Skip to main content
Erschienen in: European Journal of Applied Physiology 5/2010

01.03.2010 | Original Paper

Effect of hyperventilation and prior heavy exercise on O2 uptake and muscle deoxygenation kinetics during transitions to moderate exercise

verfasst von: Lisa M. K. Chin, George J. F. Heigenhauser, Donald H. Paterson, John M. Kowalchuk

Erschienen in: European Journal of Applied Physiology | Ausgabe 5/2010

Einloggen, um Zugang zu erhalten

Abstract

The effect of hyperventilation-induced hypocapnic alkalosis (HYPO) and prior heavy-intensity exercise (HVY) on pulmonary O2 uptake \( (\dot{V}{\text{O}}_{{ 2 {\text{p}}}}) \) kinetics were examined in young adults (n = 7) during moderate-intensity exercise (MOD). Subjects completed leg cycling exercise during (1) normal breathing (CON, PETCO2 ~ 40 mmHg) and (2) controlled hyperventilation (HYPO, PETCO2 ~ 20 mmHg) throughout the protocol, with each condition repeated on four occasions. The protocol consisted of two MOD transitions (MOD1, MOD2) to 80% estimated lactate threshold with MOD2 preceded by HVY (Δ50%); each transition lasted 6 min and was preceded by 20 W cycling. \( \dot{V}{\text{O}}_{{ 2 {\text{p}}}} \) was measured breath-by-breath and concentration changes in oxy- and deoxy-hemoglobin/myoglobin (Δ[HHb]) of the vastus lateralis muscle were measured by near-infrared spectroscopy. Adjustment of \( \dot{V}{\text{O}}_{{ 2 {\text{p}}}} \) and Δ[HHb] were modeled using a mono-exponential equation by non-linear regression. During MOD1, the phase 2 time constant (τ) for \( \dot{V}{\text{O}}_{{ 2 {\text{p}}}} \,(\tau \dot{V}{\text{O}}_{{ 2 {\text{p}}}} ) \) was greater (P < 0.05) in HYPO (45 ± 24 s) than CON (28 ± 17 s). During MOD2, \( \tau \dot{V}{\text{O}}_{{ 2 {\text{p}}}} \) was reduced (P < 0.05) in both conditions (HYPO: 24 ± 7 s, CON: 20 ± 8 s). The Δ[HbTOT] and Δ[O2Hb] were greater (P < 0.05) prior to and throughout MOD2. The Δ[HHb] mean response time was similar in MOD1 and MOD2, and between conditions, however, the MOD1 Δ[HHb] amplitude was greater (P < 0.05) in HYPO compared to CON, with no differences between conditions in MOD2. These findings suggest that the speeding of \( \dot{V}{\text{O}}_{{ 2 {\text{p}}}} \) kinetics after prior HVY in HYPO was related, in part, to an increase in microvascular perfusion.
Literatur
Zurück zum Zitat Beaver WL, Lamarra N, Wasserman K (1981) Breath-by-breath measurement of true alveolar gas exchange. J Appl Physiol 51:1662–1675PubMed Beaver WL, Lamarra N, Wasserman K (1981) Breath-by-breath measurement of true alveolar gas exchange. J Appl Physiol 51:1662–1675PubMed
Zurück zum Zitat Beaver WL, Wasserman K, Whipp BJ (1986) A new method for detecting anaerobic threshold by gas exchange. J Appl Physiol 60:2020–2027PubMed Beaver WL, Wasserman K, Whipp BJ (1986) A new method for detecting anaerobic threshold by gas exchange. J Appl Physiol 60:2020–2027PubMed
Zurück zum Zitat Behnke BJ, Kindig CA, Musch TI, Sexton WL, Poole DC (2002) Effects of prior contractions on muscle microvascular oxygen pressure at onset of subsequent contractions. J Physiol 539:927–934CrossRefPubMed Behnke BJ, Kindig CA, Musch TI, Sexton WL, Poole DC (2002) Effects of prior contractions on muscle microvascular oxygen pressure at onset of subsequent contractions. J Physiol 539:927–934CrossRefPubMed
Zurück zum Zitat Brandi G, Clode M (1969) CO2 washout during hyperventilation in man. Respir Physiol 7:163–172CrossRefPubMed Brandi G, Clode M (1969) CO2 washout during hyperventilation in man. Respir Physiol 7:163–172CrossRefPubMed
Zurück zum Zitat Brice AG, Welch HG (1985) Effect of respiratory alkalosis on skeletal muscle metabolism in the dog. J Appl Physiol 58:658–664PubMed Brice AG, Welch HG (1985) Effect of respiratory alkalosis on skeletal muscle metabolism in the dog. J Appl Physiol 58:658–664PubMed
Zurück zum Zitat Burnley M, Jones AM, Carter H, Doust JH (2000) Effects of prior heavy exercise on phase II pulmonary oxygen uptake kinetics during heavy exercise. J Appl Physiol 89:1387–1396PubMed Burnley M, Jones AM, Carter H, Doust JH (2000) Effects of prior heavy exercise on phase II pulmonary oxygen uptake kinetics during heavy exercise. J Appl Physiol 89:1387–1396PubMed
Zurück zum Zitat Chin LM, Leigh RJ, Heigenhauser GJ, Rossiter HB, Paterson DH, Kowalchuk JM (2007) Hyperventilation-induced hypocapnic alkalosis slows the adaptation of pulmonary O2 uptake during the transition to moderate-intensity exercise. J Physiol 583:351–364CrossRefPubMed Chin LM, Leigh RJ, Heigenhauser GJ, Rossiter HB, Paterson DH, Kowalchuk JM (2007) Hyperventilation-induced hypocapnic alkalosis slows the adaptation of pulmonary O2 uptake during the transition to moderate-intensity exercise. J Physiol 583:351–364CrossRefPubMed
Zurück zum Zitat DeLorey DS, Kowalchuk JM, Paterson DH (2004) Effects of prior heavy-intensity exercise on pulmonary O2 uptake and muscle deoxygenation kinetics in young and older adult humans. J Appl Physiol 97:998–1005CrossRefPubMed DeLorey DS, Kowalchuk JM, Paterson DH (2004) Effects of prior heavy-intensity exercise on pulmonary O2 uptake and muscle deoxygenation kinetics in young and older adult humans. J Appl Physiol 97:998–1005CrossRefPubMed
Zurück zum Zitat DeLorey DS, Kowalchuk JM, Heenan AP, duManoir GR, Paterson DH (2007) Prior exercise speeds pulmonary O2 uptake kinetics by increases in both local muscle O2 availability and O2 utilization. J Appl Physiol 103:771–778CrossRefPubMed DeLorey DS, Kowalchuk JM, Heenan AP, duManoir GR, Paterson DH (2007) Prior exercise speeds pulmonary O2 uptake kinetics by increases in both local muscle O2 availability and O2 utilization. J Appl Physiol 103:771–778CrossRefPubMed
Zurück zum Zitat Elwell CE (1995) A practical user’s guide to near infrared spectroscopy. Hamamatsu Photonics KK, London Elwell CE (1995) A practical user’s guide to near infrared spectroscopy. Hamamatsu Photonics KK, London
Zurück zum Zitat Endo M, Okada Y, Rossiter HB, Ooue A, Miura A, Koga S, Fukuba Y (2005) Kinetics of pulmonary VO2 and femoral artery blood flow and their relationship during repeated bouts of heavy exercise. Eur J Appl Physiol 95:418–430CrossRefPubMed Endo M, Okada Y, Rossiter HB, Ooue A, Miura A, Koga S, Fukuba Y (2005) Kinetics of pulmonary VO2 and femoral artery blood flow and their relationship during repeated bouts of heavy exercise. Eur J Appl Physiol 95:418–430CrossRefPubMed
Zurück zum Zitat Faisal A, Beavers KR, Robertson AD, Hughson RL (2009) Prior moderate and heavy exercise accelerate oxygen uptake and cardiac output kinetics in endurance athletes. J Appl Physiol 106:1553–1563CrossRefPubMed Faisal A, Beavers KR, Robertson AD, Hughson RL (2009) Prior moderate and heavy exercise accelerate oxygen uptake and cardiac output kinetics in endurance athletes. J Appl Physiol 106:1553–1563CrossRefPubMed
Zurück zum Zitat Forbes SC, Kowalchuk JM, Thompson RT, Marsh GD (2007) Effects of hyperventilation on phosphocreatine kinetics and muscle deoxygenation during moderate-intensity plantar flexion exercise. J Appl Physiol 102:1565–1573CrossRefPubMed Forbes SC, Kowalchuk JM, Thompson RT, Marsh GD (2007) Effects of hyperventilation on phosphocreatine kinetics and muscle deoxygenation during moderate-intensity plantar flexion exercise. J Appl Physiol 102:1565–1573CrossRefPubMed
Zurück zum Zitat Fukuba Y, Ohe Y, Miura A, Kitano A, Endo M, Sato H, Miyachi M, Koga S, Fukuda O (2004) Dissociation between the time courses of femoral artery blood flow and pulmonary VO2 during repeated bouts of heavy knee extension exercise in humans. Exp Physiol 89:243–253CrossRefPubMed Fukuba Y, Ohe Y, Miura A, Kitano A, Endo M, Sato H, Miyachi M, Koga S, Fukuda O (2004) Dissociation between the time courses of femoral artery blood flow and pulmonary VO2 during repeated bouts of heavy knee extension exercise in humans. Exp Physiol 89:243–253CrossRefPubMed
Zurück zum Zitat Gerbino A, Ward SA, Whipp BJ (1996) Effects of prior exercise on pulmonary gas-exchange kinetics during high-intensity exercise in humans. J Appl Physiol 80:99–107PubMed Gerbino A, Ward SA, Whipp BJ (1996) Effects of prior exercise on pulmonary gas-exchange kinetics during high-intensity exercise in humans. J Appl Physiol 80:99–107PubMed
Zurück zum Zitat Grassi B (2003) Oxygen uptake kinetics: old and recent lessons from experiments on isolated muscle in situ. Eur J Appl Physiol 90:242–249CrossRefPubMed Grassi B (2003) Oxygen uptake kinetics: old and recent lessons from experiments on isolated muscle in situ. Eur J Appl Physiol 90:242–249CrossRefPubMed
Zurück zum Zitat Grassi B, Poole DC, Richardson RS, Knight DR, Erickson BK, Wagner PD (1996) Muscle O2 uptake kinetics in humans: implications for metabolic control. J Appl Physiol 80:988–998PubMed Grassi B, Poole DC, Richardson RS, Knight DR, Erickson BK, Wagner PD (1996) Muscle O2 uptake kinetics in humans: implications for metabolic control. J Appl Physiol 80:988–998PubMed
Zurück zum Zitat Grassi B, Hogan MC, Greenhaff PL, Hamann JJ, Kelley KM, Aschenbach WG, Constantin-Teodosiu D, Gladden LB (2002) Oxygen uptake on-kinetics in dog gastrocnemius in situ following activation of pyruvate dehydrogenase by dichloroacetate. J Physiol 538:195–207CrossRefPubMed Grassi B, Hogan MC, Greenhaff PL, Hamann JJ, Kelley KM, Aschenbach WG, Constantin-Teodosiu D, Gladden LB (2002) Oxygen uptake on-kinetics in dog gastrocnemius in situ following activation of pyruvate dehydrogenase by dichloroacetate. J Physiol 538:195–207CrossRefPubMed
Zurück zum Zitat Gurd BJ, Scheuermann BW, Paterson DH, Kowalchuk JM (2005) Prior heavy-intensity exercise speeds VO2 kinetics during moderate-intensity exercise in young adults. J Appl Physiol 98:1371–1378CrossRefPubMed Gurd BJ, Scheuermann BW, Paterson DH, Kowalchuk JM (2005) Prior heavy-intensity exercise speeds VO2 kinetics during moderate-intensity exercise in young adults. J Appl Physiol 98:1371–1378CrossRefPubMed
Zurück zum Zitat Gurd B, Peters SJ, Heigenhauser GJ, LeBlanc PJ, Doherty TJ, Paterson DH, Kowalchuk JM (2006) Prior heavy exercise elevates pyruvate dehydrogenase activity and speeds O2 uptake kinetics during subsequent moderate-intensity exercise in healthy young adults. J Physiol 577:985–996CrossRefPubMed Gurd B, Peters SJ, Heigenhauser GJ, LeBlanc PJ, Doherty TJ, Paterson DH, Kowalchuk JM (2006) Prior heavy exercise elevates pyruvate dehydrogenase activity and speeds O2 uptake kinetics during subsequent moderate-intensity exercise in healthy young adults. J Physiol 577:985–996CrossRefPubMed
Zurück zum Zitat Gustafsson U, Sjoberg F, Lewis DH, Thorborg P (1993) The effect of hypocapnia on skeletal muscle microcirculatory blood flow, oxygenation and pH. Int J Microcirc Clin Exp 12:131–141PubMed Gustafsson U, Sjoberg F, Lewis DH, Thorborg P (1993) The effect of hypocapnia on skeletal muscle microcirculatory blood flow, oxygenation and pH. Int J Microcirc Clin Exp 12:131–141PubMed
Zurück zum Zitat Hayashi N, Ishihara M, Tanaka A, Yoshida T (1999) Impeding O2 unloading in muscle delays oxygen uptake response to exercise onset in humans. Am J Physiol 277:R1274–R1281PubMed Hayashi N, Ishihara M, Tanaka A, Yoshida T (1999) Impeding O2 unloading in muscle delays oxygen uptake response to exercise onset in humans. Am J Physiol 277:R1274–R1281PubMed
Zurück zum Zitat Hogan MC (2001) Fall in intracellular PO2 at the onset of contractions in Xenopus single skeletal muscle fibers. J Appl Physiol 90:1871–1876PubMed Hogan MC (2001) Fall in intracellular PO2 at the onset of contractions in Xenopus single skeletal muscle fibers. J Appl Physiol 90:1871–1876PubMed
Zurück zum Zitat Hughson RL, Schijvens H, Burrows S, Devitt D, Betik AC, Hopman MTE (2003) Blood flow and metabolic control at the onset of heavy exercise. Int J Sport Health Sci 1:9–18 Hughson RL, Schijvens H, Burrows S, Devitt D, Betik AC, Hopman MTE (2003) Blood flow and metabolic control at the onset of heavy exercise. Int J Sport Health Sci 1:9–18
Zurück zum Zitat Jones AM, Berger NJ, Wilkerson DP, Roberts CL (2006) Effects of “priming” exercise on pulmonary O2 uptake and muscle deoxygenation kinetics during heavy-intensity cycle exercise in the supine and upright positions. J Appl Physiol 101:1432–1441CrossRefPubMed Jones AM, Berger NJ, Wilkerson DP, Roberts CL (2006) Effects of “priming” exercise on pulmonary O2 uptake and muscle deoxygenation kinetics during heavy-intensity cycle exercise in the supine and upright positions. J Appl Physiol 101:1432–1441CrossRefPubMed
Zurück zum Zitat Karlsson T, Stjernstrom EL, Stjernstrom H, Norlen K, Wiklund L (1994) Central and regional blood flow during hyperventilation. An experimental study in the pig. Acta Anaesthesiol Scand 38:180–186CrossRefPubMed Karlsson T, Stjernstrom EL, Stjernstrom H, Norlen K, Wiklund L (1994) Central and regional blood flow during hyperventilation. An experimental study in the pig. Acta Anaesthesiol Scand 38:180–186CrossRefPubMed
Zurück zum Zitat Kontos HA, Richardson DW, Raper AJ, Zubair-ul-Hassan, Patterson JL Jr (1972) Mechanisms of action of hypocapnic alkalosis on limb blood vessels in man and dog. Am J Physiol 223:1296–1307 Kontos HA, Richardson DW, Raper AJ, Zubair-ul-Hassan, Patterson JL Jr (1972) Mechanisms of action of hypocapnic alkalosis on limb blood vessels in man and dog. Am J Physiol 223:1296–1307
Zurück zum Zitat Koppo K, Wilkerson DP, Bouckaert J, Wilmshurst S, Campbell IT, Jones AM (2004) Influence of DCA on pulmonary VO2 kinetics during moderate-intensity cycle exercise. Med Sci Sports Exerc 36:1159–1164CrossRefPubMed Koppo K, Wilkerson DP, Bouckaert J, Wilmshurst S, Campbell IT, Jones AM (2004) Influence of DCA on pulmonary VO2 kinetics during moderate-intensity cycle exercise. Med Sci Sports Exerc 36:1159–1164CrossRefPubMed
Zurück zum Zitat Krustrup P, Jones AM, Wilkerson DP, Calbet JA, Bangsbo J (2009) Muscular and pulmonary O2 uptake kinetics during moderate and high-intensity sub-maximal knee-extensor exercise in humans. J Physiol 587:1843–1856CrossRefPubMed Krustrup P, Jones AM, Wilkerson DP, Calbet JA, Bangsbo J (2009) Muscular and pulmonary O2 uptake kinetics during moderate and high-intensity sub-maximal knee-extensor exercise in humans. J Physiol 587:1843–1856CrossRefPubMed
Zurück zum Zitat Lamarra N, Whipp BJ, Ward SA, Wasserman K (1987) Effect of interbreath fluctuations on characterizing exercise gas exchange kinetics. J Appl Physiol 62:2003–2012CrossRefPubMed Lamarra N, Whipp BJ, Ward SA, Wasserman K (1987) Effect of interbreath fluctuations on characterizing exercise gas exchange kinetics. J Appl Physiol 62:2003–2012CrossRefPubMed
Zurück zum Zitat LeBlanc PJ, Parolin ML, Jones NL, Heigenhauser GJ (2002) Effects of respiratory alkalosis on human skeletal muscle metabolism at the onset of submaximal exercise. J Physiol 544:303–313CrossRefPubMed LeBlanc PJ, Parolin ML, Jones NL, Heigenhauser GJ (2002) Effects of respiratory alkalosis on human skeletal muscle metabolism at the onset of submaximal exercise. J Physiol 544:303–313CrossRefPubMed
Zurück zum Zitat MacDonald MJ, Naylor HL, Tschakovsky ME, Hughson RL (2001) Peripheral circulatory factors limit rate of increase in muscle O2 uptake at onset of heavy exercise. J Appl Physiol 90:83–89PubMed MacDonald MJ, Naylor HL, Tschakovsky ME, Hughson RL (2001) Peripheral circulatory factors limit rate of increase in muscle O2 uptake at onset of heavy exercise. J Appl Physiol 90:83–89PubMed
Zurück zum Zitat Paterson ND, Kowalchuk JM, Paterson DH (2005) Effects of prior heavy-intensity exercise during single-leg knee extension on VO2 kinetics and limb blood flow. J Appl Physiol 99:1462–1470CrossRefPubMed Paterson ND, Kowalchuk JM, Paterson DH (2005) Effects of prior heavy-intensity exercise during single-leg knee extension on VO2 kinetics and limb blood flow. J Appl Physiol 99:1462–1470CrossRefPubMed
Zurück zum Zitat Poole DC, Barstow TJ, McDonough P, Jones AM (2008) Control of oxygen uptake during exercise. Med Sci Sports Exerc 40:462–474CrossRefPubMed Poole DC, Barstow TJ, McDonough P, Jones AM (2008) Control of oxygen uptake during exercise. Med Sci Sports Exerc 40:462–474CrossRefPubMed
Zurück zum Zitat Richardson DW, Kontos HA, Raper AJ, Patterson JL Jr (1972) Systemic circulatory responses to hypocapnia in man. Am J Physiol 223:1308–1312PubMed Richardson DW, Kontos HA, Raper AJ, Patterson JL Jr (1972) Systemic circulatory responses to hypocapnia in man. Am J Physiol 223:1308–1312PubMed
Zurück zum Zitat Rossiter HB, Ward SA, Doyle VL, Howe FA, Griffiths JR, Whipp BJ (1999) Inferences from pulmonary O2 uptake with respect to intramuscular [phosphocreatine] kinetics during moderate exercise in humans. J Physiol 518:921–932CrossRefPubMed Rossiter HB, Ward SA, Doyle VL, Howe FA, Griffiths JR, Whipp BJ (1999) Inferences from pulmonary O2 uptake with respect to intramuscular [phosphocreatine] kinetics during moderate exercise in humans. J Physiol 518:921–932CrossRefPubMed
Zurück zum Zitat Scheuermann BW, Bell C, Paterson DH, Barstow TJ, Kowalchuk JM (2002) Oxygen uptake kinetics for moderate exercise are speeded in older humans by prior heavy exercise. J Appl Physiol 92:609–616PubMed Scheuermann BW, Bell C, Paterson DH, Barstow TJ, Kowalchuk JM (2002) Oxygen uptake kinetics for moderate exercise are speeded in older humans by prior heavy exercise. J Appl Physiol 92:609–616PubMed
Zurück zum Zitat Spriet LL, Heigenhauser GJ (2002) Regulation of pyruvate dehydrogenase (PDH) activity in human skeletal muscle during exercise. Exerc Sport Sci Rev 30:91–95CrossRefPubMed Spriet LL, Heigenhauser GJ (2002) Regulation of pyruvate dehydrogenase (PDH) activity in human skeletal muscle during exercise. Exerc Sport Sci Rev 30:91–95CrossRefPubMed
Zurück zum Zitat Straub PW, Bühlmann AA (1970) Reduction of blood volume by voluntary hyperventilation. J Appl Physiol 29:816–817PubMed Straub PW, Bühlmann AA (1970) Reduction of blood volume by voluntary hyperventilation. J Appl Physiol 29:816–817PubMed
Zurück zum Zitat Tschakovsky ME, Hughson RL (1999) Interaction of factors determining oxygen uptake at the onset of exercise. J Appl Physiol 86:1101–1113PubMed Tschakovsky ME, Hughson RL (1999) Interaction of factors determining oxygen uptake at the onset of exercise. J Appl Physiol 86:1101–1113PubMed
Zurück zum Zitat Ward SA, Whipp BJ, Koyal S, Wasserman K (1983) Influence of body CO2 stores on ventilatory dynamics during exercise. J Appl Physiol 55:742–749PubMed Ward SA, Whipp BJ, Koyal S, Wasserman K (1983) Influence of body CO2 stores on ventilatory dynamics during exercise. J Appl Physiol 55:742–749PubMed
Zurück zum Zitat Whipp BJ, Ward SA, Wasserman K (1986) Respiratory markers of the anaerobic threshold. Adv Cardiol 35:47–64PubMed Whipp BJ, Ward SA, Wasserman K (1986) Respiratory markers of the anaerobic threshold. Adv Cardiol 35:47–64PubMed
Metadaten
Titel
Effect of hyperventilation and prior heavy exercise on O2 uptake and muscle deoxygenation kinetics during transitions to moderate exercise
verfasst von
Lisa M. K. Chin
George J. F. Heigenhauser
Donald H. Paterson
John M. Kowalchuk
Publikationsdatum
01.03.2010
Verlag
Springer-Verlag
Erschienen in
European Journal of Applied Physiology / Ausgabe 5/2010
Print ISSN: 1439-6319
Elektronische ISSN: 1439-6327
DOI
https://doi.org/10.1007/s00421-009-1293-1

Weitere Artikel der Ausgabe 5/2010

European Journal of Applied Physiology 5/2010 Zur Ausgabe

Neu im Fachgebiet Arbeitsmedizin

Elterliches Belastungserleben, Unaufmerksamkeits‑/Hyperaktivitätssymptome und elternberichtete ADHS bei Kindern und Jugendlichen: Ergebnisse aus der KiGGS-Studie

Open Access ADHS Leitthema

Die Aufmerksamkeitsdefizit‑/Hyperaktivitätsstörung (ADHS) ist eine der häufigsten psychischen Störungen im Kindes- und Jugendalter [ 1 ]. In Deutschland beträgt die Prävalenz einer elternberichteten ADHS-Diagnose bei Kindern und Jugendlichen 4,4 % …

Substanzkonsum und Nutzung von sozialen Medien, Computerspielen und Glücksspielen unter Auszubildenden an beruflichen Schulen

Open Access Leitthema

Die Begrenzung von Schäden durch Substanzkonsum und andere abhängige Verhaltensweisen von Jugendlichen und jungen Erwachsenen ist ein wichtiges Anliegen der öffentlichen Gesundheit. Der Übergang von der Adoleszenz zum jungen Erwachsenenalter ist …

Berufsbelastung und Stressbewältigung von weiblichen und männlichen Auszubildenden

Leitthema

In der Öffentlichkeit wird die berufliche Ausbildung oftmals unter ökonomischen Gesichtspunkten diskutiert: Mit den geburtenstarken Jahrgängen gehen erfahrene Fachkräfte in Rente und von nachfolgenden Generationen rücken zu wenige Arbeitskräfte …

Rauschtrinken in der frühen Adoleszenz

COVID-19 Leitthema

Alkohol ist in Deutschland die mit Abstand am häufigsten konsumierte psychoaktive Substanz. Mehr als 2 Drittel aller Erwachsenen im Alter von 18 bis 64 Jahren (70,5 %) hat 2021 in den letzten 30 Tagen Alkohol konsumiert [ 1 ]. Von diesen …