Dr Justus Apffelstaedt: Wine and cardio – Why a glass won’t hurt your endurance

In my last column, I reviewed the scientific evidence with respect to wine and resistance exercise; i.e. the exercise that builds bulk muscle. In this column, I will look at recommendations concerning endurance or cardiovascular exercise with recommendations for the average couple Jane and John Smith who want to live healthily.

Jane and John are just like you and me: Two to three times a week they don their jogging shoes and head out for a 5-km run or put on the speedos and do a couple of laps in the pool; in the weekends they get on the bike and do the coffee run. How does their enjoyment of a glass of good wine with dinner impact on their athletic performance?

A couple of introductory remarks: First, alcohol abuse leads to muscle atrophy and cardiovascular compromise and is mentioned here only to be condemned. Second, when combing through the medical literature, while there are good data indicating that athletes are normal people and consume alcoholic beverages including wine just like you and me, there is an astonishing paucity on data how this impacts their performance. It is the more striking, that “sports nutritional experts” advertising their services and wares in the media often are very long and strident on opinion in this matter but base these opinions evidently on very little data. So, what is the evidence?

There are key components in wine that are of interest for physical fitness: Alcohol, antioxidants, minerals, vitamins and carbohydrates. The latter three are easier obtained from other sources as their concentrations in wine are low. Alcohol as such has been examined in detail. There is general agreement that from a blood alcohol concentration of 20 mmol/L the endurance performance declines directly in proportion to the increased blood alcohol concentration. However, a blood alcohol concentration of 20mmol/l corresponds to a more easily understood 1 promille, about twice the legal limit for driving a car in South Africa. It represents a stage of moderate inebriation. Performance suffers as multiple metabolic processes involving glucose and fat metabolism are impaired; energy supply to and utilization by muscle are compromised.

But not only that, also the recovery after exercise takes longer and is less complete. But then, everybody who has tried it will know that exercising while drunk is difficult; not only muscle metabolism but also other important aspects of physiology like coordination, thermoregulation, hydration and cardiovascular function suffer. I wish to posit here that the lab scenario is far from the reality of daily life.

To find a better approximation of what happens in real life, one must dig deep into the scientific literature. In a detailed examination of endurance performance Swiss researchers in the 1980s evaluated one tenth of the entire intake of the Swiss armed forces. Some 8,000 individuals were examined in the lab as well as in a field test. The results showed that the endurance performance did not differ between teetotallers and those who consumed alcoholic beverages. As a marker of the scientific quality of the research, even light smokers had a significant decreased performance versus the non-smokers. This leads to the conclusion, that the enjoyment of wine in moderate quantities will not impair cardiovascular exercise performance.   

As for the other main component in wine, antioxidants have been shown convincingly in laboratory settings to enhance muscle recovery after endurance exercise. In the real world, however, this has not been confirmed as convincingly. In my opinion, this has been due to the concentration of the research on a single substance, resveratrol, which is only one of the many antioxidants in wine. As a reminder: Of all foodstuffs, wine offers the highest concentration of antioxidants together with blueberries.  

But what about Jane and John Smith who exercise regularly in the morning and enjoy their glass of wine in the evening and don’t drink to excess? Here, the scientific point of view is that both exercise and wine enjoyment will not only enhance quality of life but also quantity. Muscle performance is not all; the beneficial effects of wine enjoyment for cardiovascular disease prevention will ensure, that Jane and John will be able to exercise together to a much older age than their abstinent peers. Cheers to that!

• Dr. Justus Apffelstaedt is a specialist in breast and thyroid health, leading Apffelstaedt & Associates in Cape Town and Windhoek. A surgeon with a specific interest in surgical oncology and researcher, he was Associate Professor of Surgery at Stellenbosch University (1994–2017) and Head of Surgical Oncology, managing 1,000-plus cancer cases annually. He has more than 50 publications, shaped South Africa’s breast cancer screening policy, and co-founded Breast Surgery International. A sought-after speaker, he has given over 100 international lectures. He also holds an MBA and a Diploma in Wine. Through Apffelstaedt & Associates, he continues to advance specialized, patient-centered care in Southern Africa.