Effects of heavy episodic drinking on physical performance in club level rugby union players

High prevalence of harmful drinking habits and gambling among professional rugby players: mental health symptoms and lifestyle risks among New Zealand Super Rugby players-a cross-sectional survey

Objectives

Determining the prevalence of mental health and lifestyle risk factors (smoking, alcohol consumption, recreational drug use, gambling, family violence and anger management) in New Zealand (NZ) male professional rugby players.

Study design

Cross-sectional survey of mental health symptoms and lifestyle risk factors in male professional rugby players in NZ.

Methods

Players from all five NZ men's Super Rugby Franchises were invited to complete an online questionnaire (SportCHAT) measuring demographic status and mental health symptoms. Descriptive and interferential statistical analyses were used to identify the most prevalent mental health and lifestyle risk factors.

Results

105 players participated in the study (response rate 52.5%). 51.4% of players were either at moderate or high risk for alcohol-related harm (defined as potential health, social, legal or financial problems linked to alcohol consumption). In comparison, 4.8% reported recreational drug use and 5% reported smoking tobacco. Twenty players (19%) reported engaging in gambling, with five of these reporting problematic gambling. 21% of players reported symptoms of depression, but none reached the 'mild depression' threshold of the Patient Health Questionnaire for Depression. Younger players (aged 20-29) were more likely to report symptoms of depression than older players (aged 30-39). The prevalence of anxiety symptoms was 17.1%. 66.7% of these players reported minimal symptoms (GAD-7 score 0-4) and 33.3% reported mild symptoms (GAD-7 score 5-9). Family violence was reported by 2.9% of respondents, while 12.4% reported issues with anger management. There were no significant differences between ethnic groups.

Conclusion

There is a higher prevalence of alcohol misuse and gambling, but lower reported rates of depression and anxiety symptoms in this cohort when compared with the general population.

Alcohol and Skeletal Muscle in Health and Disease

PURPOSE

Alcohol-related myopathy is one of the earliest alcohol-associated pathological tissue changes that is progressively exacerbated by cumulative long-term alcohol misuse. Acute and chronic alcohol use leads to changes in skeletal muscle mass and function. As discussed in this evidence-based review, alcohol-mediated mechanisms are multifactorial with effects on anabolic and catabolic signaling, mitochondrial bioenergetics, extracellular matrix remodeling, and epigenomic alterations. However, systematic studies are limited, especially regarding the acute effects of alcohol on skeletal muscle.

SEARCH METHODS

This review focuses on peer-reviewed manuscripts published between January 2012 and November 2022 using the search terms "alcohol" or "ethanol" and "skeletal muscle" in MEDLINE, PubMed, and Web of Science using EndNote reference management software.

SEARCH RESULTS

Eligible manuscripts included full-length research papers that discussed acute and chronic effects of alcohol on skeletal muscle mass and function in both clinical and preclinical studies. The review also includes alcohol-mediated skeletal muscle effects in the context of comorbidities. The three databases together yielded 708 manuscripts. Of these, the authors excluded from this review 548 papers that did not have "alcohol" or "muscle" in the title and 64 papers that were duplicates or did not discuss skeletal muscle. Thus, of all the manuscripts considered for this review, 96 are included and 612 are excluded. Additionally, relevant papers published earlier than 2012 are included to provide context to the review.

DISCUSSION AND CONCLUSIONS

Both acute and chronic alcohol use decrease protein synthesis and increase protein degradation. Alcohol also impairs mitochondrial function and extracellular matrix remodeling. However, there is a gap in the literature on the known alcohol-mediated mechanisms, including senescence, role of immune activation, and interorgan communication, on the development of alcohol-related myopathy. With increased life expectancy, changing alcohol use patterns, and increasing frequency of alcohol use among females, current observational studies are needed on the prevalence of alcohol-related myopathy. Additionally, the compounding effects of acute and chronic alcohol use on skeletal muscle with aging or exercise, in response to injury or disuse, and in the context of comorbidities including diabetes and human immunodeficiency virus (HIV), call for further investigation. Though evidence suggests that abstinence or reducing alcohol use can improve muscle mass and function, they are not restored to normal levels. Hence, understanding the pathophysiological mechanisms can help in the design of therapeutic strategies to improve skeletal muscle health.

Episodic Binge-like Ethanol Reduces Skeletal Muscle Strength Associated with Atrophy, Fibrosis, and Inflammation in Young Rats

Binge Drinking (BD) corresponds to episodes of ingestion of large amounts of ethanol in a short time, typically ≤2 h. BD occurs across all populations, but young and sports-related people are especially vulnerable. However, the short- and long-term effects of episodic BD on skeletal muscle function have been poorly explored. Young rats were randomized into two groups: control and episodic Binge-Like ethanol protocol (BEP) (ethanol 3 g/kg IP, 4 episodes of 2-days ON-2-days OFF paradigm). Muscle function was evaluated two weeks after the last BEP episode. We found that rats exposed to BEP presented decreased muscle strength and increased fatigability, compared with control animals. Furthermore, we observed that skeletal muscle from rats exposed to BEP presented muscle atrophy, evidenced by reduced fiber size and increased expression of atrophic genes. We also observed that BEP induced fibrotic and inflammation markers, accompanied by mislocalization of nNOSµ and high levels of protein nitration. Our findings suggest that episodic binge-like ethanol exposure alters contractile capacity and increases fatigue by mechanisms involving atrophy, fibrosis, and inflammation, which remain for at least two weeks after ethanol clearance. These pathological features are common to several neuromuscular diseases and might affect muscle performance and health in the long term.

The functional and molecular effects of problematic alcohol consumption on skeletal muscle: a focus on athletic performance

Background: Chronic alcohol misuse is associated with alcoholic myopathy, characterized by skeletal muscle weakness and atrophy. Moreover, there is evidence that sports-related people seem to exhibit a greater prevalence of problematic alcohol consumption, especially binge drinking (BD), which might not cause alcoholic myopathy but can negatively impact muscle function and amateur and professional athletic performance.Objective: To review the literature concerning the effects of alcohol consumption on skeletal muscle function and structure that can affect muscle performance.Methodology: We examined the currently available literature (PubMed, Google Scholars) to develop a narrative review summarizing the knowledge about the effects of alcohol on skeletal muscle function and exercise performance, obtained from studies in human beings and animal models for problematic alcohol consumption.Results: Exercise- and sport-based studies indicate that alcohol consumption can negatively affect muscle recovery after vigorous exercise, especially in men, while women seem less affected. Clinical studies and pre-clinical laboratory research have led to the knowledge of some of the mechanisms involved in alcohol-related muscle dysfunction, including an imbalance between anabolic and catabolic pathways, reduced regeneration, increased inflammation and fibrosis, and deficiencies in energetic balance and mitochondrial function. These pathological features can appear not only under chronic alcohol misuse but also in other alcohol consumption patterns.Conclusions: Most laboratory-based studies use chronic or acute alcohol exposure, while episodic BD, the most common drinking pattern in amateur and professional athletes, is underrepresented. Nevertheless, alcohol consumption negatively affects skeletal muscle health through different mechanisms, which collectively might contribute to reduced sports performance.

Effect of Previous-Day Alcohol Ingestion on Muscle Function and Performance of Severe-Intensity Exercise

PURPOSE

Many athletes report consuming alcohol the day before their event, which might negatively affect their performance. However, the effects of previous-day alcohol ingestion on performance are equivocal, in part, due to no standardization of alcohol dose in previous studies. The purpose of this study was to examine the impact of a standardized previous-day alcohol dose and its corresponding impact on morning-after muscular strength, muscular power, and muscular fatigue in a short-duration test and on performance of severe-intensity exercise.

METHODS

On 2 occasions, 12 recreationally active individuals reported to the Applied Physiology Laboratory in the evening and ingested a beverage containing either 1.09 g ethanol·kg-1 fat-free body mass (ALC condition) or water (PLA condition). The following morning, they completed a hangover symptom questionnaire, vertical jumps, isometric midthigh pulls, biceps curls, and a constant-power cycle ergometer test to exhaustion. The responses from ALC and PLA were compared using paired-means t tests.

RESULTS

Time to exhaustion in the cycle ergometer tests was less (P = .03) in the ALC condition (181 [39] s vs 203 [34] s; -11%, Cohen d = 0.61). There was no difference in performance in vertical jump test, isometric midthigh pulls, and biceps curls tests between the ALC and PLA conditions.

CONCLUSIONS

Previous-day alcohol consumption significantly reduces morning-after performance of severe-intensity exercise. Practitioners should educate their athletes, especially those whose events rely on anaerobic capacity and/or a rapid response of the aerobic pathways, of the adverse effect of previous-day alcohol consumption on performance.

The prevalence of common mental disorders and its relationship with mental toughness in professional South African rugby players

This study explores the relationship between common mental disorders and mental toughness in professional South African rugby players. A cross-sectional survey design was used by administering a questionnaire and preliminary and bivariate analyses were conducted. The inclusion criteria were professional rugby players who are able to communicate in English. The results indicated that, in general, these players (N = 215) portray significant mental toughness ( M = 5.69) on a 7-point scale. Anxiety/depression and distress measured the lowest ( M = 1.65) of all the common mental disorders measured in this study. Furthermore, the results indicated a positive relationship between mental toughness and sound sleep ( r = .262). Negative relationships were found between mental toughness and all other common mental disorders with the highest relationship being with anxiety/depression positive2 ( r = –.423). Other significant relationships were found with anxiety/depression ( r = –.401), distress ( r = –.259), and common mental disorders problems in general ( r = –.220). The results indicated that the management of teams and clinicians need to look at specific aspects, such as alcohol consumption among players, the implications of alcohol use on performance, but also mental wellbeing in general.

UEFA expert group statement on nutrition in elite football. Current evidence to inform practical recommendations and guide future research

Football is a global game which is constantly evolving, showing substantial increases in physical and technical demands. Nutrition plays a valuable integrated role in optimising performance of elite players during training and match-play, and maintaining their overall health throughout the season. An evidence-based approach to nutrition emphasising, a 'food first' philosophy (ie, food over supplements), is fundamental to ensure effective player support. This requires relevant scientific evidence to be applied according to the constraints of what is practical and feasible in the football setting. The science underpinning sports nutrition is evolving fast, and practitioners must be alert to new developments. In response to these developments, the Union of European Football Associations (UEFA) has gathered experts in applied sports nutrition research as well as practitioners working with elite football clubs and national associations/federations to issue an expert statement on a range of topics relevant to elite football nutrition: (1) match day nutrition, (2) training day nutrition, (3) body composition, (4) stressful environments and travel, (5) cultural diversity and dietary considerations, (6) dietary supplements, (7) rehabilitation, (8) referees and (9) junior high-level players. The expert group provide a narrative synthesis of the scientific background relating to these topics based on their knowledge and experience of the scientific research literature, as well as practical experience of applying knowledge within an elite sports setting. Our intention is to provide readers with content to help drive their own practical recommendations. In addition, to provide guidance to applied researchers where to focus future efforts.

Influence of poor preparation and sleep deficit on injury incidence in amateur small field football of both gender

INTRODUCTION

Amateur small-field football tournaments are rather common worldwide. Adequate preparation is essential for injury prevention. The consequences of insufficient injury preparation at this level are still unclear. This study investigates the factors influencing injuries in this football population.

MATERIALS AND METHODS

In 2017, medical students participating in a national amateur football tournament were analysed in a prospective cohort study. Injury incidence, injury pattern and factors influencing injuries were investigated according to the statement on data collection and injury definition of Fuller et al. (Br J Sports Med 40:193-201, 2006). Preparation for the tournament was assessed for both sexes by means of hours of sleep, alcohol consumption, training level and warm-up performance.

LEVEL OF EVIDENCE

II.

RESULTS

Of 694 amateur football players (423 men and 271 women) with a mean age of 23 years (SD 2.5), 321 (21.1%) injuries happened during the tournament. 60% of injuries affected the lower extremity. The most common types of traumatic injury were skin abrasions (40.0%) and muscle strains (23.3%). The injury incidence of male players during match exposure was 469 per 1000 h football and significantly higher than in female players 313 (p = 0.025). One potential reason for the higher injury rate of male players as measure for inadequate preparation was significantly higher alcohol consumption the evening before the tournament (p < 0.001) and the after-effects on match day (p < 0.001). Additionally, male players reported less and inadequate sleep the night before the tournament (p < 0.007) and a lower warm-up rate before the matches compared to female players (p < 0.001).

CONCLUSIONS

Small-field tournaments in football have a high injury incidence. Male players have a higher injury incidence than female players and show additionally a lack of sleep and alcohol consumption the night before the tournament and poor warm-up performance on match day. Adequate preparation for a football tournament is the key factor for preventing injuries, also in recreational football.

Behavioral Modification Enhances the Benefits from Structured Aerobic and Resistance Training

Behavioral modification (BM) is a strategy designed to sustain or restore well-being through effects such as enhanced relaxation, reduced stress, and improved sleep. Few studies have explored the role of BM delivered in the context of fitness programs for healthy adults. Thus, the purpose of this investigation was to examine whether BM combined with aerobic and resistance training programs would improve health and fitness measures more than the exercise training alone. Thirty-two healthy fitness club members (19 men) were randomized to receive a BM program (n=15) or an equal-attention (EA) control (n=17). BM consisted of twelve, 10-min education sessions between a trained fitness professional and the participant, coupled with weekly, individualized relaxation, stress reduction, and sleep improvement assignments. All participants engaged in 1 h of coached resistance training and remotely guided aerobic exercise thrice weekly for 12 weeks. Fitness measures (aerobic performance, body composition, muscle strength and endurance, lower-body power), sleep characteristics, and heart rate variability (HRV) were obtained at baseline and after the 12-week program. BM resulted in greater improvements in aerobic performance (increased maximum oxygen uptake, metabolic (lactate) threshold, and percent of maximum oxygen uptake at which metabolic threshold occurred), peak and average lower-body power, and body composition (decreased body fat percentage and fat mass) compared to EA. BM also positively influenced parasympathetic tone through increased High-frequency HRV. BM resulted in greater improvements in fitness measures, body composition, and heart rate variability compared with EA. These findings have intriguing implications regarding the role of BM in augmenting health and physical performance.

Can the Combination of Acute Alcohol Intake and One Night of Sleep Deprivation Affect Neuromuscular Performance in Healthy Male Adults? A Cross-over Randomized Controlled Trial

Rodrigues, R, Franke, RA, Teixeira, BC, Macedo, RCO, Diefenthaeler, F, Baroni, BM, and Vaz, MA. Can the combination of acute alcohol intake and one night of sleep deprivation affect neuromuscular performance in healthy male adults? A cross-over randomized controlled trial. J Strength Cond Res 33(5): 1244-1251, 2019-The aim of this work was to perform a cross-over study to compare isolated and combined effects of alcohol intake and sleep deprivation on neuromuscular responses. Ten young and physically active male subjects were allocated to 4 conditions: (a) placebo intake + normal sleep (PLA + SLE); (b) alcohol intake + normal sleep (ALC + SLE); (c) placebo intake + sleep deprivation (PLA + SDP); and (d) alcohol intake + sleep deprivation (ALC + SDP). In each condition, volunteers ingested 1 g of alcohol per kg of body mass of alcoholic beer or nonalcoholic beer (placebo), followed by one night of normal sleep or sleep deprivation. In the next morning, neuromuscular performance (knee extensor isometric and concentric peak torque and time to task failure during the endurance test) and muscle activation were assessed. No differences were observed in the neuromuscular performance. We observed a significant reduction in quadriceps activation during the knee extensor isometric test in ALC + SDP compared with PLA + SLE (-20.8%; p = 0.02; d = 0.56). Our results demonstrated that acute alcohol intake and one night of sleep deprivation reduced quadriceps muscle activation without impact on neuromuscular performance.

CORP: Measurement of upper and lower limb muscle strength and voluntary activation

Muscle strength, the maximal force-generating capacity of a muscle or group of muscles, is regularly assessed in physiological experiments and clinical trials. An understanding of the expected variation in strength and the factors that contribute to this variation is important when designing experiments, describing methodologies, interpreting results, and attempting to replicate methods of others and reproduce their findings. In this review (Cores of Reproducibility in Physiology), we report on the intra- and inter-rater reliability of tests of upper and lower limb muscle strength and voluntary activation in humans. Isometric, isokinetic, and isoinertial strength exhibit good intra-rater reliability in most samples (correlation coefficients ≥0.90). However, some tests of isoinertial strength exhibit systematic bias that is not resolved by familiarization. With the exception of grip strength, few attempts have been made to examine inter-rater reliability of tests of muscle strength. The acute factors most likely to affect muscle strength and serve as a source of its variation from trial-to-trial or day-to-day include attentional focus, breathing technique, remote muscle contractions, rest periods, temperature (core, muscle), time of day, visual feedback, body and limb posture, body stabilization, acute caffeine consumption, dehydration, pain, fatigue from preceding exercise, and static stretching >60 s. Voluntary activation, the nervous system’s ability to drive a muscle to create its maximal force, exhibits good intra-rater reliability when examined with twitch interpolation (correlation coefficients >0.80). However, inter-rater reliability has not been formally examined. The methodological factors most likely to influence voluntary activation are myograph compliance and sensitivity; stimulation location, intensity, and inadvertent stimulation of antagonists; joint angle (muscle length); and the resting twitch.

Alcohol After Resistance Exercise Does Not Affect Muscle Power Recovery

Levitt, DE, Idemudia, NO, Cregar, CM, Duplanty, AA, Hill, DW, and Vingren, JL. Alcohol after resistance exercise does not affect muscle power recovery. J Strength Cond Res 34(7): 1938-1944, 2020-The purpose of this study was to investigate the effect of alcohol consumed after heavy eccentric resistance exercise on measures of muscle power. After familiarization and an initial eccentric exercise bout to control for the "repeated-bout effect," 10 recreationally resistance-trained men completed 2 identical heavy eccentric squat bouts (4 sets of 10 repetitions at 110% of concentric 1-repetition maximum) 1 week apart. Each exercise bout was followed by ingestion of a beverage containing either alcohol (1.09 g ethanol·kg fat-free body mass) or no alcohol (placebo; volume of alcohol replaced with water). Vertical jump (VJ) peak power, VJ peak force, VJ jump height, change-of-direction ability (shuttle run), sprint acceleration (sprint test), and muscle soreness were measured before (PRE), 24 hours after (24H), and 48 hours after (48H) each eccentric exercise bout. Although the exercise bout resulted in significantly (p ≤ 0.05) decreased VJ peak power at 24H, significantly decreased VJ jump height at 24H, and significantly increased muscle soreness at 24H and 48H, consuming alcohol after the exercise bout did not affect any of the performance outcome measures. When consumed after a non-novel heavy eccentric resistance exercise bout, alcohol did not affect soreness or recovery of muscular power. Practitioners can use this information to advise their athletes with regard to responsible alcohol use after non-novel exercise. Although short-term anaerobic performance does not seem compromised as a result of acute postexercise alcohol ingestion, practitioners and athletes should be aware of potential long-term effects of such alcohol use.

Effects of Lifestyle on Muscle Strength in a Healthy Danish Population

BACKGROUND

Lifestyle is expected to influence muscle strength. This study aimed at assessing a possible relationship between smoking, alcohol intake and physical activity, and muscle strength in a healthy Danish population aged 20-79 years. Population study based on data collected from The Copenhagen City Heart Study (CCHS) and measurements of Isokinetic muscle strength from a sub-study of randomly selected healthy participants from CCHS.

METHODS

126 women and 63 men were studied. All participants completed a questionnaire regarding their lifestyle, including physical activity, alcohol intake and smoking habits. Isokinetic muscle strength was measured over the upper extremities (UE), trunk, and lower extremities (LE). Multivariate analyses including all of the variables were carried out.

RESULTS

The level of daily physical activity during leisure was positively correlated to muscle strength in the lower extremities (p = 0.03) for women, and lower extremities (p = 0.03) and trunk (p = 0.007) for men. Alcohol Intake was in general not correlated to muscle strength. No clear effect of smoking was seen on muscle strength.

CONCLUSION

Our results show that physical activity during leisure is associated with a positive effect on muscle strength in both sexes. When keeping alcohol intake within the recommended limits, alcohol does not seem to affect muscle strength negatively. No effect of smoking on muscle strength was found in our group of healthy subjects. The findings are of importance when considering recommendation on life style when wishing to keeping fit with age to be able to carry out daily activities.