Study finds that alcohol affects muscle mass in postmenopausal women

Women after menopause may think that drinking a couple of glasses of wine or liquor or a bottle or two of beer a day is harmless and a way to help reduce stress and unwind.

But, plain and simple, consuming even two drinks a day may adversely affect, among other things, skeletal muscle mass — a problem known as sarcopenia — with attendant health risks that can include early frailty.

Other studies have linked alcohol with various mental and physical health risks, more recently including dementia and breast cancer.

Now a Korean study published last week in the journal Menopause provides evidence that highrisk drinking diminishes muscle health by hindering production of muscle proteins while also adversely affecting other proteins that regulate muscle building. Alcohol also can produce an inflammatory response detrimental to muscles.

Bottom line, the study says, “High-risk alcohol drinking was associated with a higher risk of sarcopenia in postmenopausal women.”

The findings were strong enough to convince the North American Menopause Society, known as NAMS, to issue a news alert, warning women against alcohol consumption beyond a few drinks a week or, at most, one a day.

“I think the study is provocative and makes you think about what you are doing to stay healthy as you age,” said JoAnn Pinkerton, NAMS executive director. She said she monitors women’s health studies regularly and found the Korean study to be notable.

Drinking alcohol also may interact with other lifestyle factors to exacerbate muscle deterioration in aging women. Such factors can include inactivity, poor nutrition and smoking, the study says.

“Several previous studies have already found that blood pressure and cholesterol are associated with sarcopenia,” it states. “Unhealthy habits, such as smoking and alcohol drinking, could interact with one another. In our study, after adjusting for these confounding factors, there are significantly higher

odds for sarcopenia in the high-risk alcohol-drinking group.”

Study limitations include the fact it was observational, which means the results were based on population trends and not drawn from a randomized clinical trial. It also was cross-sectional, meaning the data is limited to one point in time. The fact it involved 2,373 Korean women also raises potential that the impact is limited to Asian women.

In the study, high-risk drinking is defined as 15 or more drinks per week.

Less than 8 percent of women whose alcohol consumption ranged from no drinks to seven a week experienced sarcopenia. Eight to 14 drinks per week, described as moderate drinking, raised that level to 11 percent, with nearly 23 percent of women drinking 15 or more drinks per week experiencing sarcopenia. Once the statistics were adjusted for other factors, the study concluded that excessive drinking increased the risk of sarcopenia 4.3 times higher than the lowriskgroup.

Excessive alcohol consumption can produce various health impacts including malnutrition, weight loss and muscle deterioration, all raising the risk of frailty, which, Dr. Pinkerton, also a professor of obstetrics and gynecology at the University of Virginia, said is important to avoid as we age.

“A 90-year-old whose brain is intact and who is active with good muscle mass and engaged in life is less likely to fall and receive a fracture,” she said. “Take the same woman 30 pounds lighter, who is emaciated or with little muscle mass, who trips going to the bathroom. If she falls, she will be more likely to have fractures, which are often life-changing and may be life-threatening.”

Exercise helps bolster muscle health, but it’s not yet known whether it can offset the impacts of alcohol, she said. Getting sufficient dietary protein, physical activity and vitamin D also are important in maintaining healthy muscle mass.

Estrogen therapies after menopause could have a positive impact, she said, given that skeletal muscle cells have estrogen receptors. But the hormone’s impact on muscle health is not yet clear, with some concern and continuing debate about a small increase in the risk for breast cancer for those receiving a combination of estrogen and progestogen therapy over longer periods of time.

“Would we recommend estrogen therapy to prevent sarcopenia? We’d say no,” she said. “But there might be benefits in muscle mass from it.” More studies are necessary on that topic, as well.

Eliminating alcohol altogether might be the best bet for muscle health, but one drink a day is relatively safe, Dr. Pinkerton said, based on her analysis of study results.

“Postmenopausal women should limit their drinking,” she said. “One glass a day should be the limit and may still increase the risk of breast cancer. Flipped the other way, what if you want to stay as healthy as you can as you age, increase muscle mass and eliminate fat? To do that, you have to limit alcohol, get at least seven hours of sleep and include strength training. We also must look at each woman and decide about whether estrogen therapy is beneficial at menopause.”

Healthy stress reduction is possible through exercise, conversation, meditation, mindfulness, yoga, reading and use of hot tubs or other relaxation tools.

“Alcohol is neither helping their stress nor their health,” Dr. Pinkerton said. “It would be way healthier for both men and women to limit drinking, not drink every day, and decrease stress in more healthy ways.”