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Phil Cavell: ‘If you’re over 50 you should think seriously about when and how much you drink’

Phil Cavell
9 Jun 2022

In his ongoing quest to sort fact from fiction for the older cyclist, Phil Cavell looks at the physical effects of alcohol

The party in the neighbouring camp went on all night. There was a brief hiatus around dawn as we fixed breakfast and checked our bikes over for our mountain-bike race later in the day.

Eventually the neighbouring youngsters spilled out of their tents just in time to fill bottles, grab bikes and head to the start line.

The most pallid youth paused momentarily to vomit all over his tent before wobbling off. An hour or so later they were back in high spirits – the vomiting kid had won his race in grand style. Youth is indeed wasted on the young.

Was this an example of alcohol bestowing a mechanistic advantage upon human physiology and performance? Or youth and natural talent overcoming the deleterious effects of the world’s most ubiquitous toxin, ethanol? And could this relationship change as we age and try to perform athletically at a high level?

Let’s examine that first point – is there something performance-enhancing about ethanol? The timeworn homily says that ‘a little bit of what you like does you good’ and, somewhat reassuringly, the science for many decades seemed to align behind this view.

Studies have shown that there is a J-curve relationship between alcohol consumption and cardiovascular protection – that is, the deflection from good to harmful happens quite suddenly and at a comparatively low level.

Initially, the positive influences were attributed to compounds such as polyphenols or flavonoids in red wine. More latterly research has focussed upon the concept that ethanol confers protection from something called ischemia reperfusion (IR).

IR is the return to normal blood supply (perfusion) after a period of deficit (ischemia), which can lead to localised inflammation and tissue damage. Low levels of alcohol have been linked, in some studies, to a reduction in IR damage.

This is a controversial subject and I think most clinicians would counsel against drinking in the belief it bestows a health/performance benefit, even in low volumes. Actually, the medical community seems to be moving in the opposite direction.

A study published in The Lancet (2018) that looked at data from 195 countries concluded, ‘Our results show that the safest level of drinking is none.’

Old peculiar

Bike beer

Image: Cyclist

To the second point – does our relationship with alcohol change as we age? Predictably, it does.

People tend to increase their alcohol consumption as they age, at a time when the body is less able to metabolise it.

This is firstly because of the reduced effectiveness of the enzymes involved in breaking down ethanol in the ageing liver; secondly because we tend to be more hydrated when we’re young – muscles contain more water than fat – and as we age this results in higher net levels of toxicity compared to our younger selves.

So what to do? If you’re trying to achieve fitness and performance into middle age, it’s important to accept that alcohol is a toxin, and the body will preference its metabolism over almost anything else – a problem if you’re also trying to burn fat. Consider avoiding alcohol the day before a long ride.

Ethanol can also take a wrecking ball to well-orchestrated sleep architecture (the subject of a future column).

A couple of drinks may feel like the fast lane to snooze-town but they can deviate you up an REM bypass where your normal 90-minute sleep cycle, which should transition you through to slow-wave and REM sleep, where the serious recuperation takes place, is effectively detoured. Now you are awake at 3am, unrested, boiling hot, with a raging thirst.

More concerning is the effect alcohol can have on the heart’s natural timing mechanisms. Even low doses have been linked to a higher incidence of atrial fibrillation (AF) – typically presenting as a faster or racing heartbeat.

A recent study in European Study Of Cardiology found that one drink a day represents a 16% increased risk of AF and two drinks a 28% increased risk. AF itself is not generally serious, but it will inevitably cause concern, interrupt training, and need to be treated.

Real world application

Zolder beer machine

Image: Jordan Gibbons

WorldTour team physician Dr Dave Hulse says, ‘Alcohol is a stressor – purely in terms of training and recovery, alcohol doesn’t fit well with the biochemical adaptations we’re trying to promote.’

Nevertheless, the reality is alcohol is double-stitched into the fabric of our culture, and virtually impossible to avoid. Most of us drink because it’s convivial, fun and relaxing, and we should not underestimate its social value.

But if you’re over 50 and riding hard, you should maybe think seriously about when and how much you drink. Perhaps even take an alcohol moratorium leading up to a big event? You will sleep and recover better and may also be able to train harder as a consequence.

Back to our retching youth at the start of this piece. He won his race because he was sufficiently well trained and talented to overcome his boozy excess.

He won despite the alcohol and not because of it. But I estimate he will now be around 43 years old, and the rules for booze will be very different for him today.

Phil Cavell is co-founder and bikefitter at Cyclefit in London. His book The Midlife Cyclist is published by Bloomsbury

Author photo: Danny Bird, main image: Tim de Waele via Getty. Apologies to young Thibaut Pinot for implying he's over 50.

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