Effects of Beer and Wine Consumption on Metabolic and Endocrine Health Outcomes in Relation to Physical Activity: A Systematic Review

Background/Objectives: Physical activity is a cornerstone of preventive health, yet its practice often coexists with the consumption of alcoholic beverages like beer and wine. While these beverages contain bioactive compounds with potential health properties, alcohol itself carries significant risks. This systematic review aimed to synthesize and critically assess the evidence on physical activity and beer and wine consumption. Specifically, we examined their combined effects on metabolic syndrome components (body composition, blood pressure, lipids, glucose metabolism); inflammation and oxidative stress markers; mental health outcomes (cognitive function, mood, sleep); and physical performance, neuromuscular recovery, and fluid balance. Methods: Following a pre-registered protocol (PROSPERO: CRD420261281945), a systematic search of PubMed/MEDLINE, Scopus, and SPORTDiscus was conducted for studies published between 2000 and 2025. Included studies were randomized controlled trials or observational studies involving physically active adults (aged ≥ 18 years) who consumed beer or wine. Studies focusing solely on sedentary populations were excluded. Outcomes assessed included metabolic syndrome components, inflammation, oxidative stress, mental health, cognitive function, and physical performance. Risk of bias was evaluated using Cochrane RoB 2 for RCTs and ROBINS-I for non-randomized studies. Results: Eight studies were included. Moderate beer or wine consumption did not substantially negate the beneficial effects of exercise on cardiometabolic health, body composition, or cognitive function. Higher alcohol intake was associated with elevated blood pressure. Acute post-exercise consumption of alcoholic beer impaired rehydration and neuromuscular recovery, whereas non-alcoholic beer did not. Conclusions: Given the small number of studies and risk of bias, these findings should be interpreted with caution. In physically active populations, moderate beer or wine consumption does not clearly undermine the benefits of regular exercise on metabolic syndrome components (body composition, blood pressure, lipids, glucose metabolism). No additional benefits on inflammation or oxidative stress were observed, nor on mental health outcomes (cognitive function, mood, or sleep). However, acute post-exercise alcohol intake impairs rehydration and neuromuscular recovery, whereas non-alcoholic beer represents a safer alternative.