Exercise improves physical, mental health in people with alcohol use disorder

Key takeaways:

• Patients with alcohol use disorder who underwent exercise interventions saw improvements in physical and mental health.
• Exercise interventions also significantly reduced daily alcohol consumption.

Exercise interventions reduced daily alcohol dependence and significantly improved physical and mental health, like heart rate and anxiety, among patients with alcohol use disorder, according to a systematic review and meta-analysis.

“Given the dual effects of a low rate of medical treatment and a high rate of relapse, the burden of alcohol use disorders on society is increasing, and there is an urgent need to seek alternative means to assist in the clinical treatment of AUD, improvement of physical and psychological status of AUD patients and reduction of recurrence of AUD symptoms,” Jihai Li, of the Institute of Physical Education at Xinjiang Normal University in Urumqi, Xinjiang, China, and colleagues wrote in PLoS One.

“Although many experiments have verified the effects of physical activity interventions on alcohol dependence and improving the physical and mental states of AUD patients, the conclusions are still controversial,” they added.

Li and colleagues searched the databases of PubMed, Web of Science, Cochrane Library, EBSCO and Embase to conduct a systematic review and meta-analysis of 17 randomized controlled trials published in English (United States, n = 8; Asia; n = 4; Europe, n = 5), including 1,905 patients with alcohol use disorder from the time the databases were created to June 30, 2024.

The researchers divided the participants into 17 experimental groups and 21 control groups. Those assigned to the experimental groups underwent planned exercise interventions for at least 2 weeks while maintaining their regular treatment or life.

The interventions included aerobic exercise, resistance exercise, yoga and combined exercise. The researchers categorized exercises into three levels of intensity: high, medium and low.

Single interventions ranged from 30 minutes or fewer, 30 minutes to 60 minutes or more than 60 minutes. The intervention period ranged from 12 weeks or less to more than 12 weeks.

Outcome indicators for alcohol dependence included daily alcohol consumption, weekly alcohol consumption and Alcohol Use Disorders Identification Test (AUDIT) scores. For physical and mental health, outcome indicators included maximal oxygen uptake (VO₂ max), resting heart rate and anxiety, depression and stress levels.

Compared with the control groups, exercise interventions did not have a significant effect on weekly alcohol consumption (standardized mean difference [SMD] = –0.14; 95% CI, –0.224 to –0.656) among patients in the experimental groups, according to the researchers.

However, exercise interventions did significantly reduce daily alcohol consumption (SMD = –0.661; 95% CI, –1.033 to –0.288) and AUDIT scores (SMD = –0.36; 95% CI, –0.62 to –0.1) among patients in the experimental groups compared with the control groups.

“The changes in two of the three outcome indicators of alcohol dependence (daily alcohol consumption, AUDIT) were statistically significant, indicating that exercise has an effective intervention effect on alcohol dependence in AUD patients and can be used as an adjunctive treatment for AUD,” the researchers wrote.

They also observed that exercise interventions significantly improved VO₂ max (SMD = 0.406; 95% CI, 0.116 to 0.697), resting heart rate (SMD = –0.863; 95% CI, –1.438 to –0.2288), anxiety (SMD = –0.791; 95% CI, –1.369 to –0.213), depression (SMD = –0.86; 95% CI, –1.409 to –0.31) and stress (SMD = –2.127; 95% CI, –3.91 to –0.344) among patients in the experimental groups compared with the control groups.

“The changes in the five outcome indicators of physical and mental status were statistically significant ... which proves that exercise can be an adjunctive means of improving the quality of life and reducing the relapse rate of AUD patients in conjunction with clinical treatments,” the researchers wrote.

Li and colleagues noted that after using Egger’s test, they found no publication bias for any of the outcome indicators (P > .05) despite the high heterogeneity of daily alcohol consumption, anxiety, depression and stress.

They acknowledged several study limitations, including the ambiguity in its design and the fact that the included randomized controlled trials were published in English only. In addition, they were unable to determine whether the effects differed based on exercise type duration and intensity.

“Therefore, this study calls for future studies to carefully differentiate between the types of exercise and exercise intensity and to analyze the effects of exercise of different natures on alcohol dependence more deeply to develop the most suitable exercise prescriptions for the clinical treatment of AUD according to different populations,” Li and colleagues wrote.