Acute Effects of Brief Exercise on Alcohol Craving Among Young Adults With Problematic Alcohol Use: A Systematic Review

Abstract

Alcohol craving is a key process in alcohol abuse, especially during young adulthood, a period of heightened vulnerability and continued brain development. Although acute physical exercise has been proposed as a potential strategy to reduce craving and modulate affective and cognitive processes, current evidence remains limited regarding its effectiveness and underlying mechanisms. This systematic review examined the effects of brief exercise interventions on alcohol craving in young adults with problematic alcohol use or alcohol use disorder (AUD) and explored available evidence on associated neurobiological responses. Four electronic databases were searched for studies published between 2016 and 2026 following PRISMA guidelines. The review protocol was registered in PROSPERO (CRD420261371036). Eligible studies included participants aged 18–29 years and assessed alcohol craving following a single bout of exercise. Random-effects meta-analyses using Hedges' g were conducted when sufficient data were available, while additional outcomes were synthesized narratively. Six studies met the inclusion criteria. Meta-analysis showed a moderate and statistically significant reduction in alcohol craving following acute exercise compared with baseline or control conditions (g ≈ 0.55), with moderate between-study heterogeneity. Narrative findings indicated that acute exercise was often accompanied by reductions in anxiety and negative affective state, modulation of stress-related physiological markers, improvements in executive functioning, and changes in indices of brain and autonomic activity, although findings varied across studies. Overall, available evidence suggests that a single session of physical exercise may be associated with short-term reductions in alcohol craving in young adults, highlighting the need for further clinically focused and methodologically robust research.