NASM CNC Chapter 9: Alcohol
NASM CNC Chapter 9: Alcohol

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Chapter Goals:

  • Explain the functions and structure of alcohol.
  • Describe the absorption and digestion of alcohol.
  • Find other effects of alcohol.
  • Know the key myths or other hot topics regarding alcohol.
  • Find the methods for accommodating alcohol within a dietary. 


Ethanol is the form of alcohol that we take into the body in alcoholic beverages.

Alcohol is the most commonly consumed drug, with around 1.6 gallons consumed per person over 15 years of age every year.

Other alcohols that are common are going to be isopropyl, and methyl alcohol. These are used in medical settings only, as they are extremely toxic to the body. 

Alcohol Structure and Function

Ethanol is made from glucose , and the two stay very similar in their structure. Both glucose and alcohol are made up of carbon, hydrogen, and oxygen. Glucose has six carbons and five hydroxyl groups, and the ethanol has two carbons and one single hydroxyl group. 

The metabolism of ethanol is not regulated through hormones and there is no storage area for ethanol in the body. 

Ethanol is not essential in any way in the body, and thus it will be seen as a threat to homeostasis. The body then is forced to remove it from the body rather quickly and in front of the prioritization of other macronutrients. 

Alcohol Absorptions

When alcohol is taken in, some of it is immediately metabolized in the stomach lining by the alcohol dehydrogenase. This is known as the first pass metabolism. The majority of the alcohol is actually going to be passed via the blood without being altered in any way. The alcohol reaches the small intestine and the stomach by pure diffusion alone. The solubility in water of ethanol allows for the diffusion to occur in mot tissues. The rate of absorption of alcohol depend on many factors like sex, body mass, the type of drink taken in, if your stomach is empty or not, and the speed through which the drinks are taken in.

Alcoholic beverages and food

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It is somewhat true that you should not consume alcohol while you have an empty stomach. No food in the stomach is a main determinant to how quickly the alcohol will be put in the bloodstream. Food slows absorption but also increases the rate of metabolization of the alcohol. 

Sex and body composition

The rate of metabolization and absorption is similar in males and females, but typically females will result in a higher blood alcohol content due to many physiological differences. Males are usually about 68% water and females usually 55%.

Metabolism of Ethanol

When alcohol is in circulation through the body , 90% is metabolized by the liver by the ADH at around a quarter of an ounce per hour. The remaining 10% of alcohol is then put out via breathing, sweat, and even through urine. 

The Dietary Impact of Alcohol

Programming alcohol into a diet is completely unnecessary, but we need to often consider it due to alcohol being popular and socially acceptable. So, it is unrealistic now to expect it to not be present in someone’s diet in some way.

Alcohol Intake Guidelines

Alcohol, if it needs to be taken in, should be done so in a very moderate consumption. Moderate drinking is seen as one standard drink that has 0.6 ounces of ethanol for women, and up to two drink for males. It is considered to. Be high risk drinking when a woman consumes four or more drinks per day or 8 or more drinks per week. For men, five or more drinks per day, and 15 or more in a week is high risk drinking.  

Binge drinking is one single time of more than four or five standard drinks by either male or female. 

Some harms to physical health

  • Behaviors relating to too much risk taking, possible injury and death as a result. 
  • Unconsciousness.
  • Irritation of the gut and diarrhea. 
  • Inflammation of your pancreas.
  • Problems sexually.
  • Some harms to mental health
  • Suicidal thoughts and possible behaviors.
  • Increases in stress and aggravation in general.
  • Aggravation with sleeping disorders.

Defining a Drink

Alcohol content of alcoholic beverages ranges greatly, so it is important to not the percentages of alcohol contained in them. Beer is usually 4 – 5% and then spirits can be over 40%. 

Accommodating Alcohol into a Healthy Diet

Some alcoholic beverage like beer will contain carbohydrates and some vitamins and minerals. Wine may have some polyphenols, flavonoids, and antioxidants. Ethanol though is just a source of empty energy essentially. 

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So, once we have met our goals in terms of nutrition, we must consider these empty calories into our calorie goals.

Alcohol and Body Consumption

Ethanol may have some influence on body composition due to it being stored as fat. But, this depends on a lot of things. 

Monitoring Alcohol Use

It is essential to know what your client drinks and takes in as far as alcohol goes. 

We use 3 questions to determine the alcohol consumption of someone. 

How often do you have a drink with alcohol in it?

How many drinks with alcohol do you have on a usual day?

How often do you have (5 for men, and 4 for women or men over 65 years old) or more drinks at one time?

The Physiological and Health Effects of Alcohol

The recommendations of ethanol consumption in moderate levels  comes from detrimental acute and chronic physiological effects that ethanol has on the body. 

The regular consumption of moderate to harmful levels of ethanol is directly linked to more than 200 health conditions. 

Health Effects of Alcohol

  • Brain = hangovers, slowed reaction time, loss of memory, and headaches.
  • Lungs = infection increases, more risk for pneumonia.
  • Liver = scarring, organ failure, Cirrhosis.
  • Feet = Painful nerve problems, numb feelings, and tingling in the toes.
  • Throat = possible cancer.
  • Heart = heart failure chance, lowered heart rate, weakening of the heart.
  • Stomach Intestinetine = Burning, bleeding, ulcers, malnutrition, diarrhea, vomiting, severe swelling.
  • Hands = Trembling in your hands, numbness, and tingling in the fingers.

Effects on the Central Nervous System

The effects get worse as the blood alcohol content starts to go up. We see effects begin around 0.03 blood alcohol content. 

Effects on the Cardiovascular System

Drinking alcohol is going to increase acute effects in heart rate, and slightly in blood pressure. 

Chronic consumption sees increases in the risk of coronary artery disease and alcoholic cardiomyopathy.

Effects on Immune and Hormonal Function

Chronic consumption sees altered immune function. As shown in the infectibility of chronic alcoholics. So, all together, it is very likely to see decreases in immune function.

Alcohol Myths and Hot Topics

Lots of misinformation exists for alcohol, like it does with the other macronutrients. 

Ethanol Helps Protect the Cardiovascular System

Light to moderate consumption has been suggested to reduce mortality and protect from cardiovascular disease and even from strokes. So, daily consumption of wines is an actual recommendation made for a healthy diet. 

Drinking Ensures a Good Night’s Sleep

Alcohol seems like an ideal way to get a good night of sleep due to its depressant effects. But, unfortunately the ethanol can negatively affect the sleep quality, and the REM cycle as a whole. 

Alcohol Improves Athletic Performance

Short duration events like sprints do not seem to be affected in any way, even with higher blood alcohol contents. 

NASM CNC Chapter 9: Alcohol 4
NASM CNC Chapter 9: Alcohol 5
NASM CNC Chapter 9: Alcohol 6

Tyler Read

Tyler Read, BSc, CPT. Tyler holds a B.S. in Kinesiology from Sonoma State University and is a certified personal trainer (CPT) with NASM (National Academy of sports medicine), and has over 15 years of experience working as a personal trainer. He is a published author of running start, and a frequent contributing author on Healthline and Eat this, not that.

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