Why doctors should ask their fittest patients about their drinking habits

There is an assumption that someone who exercises regularly, indeed visits the gym four times a week, will have a healthy diet and not drink alcohol to excess. However, this is not always the case.  Research we have carried out at Alcohol Concern showed that more than a quarter of people drinking at levels which indicate a possible alcohol dependency are ostensibly fit.

Our survey, “The Way We Drink Now” showed that 27 per cent of people most at risk of alcohol abuse exercise four times a week; only nine per cent of them didn’t exercise at all.  I can only assume these people think gym visits will offset the harmful effects the alcohol is having on their health, or of course it could be that they are more likely to lie (to themselves and surveys) about their lifestyle.

Alcohol is extremely calorific, so the calories in the bottles of wine or pints of beer, may be burned off by gym workouts or regular runs, but the long term toxic effects of booze remain; it is not the same as exercising to compensate for eating too much.  It seems these fit, but heavy drinkers, are not aware of the other effects alcohol has on their body – the potential harm to their hearts, livers, brains, blood pressure, and the potential to increase their risk for cancer.

This may seem difficult to accept as we also know that the group of people who drink alcohol at these high levels tend to be educated and members of the A, B and C1 social class levels, so I would assume they know intellectually that exercise does not counterbalance the health dangers of too much alcohol.  But we clearly need to do more to raise awareness amongst these fit drinkers.

As yet we do not know if these people are binge drinkers – proudly staying off the wagon from Monday to Thursday, then drinking in excess at the weekend.  The pattern of drinking alcohol varies across age and social class groups, for example we know that older people tend to drink every night at home.

Out of those classed as ‘possibly dependent’ on alcohol, 59 per cent were men, and 41 per cent were women.  So what is ‘possibly dependent’ on alcohol? This description fits those who score 20 points or more on the AUDIT C questionnaire which looks at the amount and frequency of drinking.

We need to target advice and help to these fit, and seemingly healthy people who are drinking too much. This can be done in a variety of ways: It is important that family doctors and other health professionals ask all their patients about their drinking habits – even if they are visiting them for a torn ligament sustained in marathon training. Do not assume regular gym users are not abusing alcohol. It would also be helpful to raise awareness of the dangers of excess alcohol consumption in other locations, such as gyms and sports centres. Staff could ask relevant questions about drinking habits and remind members that alcoholic misuse is not something you can counteract with physical training, in fact exercising with a hangover could lead to injuries.

Personal trainers and fitness staff can make people much more aware of their at-risk drinking behaviour and focus on what they can change; they could warn their customers that exercising between bouts of heavy drinking puts extra strain on the heart and can lengthen recovery time of muscle injuries. Perhaps focusing on how alcohol affects training may resonate more effectively with younger gym members.

There are now many delicious and healthy alternatives to alcohol, and Alcohol Concern created the Zero Alcohol Awards in partnership with Britvic to recognise and celebrate no alcohol products and places where you can choose from an interesting range. If you are enjoying a post exercise drink, ask yourself if you really need the second drink, if you are really enjoying or tasting it. If not, switch to a no-alcohol alternative.

Jackie Ballard

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