Fictional British spy James Bond is well known for requesting his martinis to be “shaken, not stirred.” But new research published in the BMJ suggests that his excessive alcohol consumption means he would have had no choice but to have his martinis shaken, as he may have developed an alcohol-induced tremor.

To reach their findings, researchers from the UK, led by Dr. Patrick Davis of the Nottingham University Hospitals NHS Trust, read all 14 original James Bond novels by Ian Fleming between January and July 2013.

When you think of the character James Bond, the first three words that spring to mind are cars, alcohol and women. Yet regardless of these factors, the researchers note that Bond always appeared to be calm under pressure and in charge of all given situations.

When reading the novels, the investigators noted that Bond’s alcohol consumption was excessive, leading them to question whether he would have been able to function normally, even when carrying out standard day-to-day activities.

The researchers compiled notes detailing every alcoholic drink Bond consumed.

In order to calculate his alcohol consumption, the investigators used pre-defined alcohol unit level definitions described by the UK’s National Health Service (NHS).

When alcohol consumption was not specifically described, the researchers estimated the number of drinks he may have had. They also took into consideration the days Bond would be unable to drink, due to imprisonment, for example.

The researchers estimated that Bond’s alcohol intake would have been between 65 and 92 units per week. This is up to four times more than the maximum alcohol consumption guidelines of 21 units per week for a man.

In detail, Bond’s maximum daily alcohol consumption was estimated at 49.8 units. Of the 87.5 days he was able to drink, 12.5 days were alcohol-free.

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No choice but to be ‘shaken’? Researchers say James Bond’s love of martinis may have given him alcohol-induced hand tremors.

Additionally, the researchers point out that the majority of people underestimate their alcohol consumption by 30%, suggesting that his actual alcohol consumption may have been up to 130 units each week.

According to the Centers for Disease Control and Prevention (CDC), around 13.6% of adults age 18 or over are regular drinkers, defined as consuming at least 12 drinks in the past year.

Excessive alcohol consumption can lead to numerous health conditions, such as liver disease, heart problems and increased risk of cancer, and in turn, can reduce a person’s life expectancy.

Based on Bond’s alcohol consumption, the researchers note that, realistically, he may have experienced early death.

“Presuming survival despite the high risk nature of his profession, we anticipate that James Bond’s life expectancy would be significantly reduced,” they say.

“In fact, the author Ian Fleming died aged 56 of heart disease after a life notable for alcohol and tobacco excess. We suspect that Bond’s life expectancy would be similar.”

Furthermore, the researchers believe the excessive alcohol intake Bond demonstrated may have led him to develop hand tremors – another effect of high alcohol intake.

They suggest that because of this, he may have asked for his martinis “shaken, not stirred” not out of preference, but because he would not be able to stir them.

The investigators note that to reduce the effects of alcohol consumption, Bond would benefit from reducing his intake.

They write:

We conclude that James Bond was unlikely to be able to stir his drinks, even if he would have wanted to, because of likely alcohol-induced tremor.

Although we appreciate the societal pressures to consume alcohol when working with international terrorists and high stakes gamblers, we would advise Bond be referred for further assessment of his alcohol intake and reduce his intake to safe levels.”

Earlier this year, Medical News Today reported on a study suggesting that excessive alcohol has a lasting negative impact on the brain.