Can exercise offset the risks of drinking alcohol?
Research tracking thousands of adults found that staying fit lowered mortality and liver disease risk among drinkers—though rising alcohol use still took a toll.
Over the past year, public health messaging about alcohol has shifted sharply. For decades, many people clung to the idea that a nightly glass of red wine might protect the heart. Now, both the World Health Organization and the U.S. Surgeon General have taken firm stances: no amount of alcohol is risk-free.
Yet alcohol remains deeply embedded in how we celebrate, socialize, and relax. Despite the risks, many people still feel it’s worth drinking at least occasionally. “The recent guidelines clearly say that if you avoid alcohol like 100 percent, that is the best for you,” says Javaid Nauman, a professor at the Institute of Public Health at the United Arab Emirates University. “But we know at human levels, I don't think that it will ever happen.” That reality has prompted a new question among researchers: Can exercise buffer some of alcohol’s long-term risks?
Emerging evidence suggests a cautious yes. Exercise appears to offer some protection, but it doesn’t erase the risks. Here’s what you need to know.
What does the research show?
Large longitudinal studies are beginning to clarify how fitness and alcohol interact over time. The most recent evidence comes from a 2025 study in Sports Medicine that followed more than 24,000 adults over 16 years and classified them as “fit” or “unfit” based on age, physical activity, resting heart rate, and waist circumference.
Researchers found that people who increased their alcohol intake and remained unfit (among the lowest 20 percent of participants) had a 44 percent higher risk of death than those who stayed fit and abstinent.
For participants who stayed fit, changes in alcohol intake didn’t increase mortality risk, except among those who began drinking during the study period. But even fit drinkers fared better than unfit abstainers. “It appears that a fit person who drinks moderately is more likely to live longer compared to an inactive non-drinker,” says Nauman.
Other alcohol researchers say the finding is striking—but biologically plausible.
“In some of the analyses from this study, it looks like fitness was even more important than alcohol intake. And I say, that’s entirely possible,” says Timothy Naimi, physician, alcohol epidemiologist, and director of the University of Victoria’s Canadian Institute for Substance Abuse Research.
A 2017 study in the British Journal of Sports Medicine supported this theory, finding that physical activity (within recommended guidelines of 150 minutes of moderate or 75 minutes of vigorous exercise) attenuated the association between alcohol intake and mortality risk.
(If you’re going to drink, what’s the ‘healthiest’ way to do it?)
Similar results show up in liver-related research, too: Another 2026 study in the Journal of Hepatology found that people who met weekly physical activity guidelines had lower liver mortality risk—even among heavy drinkers and binge drinkers. The benefits were more significant in women than in men. A 2024 study in Alcohol and Alcoholism examined high-risk drinkers for over 10 years and found that those who exercised at least 2.5 hours per week had reduced rates of alcohol-associated liver disease.
Still, none of these findings suggest that exercise neutralizes alcohol’s harm, says Nauman. “I wanted to find that it won’t matter how much people drink—as long as they’re fit, they’d be fine. That’s not the case,” he says. “Alcohol drinking is still bad for your health.” In the study, anyone—fit or unfit—who increased alcohol use over the years had an increased risk of death.
Why is exercise so powerful?
It’s not surprising that exercise protects against some alcohol risks, as this effect shows up across nearly every disease category, says Peter Kokkinos, director of the Center for Exercise and Aging at Rutgers University. “It reduces the risk of diabetes, of developing hypertension, kidney failure, Alzheimer’s, all kinds of cancer, all kinds of major chronic diseases that afflict the human body,” he says.
The reason exercise has such a protective effect is that it makes the body more resilient. “Once the muscles are under demand, all other systems have to follow to meet that demand,” says Kokkidos.“That’s why when you’re not doing anything, the heart weakens, the muscles, every system weakens.”
For example, Kokkidos points to the arteries. Regular exercise causes them to expand, while regular drinking can result in plaque buildup. “Let’s say you and I have the same volume of plaque in our arteries. However, your artery is double the diameter of mine,” he says. “So if my plaque blocks 50 percent of the diameter of the artery, yours blocks only 25 percent.” That extra margin can be what prevents a stroke or heart attack.
(Alcohol is killing more women than ever before.)
The liver also gets hit hard by alcohol, but responds well to exercise. “The liver loves exercise,” says Elliott Tapper, academic chief of hepatology at the University of Michigan Health, who focuses on improving quality of life and reducing symptoms in patients with liver damage. Alcohol encourages the liver to retain fat, which becomes inflamed, he says. But resistance training improves insulin sensitivity and helps clear fat from the liver. “Pound for pound, even people who don’t lose weight, people who start exercising can have better looking livers under the microscope,” he says.
There’s also a possible feedback loop. Regular exercise may reduce alcohol intake over time, possibly by improving mood, reducing stress, or shifting social habits. While research results are less definitive, Naimi and Tapper have both seen it anecdotally.
What the studies can’t tell us
As compelling as the findings are, they come with important caveats. In the 2025 study, cardiorespiratory fitness wasn’t assessed with physical activity testing or performance measurements. Instead, the study used a validated non-exercise prediction model based on age, waist circumference, resting heart rate, and self-reported physical activity. That approach is widely used in large population studies, but it’s still an estimate—not a direct measurement.
(Eight things we’ve learned about how alcohol harms the body.)
There’s also the issue of what fitness represents. “Fitness is also a potent marker of just whether or not one is healthy, writ large, because people, for example, if they have a lot of underlying medical conditions, it’s hard to be fit,” says Naimi. Basically, it’s difficult to fully separate the benefits of exercise from the benefits of simply being healthier overall. “If we wanted to sort of trivialize the findings, we could say that somebody who’s extremely unhealthy is more likely to die than somebody who's healthy,” he says.
Broader structural systems are also at play. “On average, the ill effects of alcohol are worse for people with lower socioeconomic status, lower income, lower educational attainment, and poor nutrition,” says Tapper. “The exercise might be doing something, but it's more likely a sign of a variety of other things that come along with the luxury of being able to add more exercise into one's day-to-day activities.”
Even in large studies, the heaviest drinkers are often underrepresented, says Naimi. In the 2025 study, anyone drinking more than the recommended weekly limit—defined as 10 or more drinks per week for men and five for women—was grouped into a single category. That means someone having 11 drinks a week was lumped in with someone drinking 30. The protective benefits might not extend to patterns of alcohol abuse or binge drinking.
This is important because when it comes to liver damage, exercise alone isn’t enough. “Binge drinking will chew through a liver in a few years. Once you've developed liver damage or you have true liver disease, I’m not sure that diet or exercise is going to be able to reverse that without significantly cutting back on the amount of alcohol,” Tapper says. “That being said, if you do cut back on the amount of alcohol, it is never too late to stop. A liver that's so sick can become healthy. Sustaining that probably requires changes in lifestyle.”
So if you do work out, how much do your bad habits matter?
The research points to a clear hierarchy. Reducing alcohol lowers risk. Improving fitness lowers risk. Doing both offers the greatest protection.
But exercise has limits. For people drinking at higher levels, including those with alcohol use disorder or frequent binge patterns, reducing alcohol intake may be a necessary first step before physical activity can meaningfully shift risk. “The curse of alcohol is that we see so many people sick from it,” says Tapper. “But the flip side is that when you stop drinking, there’s a very good chance that so much of your life is going to get better.”
