolysis and thus counter the natural breakdown of muscle
When consumed in doses of 1.5g/kg ethanol will also mess with the regular rhythmic production of testosterone and reduce its serum levels by 23% for approximately 24h (Välimäki. 1990). In that the currently available evidence indicates that testosterone acts as a testicular toxin, where it can reduce testosterone synthesis rates with no negative influence on the hypothalamus signals to the testes.
Booze can have short-lived testo- sterone boosting effects | learn more
Alcohol has virilizing effects in women: It may sound paradox, but inasmuch as it suppresses the testicular testosterone production ethanol can also increase the production of androgens in the adrenal glands - for men the contribution of adrenal androgens is irrelevant, for women, on the other hand, the alcohol-induced (over-)production of androgens paves the way to menstrual irregularity, PCOS, fertility issues, breast cancer and other health problems that are associated with high androgen and / or unbalanced androgen:estrogen levels in females.
In this context it may also be worth mentioning that the effects depend on the baseline hormonal status. In an acute study, administration of a single dose of ethanol (0.7 g/kg), for example, had no significant effect on plasma estrone and estradiol levels in healthy postmenopausal women who were not receiving estrogen replacement therapy (ERT; Ginsburg et al., 1996). In those women who were receiving oral ERT, however, ethanol significantly (P<.01) increased estradiol levels by 300% from baseline values after 50 min of alcohol ingestion.
In conjunction with the increased aromatization (=conversion to estrogens) of androgens and decreased clearance of estrogens in men consuming high(er) amounts of ethanol, the reduction in androgen levels can induce a low androgen + high estrogen state that can be similarly problematic for men and women.

"Alcohol? Unhealthy? Bullshit!" - Educated ignorance at US colleges

Against that background it's actually quite disturbing that only 10% of the randomly selected students in a nationally representative sample of 4-yr colleges in the United States say that avoid alcohol due to the potential ill health effects. The fact that even among collegiate athletes only 12.1% are convinced abstainers is - in my humble opinion - nothing but hilarious (Nelson. 2001). You disagree? Well, I guess you find "alcohol could make me fat" (30%) or "costs too much" (30%) both of which were mentioned by 30% of the athletes and 23% and 27% of the non-athletes more convincing, ha?
Alcohol exacerbates the training induced reductions in muscular force production (Barnes. 2010a)
Enough of the ranting - Let's take stock, now: Alcohol impairs protein synthesis, specifically in the fast-twitch "easy-growing" type II fibers. Alcohol nullifies the anabolic and anti-catabolic effects of insulin and IGF-1 on skeletal muscle. Alcohol increases myostatin and puts a break on muscle growth. Alcohol intoxicates the testes, reduces testosterone production in men and messes with the estrogen to androgen ratio in men and women. And, last but not least, alcohol impairs post-workout glycogen re-synthesis (Burke. 2003) and augments the loss of force associated strenuous eccentric exercise (Barnes. 2010a,b).

You can hardly need more reasons to be convinced that this true of false article is dealing with a "false" hypothesis. Alcohol will hamper skeletal muscle hypertropyh, it will decrease your testosterone levels and it will impair your strength and recovery. So, do you really want more good reasons to stay away from booze in general and "above-threshold" doses of 1.5g/kg, in particular?
  • Barnes, M.J.; Mundel, T. "Stannard, S.R. Acute alcohol consumption aggravates the decline in muscle performance following strenuous eccentric exercise." J. Sci. Med. Sport. 13 (2010a):189-193. 
  • Barnes, M.J.; Mündel, T; Stannard, S.R. "Post-exercise alcohol ingestion exacerbates eccentric-exercise induced losses in performance." Eur. J. Appl. Physiol. 108 (2010):1009-1014. 
  • Bianco, Antonino, et al. "Alcohol consumption and hormonal alterations related to muscle hypertrophy: a review." Nutrition & Metabolism 11.1 (2014): 26.
  • Burke, L.M.; Collier, G.R.; Broad, E.M.; Davis, P.G.; Martin, D.T.; Sanigorski, A.J.; Hargreaves, M. "Effect of alcohol intake on muscle glycogen storage after prolonged exercise." J. Appl. Physiol. 95 (2003): 983-990.
  • Canham, Sarah L., et al. "Binge drinking and insomnia in middle‐aged and older adults: the Health and Retirement Study." International journal of geriatric psychiatry (2014).
  • Ginsburg, Elizabeth S., et al. "Effects of alcohol ingestion on estrogens in postmenopausal women." JaMa 276.21 (1996): 1747-1751.
  • Hong-Brown LQ, Frost RA, Lang CH: Alcohol impairs protein synthesis and degradation in cultured skeletal muscle cells. Alcohol Clin Exp Res 25 (2001):1373–1382. 
  • Lisdahl, Krista M., et al. "Recent binge drinking predicts smaller cerebellar volumes in adolescents." Psychiatry Research: Neuroimaging 211.1 (2013): 17-23.
  • Nelson, Toben F., and Henry Wechsler. "Alcohol and college athletes." Medicine and Science in Sports and Exercise 33.1 (2001): 43-47.
  • Preedy VR, Salisbury JR, Peters TJ. "Alcoholic muscle disease: features and mechanisms." J Pathol 173 (1994):309–315.
  • Rantakömi, S. H., et al. "The frequency of alcohol consumption is associated with the stroke mortality." Acta neurologica Scandinavica (2014).
  • Ryu, Mikyung, et al. "Modifying Effects of Resting Heart Rate on the Association of Binge Drinking with All-cause and Cardiovascular Mortality in Older Korean Men: the Kangwha Cohort Study." Journal of Epidemiology (2014).
  • Serrador, Jorge M., Jenna Tosto, and Shieak Tzeng. "Effects of binge drinking on brain blood flow." The FASEB Journal 27 (2013): 1186-12.
  • Välimäki, Matti, et al. "The pulsatile secretion of gonadotropins and growth hormone, and the biological activity of luteinizing hormone in men acutely intoxicated with ethanol." Alcoholism: Clinical and Experimental Research 14.6 (1990): 928-931.
  • Vary TC, Lang CH. "Assessing effects of alcohol consumption on protein synthesis in
    striated muscles." Methods Mol Biol 447 (2008): 343–355.