15分钟步行或可减轻酒精渴求

由英国埃克塞特大学的Adrian H. Taylor博士带领完成的一项研究显示，短暂的疾行可减轻酗酒者的饮酒欲望。

该研究结果印证了另一项研究的结果，即中等强度的运动可减轻对食物和烟草的渴求信号，但这项研究首次报告了一段中等强度的运动可显著减轻对酒精相关图像的注意偏向及自述的渴求（Ment. Health Phys. Act. 2013 Sept. 20 [doi: 10.1016/j.mhpa.2013.09.004 ]）。之前的一项关于被诊断为酗酒者的研究发现，酒精渴求可在短暂运动期间而非之后得到减轻（Addict. 2004;99:1542-7）。



注意偏向，即注意力集中于受情绪主导的刺激物的倾向，在心理渴求研究中是一项重要指标，因为它不依赖于研究对象的自述，而依赖于对研究者所展示的图像的视觉注意力。在本研究中，研究者测量了关于酒精图像的两类注意偏向——初始注意偏向（initial attentional bias，IAB）和持续注意偏向（maintained attentional bias，MAB）。

Taylor博士和其同事招募了20名志愿者（平均年龄20.8岁，11名女性）进行这项研究，这些人并非寻求治疗的酗酒者，但自述饮酒量较大。女性自称每周饮酒不低于14个酒精单位，男性自称每周不低于21个酒精单位。研究对象被随机分配静坐15分钟不接触任何读物或其他刺激物，或在跑步机上进行15分钟中等强度步行。在静坐或步行之前和之后，参与者分别完成一项匹配中性图像或酒精图像的任务，图像随机展示200毫秒以测量IAB，或展示1秒以测量MAB。在静坐或步行之前及之后分别发放1份和3份标准化酒精渴求度问卷，以收集自述渴求的相关信息。研究结果显示，与对照组相比，运动组的MAB显著降低（P=0.058），自述的渴求也显示出下降。

Taylor博士及其同事表示，运动期间运动影响酒精渴求的介导机制尚不明确。饮酒可调整情绪并减轻负面感受。或许运动同样可以在某种程度上增强情感，从而降低把酒当作快感和奖赏来源而饮用的渴求和效果。动物研究表明药物成瘾涉及到多种神经生物学机制，并可通过运动调节，其中包括多巴胺、谷氨酸盐、去甲肾上腺素、阿片类药物、蛋白激酶A （ PKA）、细胞外信号调节激酶和脑源性神经营养因子。但研究者们承认他们无法排除干预组中所观察的效果与注意力分散而非身体活动有关的可能性，未来的研究应再纳入一组研究对象，在测试前将允许他们看电视或参与其他可分散注意力的活动。研究者还列举了另一个局限性：参与者并非经临床诊断的酗酒者，而只是自称饮酒较多。要确定短暂运动是否有助于减少饮酒者的酒精渴求，仍需做进一步研究。但是，这些结果对实践具有一定的意义：对于感觉到酒精渴求的患者来说，短暂的疾行可能是管理渴求的一项诱人的自助策略，并可达到即刻缓解。

作者们未接受任何外部资助，Taylor博士及其合著作者均无任何利益冲突。

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By: JENNIE SMITH, Internal Medicine News Digital Network

A short, brisk walk can reduce the urge to drink alcohol among heavy drinkers, a group of researchers has found.

The results of the study mirror findings from research showing that moderate exercise can reduce signals of food and cigarette cravings. However, this was the first study to report that a single session of moderate exercise can significantly reduce attentional bias toward alcohol-related images as well as self-reported cravings (Ment. Health Phys. Act. 2013 Sept. 20 [doi: 10.1016/j.mhpa.2013.09.004]). A previous study in diagnosed alcoholics found that alcohol cravings were reduced during a brief period of exercise but not after it (Addict. 2004;99:1542-7).

Attentional bias, the tendency to focus on emotionally dominant stimuli, is an important measure used in studies of cravings, as it relies not on self-reporting but on visual attention paid to images presented by investigators. In the current study, led by Adrian H. Taylor, Ph.D., of the University of Exeter, in Devon, England, investigators measured two types of attentional bias – initial and maintained – related to alcohol imagery. The latter was found to be significantly reduced in the group that had exercised, compared with the controls. Self-reported cravings also were shown to be reduced.

For their research, Dr. Taylor and his colleagues recruited 20 healthy volunteers (mean age, 20.8 years; 11 women) who were not alcoholics seeking treatment but who self-reported drinking heavily. The women reported drinking 14 units of alcohol or more per week, and the men reported drinking 21 units or more per week.

Subjects were randomly assigned either to 15 minutes of sitting without access to reading materials or other stimuli or to 15 minutes of moderate walking on a treadmill. Before and after the period of sitting or walking, participants completed a task that matched neutral and alcohol images randomly presented for either 200 ms to measure initial attentional bias (IAB) or 1 second to measure maintained attentional bias (MAB). A standardized Alcohol Urge Questionnaire also was administered before, and three times after, the period of sitting or walking to collect information on self-reported cravings.

The study’s results showed that MAB was significantly reduced after exercise, compared with the control condition (P = .058).

The mechanisms mediating the effect of exercise on alcohol urges during exercise are unclear, Dr. Taylor and his colleagues said. Drinking alcohol regulates moods and reduces negative feelings. Perhaps exercise also enhances "affect and mood in a way that reduces drinking urges and salience of alcohol as a source of pleasure and reward." Animal research has suggested that numerous neurobiological mechanisms are implicated in drug use and might be modifiable by exercise, "including dopamine, glutamate, norepinephrine, opioids, PKA [protein kinase A], extracellular signal-related kinase, and brain-derived neurotropic factor," they wrote.

However, the investigators also acknowledged that they could not exclude the possibility that the effect seen in the intervention group was tied to distraction rather than physical activity. Future studies, they said, should include a third arm of subjects who would be allowed to watch television or participate in other distracting activity prior to being tested. Another limitation cited by the investigators was the fact that participants were not clinically diagnosed as alcoholics but self-reported as heavy drinkers.

Further research is needed to determine whether short bursts of exercise could help reduce alcohol cravings in people prone to them, the authors wrote. However, they said, the findings had some immediate implications for practice: "A short, brisk walk may be an attractive self-help strategy to manage cravings and provide immediate relief for those experiencing alcohol urges."

The authors received no external funding, and neither Dr. Taylor nor his coauthors had conflicts of interest.