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Beer consumption and the 'beer belly': Scientific basis or common belief?
Abstract
The term 'beer belly' expresses the common belief that beer consumption is a major determinant of waist circumference (WC). We studied the gender-specific associations between beer consumption and WC (partially in relation to body weight and hip circumference (HC) change).
Within the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam study (7876 men, 12 749 women), cross-sectional associations were investigated applying general linear models. Prospective analyses of baseline beer consumption and an 8.5-year WC change were assessed using multivariate general linear models and polytomous logistic regression. To test the site-specific effect of beer consumption on WC, an adjustment for concurrent changes in body weight and HC was carried out. In addition, the relationship between change in beer consumption and change in WC was studied.
A positive association in men and no association in women were seen between beer consumption and WC at baseline. Men consuming 1000 ml/d beer were at 17% higher risk for WC gain compared with very light consumers. Significantly lower odds for WC gain (odds ratio=0.88; 95% confidence interval 0.81, 0.96) were found in beer-abstaining women than in very-light-drinking women. The adjustment for concurrent body weight and HC change diminished effect estimates notably, explaining most of the association between beer and change in WC. Decreasing beer consumption was related to higher relative odds for WC loss, although not statistically significant.
Beer consumption leads to WC gain, which is closely related to concurrent overall weight gain. This study does not support the common belief of a site-specific effect of beer on the abdomen, the beer belly.
... Table 6 details the studies on this subject. Although beer seems to have a direct effect on weight gain [52], and on waist circumference in men [59], there is not enough evidence to confirm whether moderate intake (<500 mL/day) is associated with general or abdominal obesity [55], although daily amounts ≥500 mL increase the risk of not losing weight [59]. In this regard, Padro et al., have reported that the moderate consumption of either alcoholic (30 g/day for men; 15 g/day for women) or non-alcoholic beer for four weeks did not increase the body weight of obese individuals [46]. ...
... Table 6 details the studies on this subject. Although beer seems to have a direct effect on weight gain [52], and on waist circumference in men [59], there is not enough evidence to confirm whether moderate intake (<500 mL/day) is associated with general or abdominal obesity [55], although daily amounts ≥500 mL increase the risk of not losing weight [59]. In this regard, Padro et al., have reported that the moderate consumption of either alcoholic (30 g/day for men; 15 g/day for women) or non-alcoholic beer for four weeks did not increase the body weight of obese individuals [46]. ...
... With regard to obesity, the study by Schütze et al. [59] suggested that only men observe a risk for an increase in waist circumference (WC) with beer consumption of >500 mL/day. In women, beer-abstainers showed lower relative odds for WC gain compared with their very low-level drinking counterparts (1 to <125 mL/day), which was close to significance. ...
There is growing interest in the potential health-related effects of moderate alcohol consumption and, specifically, of beer. This review provides an assessment of beer-associated effects on cardiovascular and metabolic risk factors to identify a consumption level that can be considered “moderate”. We identified all prospective clinical studies and systematic reviews that evaluated the health effects of beer published between January 2007 and April 2020. Five of six selected studies found a protective effect of moderate alcohol drinking on cardiovascular disease (beer up to 385 g/week) vs. abstainers or occasional drinkers. Four out of five papers showed an association between moderate alcohol consumption (beer intake of 84 g alcohol/week) and decreased mortality risk. We concluded that moderate beer consumption of up to 16 g alcohol/day (1 drink/day) for women and 28 g/day (1–2 drinks/day) for men is associated with decreased incidence of cardiovascular disease and overall mortality, among other metabolic health benefits.
... Others have indicated an inverse association, more evident among women [6,[17][18][19][20]. Still, other authors have not observed an association, even when subjects were analyzed separately according to sex [21][22][23]. ...
... The investigation of the association between alcohol consumption and adiposity in several cross-sectional and longitudinal studies using doubly indirect anthropometric parameters, such as the total body mass, BMI, WC, and WHR yielded conflicting results. In women, some studies found an association with at least one of these indicators [12,16,23,26]. However, the vast majority of studies, including one in Brazil, either found no association or observed an inverse association with alcohol consumption in women [6,13,17,18,20]. ...
... However, the vast majority of studies, including one in Brazil, either found no association or observed an inverse association with alcohol consumption in women [6,13,17,18,20]. Among men, this association was found to be more consistent across several studies [12,23,26,27], including studies in Brazil [13,15]. Inverse or no associations between alcohol consumption among males have been less reported [35]. ...
Purpose
Evaluate the association between alcohol consumption and body adiposity.
Methods
We analyzed cross-sectional data from a longitudinal investigation (Pró-Saúde Study), comprising a sample of 514 civil servants of both sexes (35–64 years). Daily alcohol consumption (wine, beer, and other alcoholic drinks) over the previous 6 months was assessed via food frequency questionnaire and categorized as no doses, up to 1 dose, and ≥1 dose. The total body mass, total fat mass (TFM), android fat mass (AFM), and gynoid fat mass (GFM) were measured via dual-energy X-ray absorptiometry. AFM (AFM%) and GFM (GFM%) were expressed as percentages relative to TFM. The ratio of AFM% and GFM% was calculated. Multiple linear regression analyses were performed after adjusting for age, calories not originating from alcohol, leisure-time physical activity and education.
Results
Among nondrinkers, 59 % were women, and the age range between 45 and 54 years was predominant (44.3 %); 63.7 % of the nondrinkers were overweight/obese. Among drinkers of 1 dose or more/day, 67 % were males aged between 45 and 54 years (43.7 %); 69.1 % were overweight/obese. Among men, the daily consumption of ≥1 alcohol dose (13 g) was associated with an approximately 2 % (β = 2.2, IC = 0.077; 4.303) adjusted for age, calories not originated from alcohol, leisure-time physical activity and education, increase in TFM, compared to those who reported no alcohol consumption during the previous 6 months. This association was not observed among women. In both sexes, no associations were observed between alcohol consumption and the other evaluated parameters of adiposity.
Conclusion
Among men only, daily consumption of ≥1 alcohol dose was associated with increased adiposity, despite the relatively low average alcohol consumption in this study population.
... Sayon-Orea et al. [46] found that drinking more than seven times per week was associated with increased risk of weight gain and development of overweight and obesity. Shütze et al. [47] found that male light-to-moderate beer drinkers had smaller increases in WC and weight than nondrinkers or heavy drinkers over 8.5 years of follow up. However, conversely, in women they found a dose-response relationship between beer intake and weight gain and WC gain [47]. ...
... Shütze et al. [47] found that male light-to-moderate beer drinkers had smaller increases in WC and weight than nondrinkers or heavy drinkers over 8.5 years of follow up. However, conversely, in women they found a dose-response relationship between beer intake and weight gain and WC gain [47]. There are many reasons as to why the relationship between alcohol and adiposity varies between men and women, involving genetic and lifestyle factors, some of which will be discussed in depth below. ...
... Collectively, the most recent prospective studies suggest that light-to-moderate alcohol intake is not associated with weight gain or changes in WC [44•]. Heavy drinking, however, has been more consistently associated with weight gain [45][46][47]. Furthermore, increases in alcohol intake patterns appear to promote weight gain [15,31,43]. ...
Recreational alcohol intake is a widespread activity globally and alcohol energy (7 kcal/g) can be a contributing factor to weight gain if not compensated for. Given that both excessive alcohol intake and obesity are of public health interest, the present paper provides an update on the association between alcohol consumption and body weight. In general, recent prospective studies show that light-to-moderate alcohol intake is not associated with adiposity gain while heavy drinking is more consistently related to weight gain. Experimental evidence is also mixed and suggests that moderate intake of alcohol does not lead to weight gain over short follow-up periods. However, many factors can explain the conflicting findings and a better characterization of individuals more likely to gain weight as a result of alcohol consumption is needed. In particular, individuals who frequently drink moderate amounts of alcohol may enjoy a healthier lifestyle in general that may protect them from weight gain. In conclusion, despite the important limitations of current studies, it is reasonable to say that alcohol intake may be a risk factor for obesity in some individuals, likely based on a multitude of factors, some of which are discussed herein.
... 7,8 Several studies have pointed towards a difference between genders, but the picture is not clear; positive associations between beer consumption and WHR have been found to be stronger among women in a French population, 9 whereas in German and Czech populations, positive associations were found among men only. 4,10 In a few prospective studies, beer consumption was positively associated with WC in both men and women 11,12 or in women only, 10 but these observations were not confirmed in other cohorts. [13][14][15] A recent review examining the association of alcohol intake in general with BW concluded that it is currently unclear whether alcohol consumption is a risk factor for weight gain. ...
... 7,8 Several studies have pointed towards a difference between genders, but the picture is not clear; positive associations between beer consumption and WHR have been found to be stronger among women in a French population, 9 whereas in German and Czech populations, positive associations were found among men only. 4,10 In a few prospective studies, beer consumption was positively associated with WC in both men and women 11,12 or in women only, 10 but these observations were not confirmed in other cohorts. [13][14][15] A recent review examining the association of alcohol intake in general with BW concluded that it is currently unclear whether alcohol consumption is a risk factor for weight gain. ...
... One of the prospective studies also presented a cross-sectional baseline analysis. 10 Cross-sectional studies included from 439 to 258,177 subjects and prospective studies followed between 317 and 44,080 subjects for periods of 3.7 to 10 years. Table 1 provides a summary of the crosssectional 4-10,18,21-38 and prospective [10][11][12][13][14][15][39][40][41][42] cohort studies included. ...
A systematic review was conducted to assess the evidence linking beer consumption to abdominal and general obesity. Following a systematic search strategy, 35 eligible observational studies and 12 experimental studies were identified. Regarding abdominal obesity, most observational data pointed towards a positive association or no association between beer intake and waist circumference or waist-to-hip ratio in men, whereas results for women were inconsistent. Data from a subset of studies indicated that beer intake > 500 mL/day may be positively associated with abdominal obesity. Regarding general obesity, most observational studies pointed towards an inverse association or no association between beer intake and body weight in women and a positive association or no association in men. Data from six experimental studies in men, in which alcoholic beer was compared with low-alcoholic beer, suggested that consumption of alcoholic beer (for 21-126 days) results in weight gain (0.73 kg; P < 0.0001), but data from four studies comparing intake of alcoholic beer with intake of no alcohol did not support this finding. Generally, experimental studies had low-quality data. In conclusion, the available data provide inadequate scientific evidence to assess whether beer intake at moderate levels (<500 mL/day) is associated with general or abdominal obesity. Higher intake, however, may be positively associated with abdominal obesity.
... Thus, for instance, drinking alcoholic beverages during meals was significantly more prevalent in females than in males in one study population [35]. In addition, it has been suggested that enlarged waist circumference (WC), known as "beer belly", commonly observed in regular beer consumers might be more due to unhealthy lifestyle factors and drinking patterns (e.g., physical inactivity and smoking) rather than to beer consumption alone [36]. ...
... Consequently, it can be stated that excessive beer intake may contribute to a higher WC and WHR, and even a higher overall BMI, yet the regular consumption of less than 0.5 L/day of beer (4% alcohol) seems unlikely to have this effect, according to the data available in cross-sectional and prospective observational studies [40]. Women studies evaluating the relationship between beer consumption and abdominal fat increase has been summarized in Table 2 [33,[35][36][37]41,[43][44][45][46][47][48][49][50][51][52][53][54][55]. ...
Several studies have shown that binge drinking of alcoholic beverages leads to non-desirable outcomes, which have become a serious threat to public health. However, the bioactive compounds in some alcohol-containing beverages might mitigate the negative effects of alcohol. In beer, the variety and concentration of bioactive compounds in the non-alcoholic fraction suggests that its consumption at moderate levels may not only be harmless but could also positively contribute to an improvement of certain physiological states and be also useful in the prevention of different chronic diseases. The present review focuses on the effects of non-alcoholic components of beer on abdominal fat, osteoporosis, and body hydration in women, conditions selected for their relevance to health and aging. Although beer drinking is commonly believed to cause abdominal fat deposition, the available literature indicates this outcome is inconsistent in women. Additionally, the non-alcoholic beer fraction might improve bone health in postmenopausal women, and the effects of beer on body hydration, although still unconfirmed seem promising. Most of the health benefits of beer are due to its bioactive compounds, mainly polyphenols, which are the most studied. As alcohol-free beer also contains these compounds, it may well offer a healthy alternative to beer consumers.
... Some studies have reported that alcohol consumption is associated with an increase in VAT [21,49,50], and could stimulate lipogenesis and inhibit lipolysis on healthy adults [21]. In this sense, it is believed that beer consumption is associated with increased WC or WHiR, particularly in men, a phenomenon popularly referred to as "beer belly" [52]. This belief might be supported by cross-sectional research, reporting abdominal obesity as being associated with beer consumption [53]. ...
... This belief might be supported by cross-sectional research, reporting abdominal obesity as being associated with beer consumption [53]. However, some prospective studies have shown inconsistent results, such as the study of Schütze et al. [52], who have reported only limited evidence for a site-specific effect of beer drinking on WC. Notwithstanding, the effect of alcohol on fat metabolism remains obscure, our results agree with those obtained by Kim et al. [50], who found that the participants decreased in subcutaneous adipose tissue in spite of their alcohol intake. ...
High-intensity interval training (HIIT) is promoted as a time-efficient strategy to improve body composition but concomitant beer intake, which is common among physically active individuals, may interfere with these effects. The primary aim of this study is to determine the effects of a 10-week (2 days/week) HIIT program on anthropometric and body composition measurements, and to assess whether those effects are influenced by the moderate consumption of beer (at least 5 days/week), or its alcohol equivalent. Young (24 ± 6 years old) healthy adults (n = 72, 35 females) volunteered for a non-training group (Non-Training group) or for HIIT training. Those going for training choose whether they preferred to receive alcohol or not. Those choosing alcohol were randomly allocated for receiving beer (5.4%; T-Beer group) or the equivalent amount of alcohol (vodka; T-Ethanol group) in sparkling water. Those choosing no-alcohol were randomly allocated for receiving alcohol-free beer (0.0%; T-0.0Beer group) or sparkling water (T-Water group). From Monday through Friday, men ingested 330 mL of the beverage with lunch and 330 mL with dinner; women ingested 330 mL with dinner. Before and after the intervention, anthropometry and body composition, through dual-emission X-ray absorptiometry, were measured. No changes in body mass, waist circumference, waist/hip ratio, visceral adipose tissue or bone mineral density occurred in any of the groups. By contrast, in all the training groups, significant decreases in fat mass together with increases in lean mass (all p < 0.05) occurred. These positive effects were not influenced by the regular intake of beer or alcohol. In conclusion, a moderate beer intake does not blunt the positive effect of 10-week HIIT on body composition in young healthy adults.
... 37 In our study, 25.3% of participants reported an increased alcohol and beverage consumption though it was not significantly associated with body weight gain. Several prospective studies [38][39][40][41] showed that light-to-moderate alcohol intake was not associated with adiposity gain but heavy drinking was associated with weight gain. Another Australian cohort study 42 showed that there was no association between alcohol intake and body weight or waist circumference. ...
Background
The impact of quarantine-induced changes in dietary behavior on weight gain remained unclear. This study aimed to evaluate the association between changes in dietary behavior and body weight during quarantine and to identify the risk factors of weight gain.
Methods
This was a pilot observational cross-sectional study. All the potential participants were those who underwent body weight management program in one teaching hospital in China from 26th April 2021 to 31st March 2022. An online self-reported questionnaire was sent to collect information on sex, age, self-reported body weight before and after quarantine, dietary quality, meal time, food consumption, physical activities, and sleep quality. Weight gain was defined as an increase of 1 kilogram or more. The study has been performed in accordance with the Declaration of Helsinki and approved by the Ethics Committee (KY2020-204). The participants were informed about the objectives of the study and electronic informed consent was obtained from each participant.
Results
Finally, 79 participants (22.8% male and 77.2% female, aged 33.3 ± 7.1 years) was included in the analysis. During quarantine, the mean body weight gain was 0.8 (interquartile range: −1.0~3.0) kg. The proportion of weight gain among the participants was 45.6%. Increased cooked white rice (OR=16.93; 95% CI: 2.66–108.00), convenient food (OR=11.69; 95% CI: 2.00–68.26), and snack consumption (OR=5.56; 95% CI: 1.08–28.56), delayed dinner time (OR=6.64; 95% CI: 1.20–36.74) and house working time less than 30 minutes (OR=12.80; 95% CI: 2.01–81.44) were risk factors for body weight gain.
Conclusion
During the quarantine, weight gain was observed even in participants who were previously on body weight management. Increased consumption of cooked white rice, convenient food, and snack, as well as delayed dinner time and reduced house working time (less than 30 minutes), were found to be associated with body weight gain.
... To describe the distribution of socio-demographic and lifestyle characteristics of people who drank compared to those who didn't drink at baseline, participants were categorized into sex-specific drinking categories using alcoholic beverage intake at exam year 0. Category definitions were based on the National Institute on Alcohol Abuse and Alcoholism (NIAAA) guidance on drinking levels [34,[53][54][55][56]. Based on the sum of the usual intake of beer, wine, and liquor/mixed drinks per week (drinks/wk) as reported on the AUQ at exam year 0, men were classified as "non-drinker", "light drinker" (<7 drinks/wk), "moderate drinker" (7 to 14 drinks/wk), or "excessive drinker" (>14 drinks/wk), and women were classified as "nondrinker", "light drinker" (<4 drinks/wk), "moderate drinker" (4 to 7 drinks/wk), or "excessive drinker (> 7 drinks/wk) [8,53]. ...
Objective:
This study aimed to shed light on contradictory associations of alcohol intake with waist circumference (WC) and body mass index (BMI) by examining 5-yr changes in alcohol intake in relation to 5-yr WC and BMI changes.
Methods:
This prospective study included 4,355 participants (1,974 men and 2,381 women) enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study at baseline (1985-1986) and followed over 25 years (2010-2011). Longitudinal random effects linear regression models were used to test whether changes in drinking (defined categorically) as starting to drink, increasing, decreasing, stable drinking or stopping drinking (versus stable non-drinking) over a series of 5-yr periods were associated with corresponding 5-yr WC and BMI changes. Associations with 5-yr changes (defined categorically as starting, stable or stopping) in drinking level (i.e., light/moderate and excessive) and 5-yr changes (defined categorically as increasing, no change, or decreasing) by beverage type (i.e., beer, wine and liquor/mixed drinks) were also examined.
Results:
In men, compared to stable non-drinking, decreasing total alcohol intake was associated with lower 5-yr WC (β:-0.62 cm; 95% CI: -1.09, -0.14 cm) and BMI gains (β:-0.20 kg/m2; 95% CI: -0.30, -0.03 kg/m2) and stopping excessive drinking was associated with lower 5-yr WC gains (β:-0.77 cm; 95% CI: -1.51, -0.03 cm). In women, compared to those with stable non-drinking habits, starting light/moderate drinking was associated with lower 5-yr WC (β: -0.78 cm; 95% CI: -1.29, -0.26 cm) and BMI gains (β:-0.42 kg/m2; 95% CI: -0.64, -0.20 kg/m2). Increasing wine intake was associated with a lower 5-yr BMI gain (β:-0.27 kg/m2; 95% CI: -0.51, -0.03 kg/m2). Decreasing liquor/mixed drink (β:-0.33 kg/m2; 95% CI: -0.56, -0.09 kg/m2) intake was associated with lower 5-yr WC (β:-0.88 cm; 95% CI: -1.43, -0.34 cm) and BMI (β:-0.33 kg/m2; 95% CI: -0.56, -0.09 kg/m2) gains.
Conclusions:
Associations of alcohol intake with obesity measures are complex. In women, wine and liquor/mixed drink intakes had contrasting associations with WC and BMI change. In men, decreasing weekly alcoholic beverage intake with an emphasis on stopping excessive consumption may be beneficial in managing WC and BMI gains.
... However, this association was not observed in other studies (10). Varied types of alcoholic beverages have been studied about obesity, and the results are con icting (9,(11)(12)(13). The inconsistency in the evidence of the association between alcohol consumption and obesity could be attributed to many factors, including methods used, types of confounders controlled for, different alcohol exposure measurements (quantity, frequency, or both), and outcomes of interest (BMI, WC, waist-to-hip ratio [WHR], waist-to-height ratio [WHtR], or percent body fat [%BF]) studied. ...
Background: The prevalence of obesity is increasing worldwide. Alcohol has been studied as a possible risk factor for obesity, but the evidence is discordant. This study examined the association between alcohol consumption and obesity in an Irish population.
Method: A cross-sectional study using secondary data from the Healthy Ireland Survey 2017 was conducted. Descriptive and comparative data were analysed to identify associations of alcohol-related variables with waist circumference (WC) and body mass index (BMI). Regression analysis was performed to examine the associations between harmful alcohol consumption (AUDIT-C score≥ 5) and obesity indicators. Adjustments were made for sociodemographic variables, health-related variables, and other alcohol-related variables.
Result: A total of 7486 participants took part in this survey (response rate=60.4%). Most of the participants (86.5%) were alcohol drinkers, with the majority drinking less than 3 times per week (77.5%); 49.1% were considered harmful drinkers. After controlling for possible confounders, positive associations of harmful alcohol consumption with WC (β=1.98, 95% CI: 1.00, 2.96) and BMI (OR=1.25, 95% CI: 1.06, 1.47) were observed. Further controlling for alcohol consumption frequency and binge drinking made this association nonsignificant. Unlike less frequent binge drinking, frequent binge drinking was positively associated with WC (β=2.03, 95% CI: 0.89, 3.17).
Conclusion: Harmful alcohol consumption was associated with obesity (high BMI, large WC) after controlling for possible confounders; however, this association became nonsignificant after controlling for other alcohol-related variables. Frequent binge drinkers were more likely to have a large WC. Further longitudinal studies to examine the exact association between alcohol consumption and obesity are warranted.
... In their prospective study, Halkjaer et al. [34] found a U-shaped association between alcohol from wine and differences in WC for both sexes and a positive association of alcohol from spirits with differences in WC in women. In contrast to our study, Schutze et al. [35] showed a positive association in men and no association in women between beer consumption and WC in their prospective study. Sex-specific differences in the metabolism of alcohol may explain these results. ...
The evidence on the association between alcohol consumption and adiposity is inconsistent and fragmented. We investigated the longitudinal association between alcohol consumption pattern and four different adiposity markers with repeated measures of adiposity and obesity incidence. We categorized current drinkers based on the sex-specific quartiles of their weekly alcohol consumption and the UK alcohol drinking guidelines. We used multivariable adjusted generalised linear models. With the exception of a direct association between alcohol volume and body fat percentage (BF%) in women (B = 0.42%; 95%CI: 0.04, 0.80% for women in the top quartile), we found no associations between alcohol consumption and adiposity markers for either sex. Red wine and champagne/white wine consumption were inversely associated with waist circumference (WC) for both sexes (B = −0.58 cm, 95%CI: −0.77, −0.38 cm and B= −0.49 cm, 95%CI: −0.68, −0.29 cm, respectively, for women; B = −0.28 cm, 95%CI: −0.47, −0.08 cm and B = −0.23 cm, 95%CI: −0.42, −0.04 cm, respectively, for men). Female and male spirit drinkers had higher WC than non-spirit drinkers. Alcohol consumption was associated with a lower risk of obesity incidence in women (OR:0.60, 95%CI:0.45, 0.80 for the 2nd quartile, OR:0.53, 95%CI: 0.40, 0.70 for the 3rd quartile and OR:0.61, 95%CI:0.46, 0.80 for the 4th quartile). We found limited evidence of longitudinal associations between alcohol intake and adiposity. The few statistically significant associations we observed are unlikely to be of clinical importance.
... Specifically, they found that male heavy beer drinkers (more than one litre/day) had a 17% greater gain in abdominal fat deposition than very light drinkers during eight and a half years of followup. Furthermore, an increase in visceral adiposity was significantly lower in beer-abstaining women than in very-light-drinking women [44]. Finally, other recent studies have shown that heavy drinking may be more of a risk factor for weight gain than light-tomoderate drinking [45]. ...
Recent data show that young people, mainly due to the pressure of some risk factors or due to disrupted interpersonal relationships, utilise greater reward value and display greater sensitivity to the reinforcing properties of “pleasurable stimuli”, specifically in those situations in which an enhanced dopamine release is present. Alcoholic beverages, foods rich in sugar and fat, and illicit drug use are pleasurable feelings associated with rewards. Research shows that there is a link between substance abuse and obesity in brain functioning. Still, alcohol excess is central in leading to obesity and obesity-related morbidities, such as hepatic steatosis, mainly when associated with illicit drug dependence and negative eating behaviours in young people. It is ascertained that long-term drinking causes mental damage, similarly to drug abuse, but also affects liver function. Indeed, beyond the pharmacokinetic interactions of alcohol with drugs, occurring in the liver due to the same metabolic enzymes, there are also pharmacodynamic interactions of both substances in the CNS. To complicate matters, an important noxious effect of junk foods consists of inducing obesity and obesity-related NAFLD. In this review, we focus on some key mechanisms underlying the impact of these addictions on the liver, as well as those on the CNS.
... Experimental studies on beer and wine drinking noted that light-to-moderate and frequent consumption had no effect in weight gain or significant changes in body weight indicators in both genders [13,[69][70][71]. The negative correlation between BMI and beer-wine drinking in normal weight men, as supported from our findings, may be linked to the lifestyle factors of this specific consumer segment. ...
The increasing global prevalence of overweight and obesity highlights an urgent need to explore modifiable obesogenic factors. This study investigated the impact of lifestyle factors, such as beer and wine drinking, cigarette smoking, and leisure time screen viewing activities, on body weight and the development of obesity. Individual level data were selected from a random sample of 3471 German adults using a two-stage disproportionate random sampling procedure. The empirical analysis employed a two-stage equations system and combined the endogenous treatment effects model with the quantile regression technique. Our estimations showed that the decisions to smoke and consume wine and beer were positively interrelated, especially in women. Frequent beer/wine drinkers of normal weight were found to have a lower BMI in the male subsample. Quantile regression estimates indicated a significant influence of smoking on BMI in both genders, with smokers’ BMI following an upward trend, especially in the upper quantiles of the distribution. Leisure time screen activity was found to have a major impact on females’ BMI. Prolonged television viewing and regular computer gaming had a strong relationship with weight increase in overweight women, whereas internet surfing was inversely correlated with the BMI of normal weight and slightly overweight female participants. Nutrition and health policies should direct individuals toward alternative recreational activities in order to substitute screen usage and reduce sedentary time. This study also raised doubts about the general belief that smokers have a lower body weight. As unhealthy behaviors usually co-occur or cluster together, obesity prevention interventions might also contribute to a decrease in smoking.
... 7,8 A previous study showed a 17% higher risk for WC gain in men consuming 1,000 mL/day beer compared with those drinking less than 250 mL/day beer. 9 There seems to be a stronger connection between heavy drinking and increased body weight in men at different ages than in women. 8,10 In elderly men, greater BMI (+4.8%) and WC (+5%) were shown to be related to alcohol intake ≥50 g/day. ...
The diagnosis of metabolic-associated fatty liver disease is based on the detection of liver steatosis together with the presence of metabolic dysfunction. According to this new definition, the diagnosis of metabolic-associated fatty liver disease is independent of the amount of alcohol consumed. Actually, alcohol and its metabolites have various effects on metabolic-associated abnormalities during the process of alcohol metabolism. Studies have shown improved metabolic function in light to moderate alcohol drinkers. There are several studies focusing on the role of light to moderate alcohol intake on metabolic dysfunction. However, the results from studies are diverse, and the conclusions are often controversial. This review systematically discusses the effects of alcohol consumption, focusing on light to moderate alcohol consumption, obesity, lipid and glucose metabolism, and blood pressure.
... Our results there are in line with other studies that showed that the weight gain in drinkers was general and not just localized at the abdominal level. [35] However, a previous study showed that for a 1 cm increase in waist circumference, the relative risk of a cardiovascular disease event was increased by 2% (95% CI: 1-3%). [36] Taking this estimation into account, the 8-9 cm increase in the waist circumference of drinkers may represent a 16-18% increase in relative risk of cardiovascular disease event while the waist-to-hip ratio was not suggesting such additional risk. ...
Background: The negative effects of alcohol abuse are well documented. However, definitions of moderate alcohol consumption are still controversial, differ in many parts of the world, and are rarely including African countries.
Objective: This study aimed to assess the effects of moderate consumption of beer as defined in many studies (less than 30 g alcohol per day) on the anthropometry and metabolism of Cameroonian drinkers.
Materials and methods: The study included a total of 75 participants (aged 34-50). Among them, 37 were moderate beer drinkers and were compared to 38 lifetime abstainers. Anthropometric measurements were performed in all participants and included height, weight, body mass index (BMI), waist circumference, waistto-hip ratio and adiposity. Hemodynamic parameters (systolic blood pressure, diastolic blood pressure and pulse rate were also measured. Fasting plasma glucose, lipid profile and cardiometabolic risk indices were measured to monitor metabolism.
Results: The prevalence of overweight and obesity were higher among beer drinkers. Significantly higher values were found in drinkers concerning mean BMI in females (+18.66%; p<0.01), waist circumference (+8-9 cm; p<0.01), and body fat (+4-6%; p<0.05) in both genders. Fasting plasma glucose in males (p<0.01), total cholesterol in females (+71.20%; p<0.01), HDL-cholesterol (+16.85-21.17%; p<0.01), LDL-cholesterol (+59.87%-78.37%) were significantly higher among drinkers. No significant difference between drinkers and abstainers was noticed concerning blood pressure, pulse rate, plasma triglycerides and cardiometabolic risk indices.
Conclusion: The occurrence of metabolic disturbances under the 30 g alcohol/ day threshold should raise awareness about defining moderate beer consumption locally in order to avoid alcohol-related health problems in the long term.
Keywords: adiposity, beer, blood glucose, lipid profile, moderate consumption.
... Interestingly, the previous Danish study indicated that the most frequent drinkers with light consumption had the lowest odds ratios for being obese (32) . Likewise, the result of the European Prospective Investigation into Cancer and Nutrition (EPIC) -Potsdam study showed that light to moderate beer consumption leads to smaller WC and body weight gain in men (36) . Therefore, obesity can be dependent on dose of alcohol consumption and alcohol pattern. ...
Objective
To assess the prevalence of metabolic syndrome (MetS) in Chinese adults living in Ningbo and to examine the association between alcohol consumption, and MetS and its medical components.
Design
A representative survey in Ningbo was conducted in 2015 covering socio-demography. A food frequent questionnaire together with additional questionnaires was used to collect information on alcohol consumption, diet, demography, lifestyle, and medical information. Multivariable logistic regression and generalized linear models were used to examine the association between alcohol consumption, and both MetS and its medical components, respectively.
Setting
Ningbo, China
Participants
Total 2853 adults ≥20 years (44% men) in this final analysis.
Results
The prevalence of frequent alcohol drinkers and MetS were 29.9% and 28.0%, respectively. Significantly higher prevalence of MetS and mean values of medical components were found in the group of frequent alcohol drinkers with an exception for HDL-C, compared to less or non-alcohol drinkers. Frequent alcohol consumption was associated with higher odds of developing MetS and positively associated with medical components excepting waist circumference.
Conclusions
Frequent alcohol consumption contributed to higher prevalence of MetS, and unfavorable influence on MetS and its medical components among Chinese adults. A public health intervention on alcohol restriction is necessary for the prevention and control the ongoing epidemic MetS.
... Similar to our figures, mild to moderate consumption of beer had favorable influence on WC (Freiberg et al., 2004), on other metabolic syndrome components, such as lipid profile and fasting insulin (Freiberg et al., 2004) and on BMI (Breslow et al., 2005). Consumption of more than 21 beers/week for men and 14 beers/week for women was found as risk for an increase WC in a large prospective Danish study (Vadstrup, 2003), but a 8.5 years prospective study of the EPIC cohort showed that the beer consumption odds ratio for WC increase is mostly explained by change in BMI (Schutze et al., 2009). In the same cohort, alcohol from beer showed higher risk than expected from BMI increase when average lifelong consumption was the risk factor considered in the analysis (Bergmann et al., 2011). ...
Central obesity is the accumulation of fat in the abdominal region, and is a marker
for Metabolic Syndrome. Since beer is a popular drink in Romania, we searched
for eventual connection between beer consumption and waist circumference
(WC). We carried out a transversal semi-quantitative study targeting the adult
population of Romania. The relations between WC, WHR (waist hip ratio) and
beer consumption were variable and non-linear. Regressions for WC and WHR
did not bring statistically significant coefficients, showing that there is no
significant link between beer consumption and WC or WHR. We could conclude
that beer ingestion by itself is not associated with a higher prevalence of
abdominal obesity
... Similar to our figures, mild to moderate consumption of beer had favorable influence on WC (Freiberg et al., 2004), on other metabolic syndrome components, such as lipid profile and fasting insulin (Freiberg et al., 2004) and on BMI (Breslow et al., 2005). Consumption of more than 21 beers/week for men and 14 beers/week for women was found as risk for an increase WC in a large prospective Danish study (Vadstrup, 2003), but a 8.5 years prospective study of the EPIC cohort showed that the beer consumption odds ratio for WC increase is mostly explained by change in BMI (Schutze et al., 2009). In the same cohort, alcohol from beer showed higher risk than expected from BMI increase when average lifelong consumption was the risk factor considered in the analysis (Bergmann et al., 2011). ...
Central obesity is the accumulation of fat in the abdominal region, and is a marker for Metabolic Syndrome. Since beer is a popular drink in Romania, we searched for eventual connection between beer consumption and waist circumference (WC). We carried out a transversal semi-quantitative study targeting the adult population of Romania. The relations between WC, WHR (waist hip ratio) and beer consumption were variable and non-linear. Regressions for WC and WHR did not bring statistically significant coefficients, showing that there is no significant link between beer consumption and WC or WHR. We could conclude that beer ingestion by itself is not associated with a higher prevalence of abdominal obesity.
... This misconception gave rise to the term "beer belly." Studies have shown that beer consumption does not specifically increase the belly size but rather increases the overall body weight (Schutze et al., 2009). Therefore, it is unlikely that beer consumption specifically increases the abdominal visceral fat or is particularly responsible for android obesity. ...
Men have a higher tendency to accumulate abdominal visceral fat compared to pre-menopausal women. The accumulation of abdominal visceral fat in men, which is a strong independent predictor of mortality, is mainly due to the higher dietary fat uptake by their abdominal visceral fat. Since dietary fat is absorbed by the enterocytes and transported to the circulation in the forms of chylomicrons and very low density lipoproteins (VLDLs), it is crucial to understand how these lipoproteins are different between men and women. The chylomicrons in men are generally bigger in size and more in quantity than those in women. During the postprandial state, these chylomicrons congest the lamina propria and the low-pressure lymphatics. In this paper, we propose that this congestion predisposes the chylomicron triglycerides to hydrolysis by lipoprotein lipase (LPL). The liberated fatty acids are then stored by the nearby abdominal visceral adipocytes, leading to the accumulation of abdominal visceral fat. These mechanisms perhaps explain why men, through their bigger and higher production of chylomicrons, are more likely to accumulate abdominal visceral fat than pre-menopausal women. This accumulation eventually leads to belly enlargement, which confers men their apple-shaped body.
... The discrepancy in results could partly be attributed to variation in types of alcohol beverage consumed. Studies have found mixed results for wine [16][17][18][19], and beer intake [20][21][22], while spirit intake was more consistently found to be directly related to risk of weight gain [16,20,23]. However, these studies were primarily based on adult populations and cannot be generalized to adolescents. ...
Background:
Several studies have suggested a link between the type of alcoholic beverage consumption and body weight. However, results from longitudinal studies have been inconsistent, and the association between adolescent alcohol consumption long-term weight gain has generally not been examined.
Methods:
The study was based on data from 720 Danish adolescents aged between 15 to 19 years at baseline from the Danish Youth and Sports Study (YSS). Self-reported alcohol use, height, weight, smoking, social economic status (SES) and physical activity levels were assessed in baseline surveys conducted in 1983 and 1985, and in the follow up survey which was conducted in 2005. Multiple linear regression analyses were used to examine the association between alcohol consumption in adolescence and subsequent weight gain later in midlife.
Results:
There was no significant association between total alcohol consumption during adolescence and change in BMI into midlife (P = 0.079) (β - 0.14; 95% CI -0.28, 0.005). Wine consumption was found to be inversely associated to subsequent BMI gain (P = 0.001) (β - 0.46; 95% CI -0.82, - 0.09) while the results were not significant for beer and spirit. The relationship did not differ by gender, but smoking status was found to modify the relationship, and the inverse association between alcohol and BMI gain was seen only among non-smokers (P = 0.01) (β - 0.24; 95% CI -0.41, - 0.06) while no association was found among smokers. Neither adolescent nor attained socioeconomic status in adulthood modified the relationship between alcohol intake and subsequent BMI gain.
Conclusion:
Among non-smoking adolescents, consumption of alcohol, and in particular wine, seems to be associated with less weight gain until midlife.
Trial registration:
The YSS cohort was retrospectively registered on August 2017. (Study ID number: NCT03244150 ).
... The heterogeneity across the spectrum of alcohol intake, including an adverse effect on BP as opposed to a potentially favourable influence on HDL-C and insulin sensitivity, at least at lower levels of intake, has led to a confusing picture when alcohol consumption has been evaluated against the prevalence and/or incidence of the metabolic syndrome. This may also reflect conflicting findings as to whether alcohol consumption leads to weight gain [26,27] or central adiposity [28]. ...
Purpose of Review
To examine outstanding issues in the relationship of alcohol to hypertension. These include whether the increase in BP with alcohol is causally related, the nature of the relationship in women, the contribution of alcohol-related increases in BP to cardiovascular disease and the aetiology of alcohol-related hypertension.
Recent Findings
Intervention studies and Mendelian randomisation analyses confirm the alcohol–BP relationship is causal. The concept that low-level alcohol intake reduces BP in women is increasingly unsustainable. Alcohol-related hypertension is in the causal pathway between alcohol use and increased risk for several cardiovascular outcomes. The aetiology of alcohol-related hypertension is multifactorial with recent data highlighting the effects of alcohol on the vasoconstrictor 20-HETE and oxidative stress.
Summary
The high prevalence of both alcohol use and hypertension mandates a careful alcohol history in every patient with elevated BP. Early intervention for excessive alcohol use offers the promise of lower levels of BP and reduced risk of adverse cardiovascular outcomes.
... In women, there was a significant inverse compared to very-light drinking women. However, after adjusting for concurrent body weight and hip circumference, a non-significant association was observed.19 ...
The relationship between alcohol, marijuana and metabolic syndrome
remains controversial. Marijuana has been found to be a commonly used drug among those who drink alcohol, yet little is known about the effect of using both substances concurrently with metabolic syndrome. With decriminalization of marijuana across different states in the United States, it is expected that the prevalence of marijuana use will increase. Therefore, it is of utmost importance to understand the adverse impact of these drugs on metabolic syndrome.
... However, the extensive consumption of beer (i.e. >60 g/day of ethanol) may increase the risk for a positive energy balance that could lead to abdominal or general obesity [4,5]. Thus consumers should be informed on their daily energy requirements as well as on the caloric content of their preferred beer. ...
A large evidence-based review on the effects of a moderate consumption of beer on human health has been conducted by an international panel of experts who reached a full consensus on the present document.
... Those in the largest waist circumference category who drank alcoholic beverages on the day preceding the survey had significantly more standard drinks than those in the other categories and a greater contribution to energy intake from alcoholic beverages. Beer consumption was associated with waist circumference gain in men but not women in the EPIC study (43) . It has been suggested that this difference between sexes may be a consequence of habitual drink choice, with men consuming more beer. ...
Objective:
To assess alcoholic beverage intake among Australian adults and its contribution to dietary energy intake.
Design:
Secondary analysis of a national dietary survey using 24 h dietary recall.
Setting:
Australian National Nutrition and Physical Activity Survey (NNPAS) conducted from May 2011 to June 2012.
Subjects:
Adults (n 9341) aged 19 years and over.
Results:
On the day preceding the survey, 32·8% of Australian adults consumed one or more alcoholic drinks. The median contribution to total energy intake for consumers did not differ significantly between males and females (13·7% and 12·9%, respectively; P=0·10). The prevalence of consumption of alcoholic drinks on Friday, Saturday and Sunday was 38·8 (95% CI 37·1, 40·5)%, higher than the other days (28·6 (95% CI 27·5, 29·8)%). Consumers had a median daily intake of 4·0 standard drinks on the weekend compared with 3·0 standard drinks during the week (P<0·001). Beer was the most commonly consumed alcoholic beverage for men and white wine for women. The highest prevalence of alcoholic beverage intake occurred in the highest quintile of adjusted household income (42·7 (95% CI 40·4, 45·0)%) and the 'overweight' BMI category (40·3 (95% CI 38·5, 42·0)%). Alcoholic beverage intake among consumers was significantly different by household income quintile (median 3·84 (highest) v. 3·05 standard drinks (lowest); P<0·05) and by waist circumference category (median 4·09 standard drinks (highest)).
Conclusions:
Alcoholic drinks contribute substantially to the dietary energy intake of Australian adults. The type and pattern of consumption of alcoholic beverage intake should be considered in the development of strategies to improve dietary intake.
... A recent systematic review summarized short-term clinical trials (16) that mostly involved healthy participants and suggested that moderate alcohol consumption is associated with favorable patterns of biomarkers of cardiovascular risk. The effect of moderate alcohol consumption on blood pressure (BP) (17) and adiposity remains controversial (18,19). ...
Background:
Recommendations for moderate alcohol consumption remain controversial, particularly in type 2 diabetes mellitus (T2DM). Long-term randomized, controlled trials (RCTs) are lacking.
Objective:
To assess cardiometabolic effects of initiating moderate alcohol intake in persons with T2DM and whether the type of wine matters.
Design:
2-year RCT (CASCADE [CArdiovaSCulAr Diabetes & Ethanol] trial). (ClinicalTrials.gov: NCT00784433).
Setting:
Ben-Gurion University of the Negev-Soroka Medical Center and Nuclear Research Center Negev, Israel.
Patients:
Alcohol-abstaining adults with well-controlled T2DM.
Intervention:
Patients were randomly assigned to 150 mL of mineral water, white wine, or red wine with dinner for 2 years. Wines and mineral water were provided. All groups followed a Mediterranean diet without caloric restriction.
Measurements:
Primary outcomes were lipid and glycemic control profiles. Genetic measurements were done, and patients were followed for blood pressure, liver biomarkers, medication use, symptoms, and quality of life.
Results:
Of the 224 patients who were randomly assigned, 94% had follow-up data at 1 year and 87% at 2 years. In addition to the changes in the water group (Mediterranean diet only), red wine significantly increased high-density lipoprotein cholesterol (HDL-C) level by 0.05 mmol/L (2.0 mg/dL) (95% CI, 0.04 to 0.06 mmol/L [1.6 to 2.2 mg/dL]; P < 0.001) and apolipoprotein(a)1 level by 0.03 g/L (CI, 0.01 to 0.06 g/L; P = 0.05) and decreased the total cholesterol-HDL-C ratio by 0.27 (CI, -0.52 to -0.01; P = 0.039). Only slow ethanol metabolizers (alcohol dehydrogenase alleles [ADH1B*1] carriers) significantly benefited from the effect of both wines on glycemic control (fasting plasma glucose, homeostatic model assessment of insulin resistance, and hemoglobin A1c) compared with fast ethanol metabolizers (persons homozygous for ADH1B*2). Across the 3 groups, no material differences were identified in blood pressure, adiposity, liver function, drug therapy, symptoms, or quality of life, except that sleep quality improved in both wine groups compared with the water group (P = 0.040). Overall, compared with the changes in the water group, red wine further reduced the number of components of the metabolic syndrome by 0.34 (CI, -0.68 to -0.001; P = 0.049).
Limitation:
Participants were not blinded to treatment allocation.
Conclusion:
This long-term RCT suggests that initiating moderate wine intake, especially red wine, among well-controlled diabetics as part of a healthy diet is apparently safe and modestly decreases cardiometabolic risk. The genetic interactions suggest that ethanol plays an important role in glucose metabolism, and red wine's effects also involve nonalcoholic constituents.
Primary funding source:
European Foundation for the Study of Diabetes.
... Frequency and amount of alcohol consumption also plays important role. Less frequent but heavy drinkers seem to be at higher risk of obesity than frequent and moderate drinkers (Schutze M, et.al, 2009). Presently, it can be said that alcohol calories count in combination with a high-fat diet and in overweight and obese subjects (Colditz G, et.al., 1991). ...
ABSTRACT: Obesity has reached epidemic proportions in India as well as in Gujarat state. Recent research has
suggested prominent role of indirect unconventional parameters influencing hunger and appetite. A cross sectional
study was designed to determine the prevalence of obesity and indirect determinants like pattern of caffeine
products and alcohol consumption, depression status and levels of hunger-satiety amongst the non-obese and obese
young bank employees of urban Baroda. Bank employees (595) were screened for anthropometric measurements.
Pattern of caffeine products and alcohol consumption, depression and hunger-satiety were studied using a score
card. Non-obese (100) and obese grade I (126) young bank employees (25-35 yrs) were selected for further study.
Out of 595 subjects, 41% were obese (BMI >25) and 20% were overweight. Consumption pattern of caffeine
products and alcohol showed that obese subjects consumed more alcohol (57%), cigarette (28%), tea (68%) and
coffee (25%) (p<0.001). Depression was more pronounced in non-obese (20%) subjects. Obese subject reported
significantly higher (p<0.001) scores for delayed satiety. A strong significant association (p<0.001) was observed
between consumption pattern of caffeine products and alcohol, its degree of consumption, and satiety scores of
obese subjects. The significant difference in consumption pattern of caffeine products and alcohol, satiety scores
and depression between obese and non-obese subjects may have played a role in the higher prevalence of obesity
in the Bank employees.
Key words: Indirect determinants, Depression, Hunger, Satiety, Caffeine, Alcohol
... Frequency and amount of alcohol consumption also plays important role. Less frequent but heavy drinkers seem to be at higher risk of obesity than frequent and moderate drinkers (Schutze M, et.al, 2009). Presently, it can be said that alcohol calories count in combination with a high-fat diet and in overweight and obese subjects (Colditz G, et.al., 1991). ...
Obesity has reached epidemic proportions in India as well as in Gujarat state. Recent research has suggested prominent role of indirect unconventional parameters influencing hunger and appetite. A cross sectional study was designed to determine the prevalence of obesity and indirect determinants like pattern of caffeine products and alcohol consumption, depression status and levels of hunger-satiety amongst the non-obese and obese young bank employees of urban Baroda. Bank employees (595) were screened for anthropometric measurements. Pattern of caffeine products and alcohol consumption, depression and hunger-satiety were studied using a score card. Non-obese (100) and obese grade I (126) young bank employees (25-35 yrs) were selected for further study. Out of 595 subjects, 41% were obese (BMI >25) and 20% were overweight. Consumption pattern of caffeine products and alcohol showed that obese subjects consumed more alcohol (57%), cigarette (28%), tea (68%) and coffee (25%) (p<0.001). Depression was more pronounced in non-obese (20%) subjects. Obese subject reported significantly higher (p<0.001) scores for delayed satiety. A strong significant association (p<0.001) was observed between consumption pattern of caffeine products and alcohol, its degree of consumption, and satiety scores of obese subjects. The significant difference in consumption pattern of caffeine products and alcohol, satiety scores and depression between obese and non-obese subjects may have played a role in the higher prevalence of obesity in the Bank employees.
... Energy expenditure in the preparation of food is also low, because many households have a maid to help with many household tasks. Alcohol is not consumed whereas in European populations this is a significant additional source of variability of energy intake and weight gain (e.g., in vernacular, though a little misleadingly, the "beer belly" [6]). Taken together, these features would be predicted to combine to reduce the variables influencing obesity in Saudi Arabia, leaving a potentially greater impact particularly for determinants of appetite, amongst which genetic factors have an important role. ...
Large scale studies in Europeans have clearly identified common polymorphism affecting BMI and obesity. We undertook a genotype study to examine the impact of variants, known to influence obesity, in a sample from the Saudi Arabian population, notable for its profound combination of low mean physical activity indices and high energy intake. Anthropometry measures and genotypes were obtained for 367 Saudis, taken from King Saud University and Biomarker Screening Project in Riyadh (Riyadh Cohort). We observed large effect sizes with obesity for rs10767664 (BDNF) (OR = 1.923, P = 0.00072) and rs3751812 (FTO) (OR = 1.523, P = 0.016) in our sample and, using weighted genetic risk scores, we found strong evidence of a cumulative effect using 11 SNPs taken predominantly from loci principally affecting appetite (OR = 2.57, P = 0.00092). We used conditional analyses to discern which of our three highly correlated FTO SNPs were responsible for the observed signal, although we were unable to determine with confidence which best marked the causal site. Our analysis indicates that markers located in loci known to influence fat mass through increased appetite affect obesity in Saudi Arabians to an extent possibly greater than in Europeans. Larger scale studies will be necessary to obtain a precise comparison.
... Frequency and amount of alcohol consumption also plays important role. Less frequent but heavy drinkers seem to be at higher risk of obesity than frequent and moderate drinkers (Schutze M, et.al, 2009). Presently, it can be said that alcohol calories count in combination with a high-fat diet and in overweight and obese subjects (Colditz G, et.al., 1991). ...
Obesityhas reached epidemic proportions inIndiaas well as in Gujarat state.Recent research has suggested prominent role of indirect unconventional parameters influencing hunger and appetite. A cross sectional study was designed to determine the prevalence of obesity and indirect determinants like pattern of caffeine products and alcohol consumption, depression status and levels of hunger-satiety amongst the non-obese and obese young bank employees of urban Baroda. Bank employees (595) were screened for anthropometric measurements. Pattern of caffeine products and alcohol consumption, depression and hunger-satiety were studied using a score card. Non-obese (100) and obese grade I (126) young bank employees (25-35 yrs) were selected for further study. Out of 595 subjects, 41% were obese (BMI >25) and 20%were overweight. Consumption pattern of caffeine products and alcohol showed that obese subjects consumed more alcohol (57%), cigarette (28%), tea (68%) and coffee (25%) (p
... 111 The relationship between obesity and alcohol consumption differs between men and women. 112,113 In obese persons, excessive drinking leads to increased risks of liver disease, 114,115 liver cirrhosis, and mortality. [116][117][118] High body mass index and fasting glucose are independent risk factors for the progression of liver fibrosis even after correcting for the amount of alcohol consumed and the duration of alcohol abuse, 119 which is thought to be due to insulin resistance and hyperinsulinemia. ...
Alcoholic liver disease (ALD) is the most prevalent cause of advanced liver disease in Europe. However, there has been limited research investment into ALD despite its significant burden on the health of Europeans. This disparity is reflected by the ETOh score - the ratio of the estimated population mortality rate to the number of trials focused on a particular disease. The ETOh score for ALD is 358, compared with 1.4 for hepatitis B, 4.9 for hepatitis C, and 15.2 for primary biliary cirrhosis [1]. In recent years however, the mechanisms driving disease progression and the natural history of ALD have been better defined and novel targets for therapy have been identified [2]. In addition, significant clinical research has produced a clear framework for the evaluation of new therapies in particular in patients with alcoholic steatohepatitis (ASH). ALD is a complex disease, the successful management of which hinges on the integration of all the competences in public health, epidemiology, addiction behavior and alcohol-induced organ injury. Both primary intervention to reduce alcohol abuse and secondary intervention to prevent alcohol-associated morbidity and mortality rely on the coordinated action of multidisciplinary teams established at local, national, and international levels. These guidelines are largely based on the issues raised during the EASL monothematic conference on ALD held in Athens in 2010. The guidelines have three main aims: (1) to provide physicians with clinical recommendations; (2) to emphasize the fact that alcohol can cause several liver diseases (steatosis, steatohepatitis, cirrhosis), all of which may coexist in the same patient; (3) to identify areas of interest for future research, including clinical trials. The evidence and recommendations in these guidelines have been graded according to the Grading of Recommendations Assessment Development and Evaluation (GRADE) system [3]. The strength of recommendations thus reflects the quality of underlying evidence. The principles of the GRADE system have been enunciated. The quality of the evidence in these clinical practical guidelines (CPGs) has been classified into one of three levels: high (A), moderate (B) or low (C). The GRADE system offers two grades of recommendation: strong (1) or weak (2) (Table 1). The CPGs thus consider the quality of evidence: the higher the quality of evidence, the more likely a strong recommendation is warranted; the greater the variability in values and preferences, or the greater the uncertainty, the more likely a weaker recommendation is warranted.
... Our results are in line with these studies. With regard to waist circumference, previous studies have not shown a consistent relation with alcohol consumption for men or women [29][30][31]. Adjusting for BMI attenuated the relation amongst women, but not men, indicating that BMI may to some extent explain the different associations between men and women. Adjusting for waist and hip circumference attenuated the association amongst women to a level very similar to that observed amongst men. ...
Beulens JWJ, van der Schouw YT, Bergmann MM, Rohrmann S, B Schulze M, Buijsse B, Grobbee DE, Arriola L, Cauchi S, Tormo M-J, Allen NE, van der A DL, Balkau B, Boeing H, Clavel-Chapelon F, de Lauzon-Guillan B, Franks P, Froguel P, Gonzales C, Halkjær J, Huerta JM, Kaaks R, Key TJ, Khaw KT, Krogh V, Molina-Montes E, Nilsson P, Overvad K, Palli D, Panico S, Ramón Quirós J, Ronaldsson O, Romieu I, Romaguera D, Sacerdote C, Sánchez M-J, Spijkerman AMW, Teucher B, Tjonneland A, Tumino R, Sharp S, Forouhi NG, Langenberg C, Feskens EJM, Riboli E, Wareham NJ (University Medical Center Utrecht, The Netherlands; German Institute of Human Nutrition, Potsdam-Rehbrücke, Germany; German Cancer Research Centre, Heidelberg, Germany; Basque Government, San Sebastian, CIBERESP, Spain; Institut de Biologie de Lille, Lille, France; Murcia Regional Health Council, Murcia, Spain; CIBER Epidemiologia y Salud Publica (CIBERESP), Spain; University of Oxford, Oxford, UK; National Institute of Public Health and the Environment, Bilthoven, The Netherlands; Inserm, CESP Centre for Research in Epidemiology and Population Health, Villejuif Cedex, France; Lund University, Malmö, Sweden; Imperial College, London, UK; Department of Epidemiology, Barcelona, Spain; Danish Cancer Society, Copenhagen, Denmark; University of Cambridge, Cambridge, UK; Fondazione IRCCS Istituto Nazionale Tumori Milan, Milan, Italy; Andalusian School of Public Health, Granada, Spain; School of Public Health, Aarhus, Denmark; Cancer Research and Prevention Institute (ISPO), Florence, Italy; Università Federico II, Napoli, Italy; Consejeria de Salud y Servicios Sanitarios, Oviedo-Asturias, Spain; Umea University, Umea, Sweden; International Agency for Research of Cancer, Lyon, France; Center for Cancer Prevention (CPO-Piemonte), Torino, Italy; “Civile - M.P. Arezzo” Hospital, Ragusa, Italy; Addenbrooke’s Hospital, Cambridge, UK; and Wageningen University, Wageningen, The Netherlands). Alcohol consumption and risk of type 2 diabetes in European men and women: influence of beverage type and body size. The EPIC–InterAct study. J Intern Med 2012; 272: 358–370.
Objective: To investigate the association between alcohol consumption and type 2 diabetes, and determine whether this is modified by sex, body mass index (BMI) and beverage type.
Design: Multicentre prospective case–cohort study.
Setting: Eight countries from the European Prospective Investigation into Cancer and Nutrition cohort.
Subjects: A representative baseline sample of 16 154 participants and 12 403 incident cases of type 2 diabetes.
Interventions: Alcohol consumption assessed using validated dietary questionnaires.
Main outcome measures: Occurrence of type 2 diabetes based on multiple sources (mainly self-reports), verified against medical information.
Results: Amongst men, moderate alcohol consumption was nonsignificantly associated with a lower incidence of diabetes with a hazard ratio (HR) of 0.90 (95% CI: 0.78–1.05) for 6.1–12.0 versus 0.1–6.0 g day−1, adjusted for dietary and diabetes risk factors. However, the lowest risk was observed at higher intakes of 24.1–96.0 g day−1 with an HR of 0.86 (95% CI: 0.75–0.98). Amongst women, moderate alcohol consumption was associated with a lower incidence of diabetes with a hazard ratio of 0.82 (95% CI: 0.72–0.92) for 6.1–12.0 g day−1 (P interaction gender <0.01). The inverse association between alcohol consumption and diabetes was more pronounced amongst overweight (BMI ≥ 25 kg m−2) than normal-weight men and women (P interaction < 0.05). Adjusting for waist and hip circumference did not alter the results for men, but attenuated the association for women (HR=0.90, 95% CI: 0.79–1.03 for 6.1–12.0 g day−1). Wine consumption for men and fortified wine consumption for women were most strongly associated with a reduced risk of diabetes.
Conclusions: The results of this study show that moderate alcohol consumption is associated with a lower risk of type 2 diabetes amongst women only. However, this risk reduction is in part explained by fat distribution. The relation between alcohol consumption and type 2 diabetes was stronger for overweight than normal-weight women and men.
... Earlier studies on different types of alcohol containing beverages on abdominal obesity have also shown conflicting results. Some studies have found association between beer consumption and central obesity (Vadstrup et al., 2003;Krachler et al., 2006) whereas other prospective studies have not found this association (Schutze et al., 2009) or inconsistent results (Bobak et al., 2003). Sakurai et al., found that spirits consumption was associated with increased waist girth but not with BMI (Sakurai et al., 1997). ...
Alcohol and dietary fat have high energy densities and may therefore be related to body weight and fat deposition. We studied associations between alcohol and macronutrient intake patterns and general and central adiposity.
A population-based cross-sectional study of 524 men and 611 women. The participants answered a dietary questionnaire describing habitual food consumption including intake of alcoholic beverages. Macronutrient intake was analysed in relation to anthropometric measures and dual energy X-ray absorptiometry determined body fat.
In women, total alcohol intake was negatively associated with body fat percentage (β:-0.67, P<0.01). In men, total alcohol intake was positively associated with sagittal abdominal diameter (SAD) (β: 0.28, P=0.01). In addition, positive associations were found between intake of alcohol from spirits and body fat percentage (β: 1.17, P<0.05), SAD (β: 0.52, P<0.05) and waist circumference (β: 2.29, P=0.01). In men, protein intake was positively associated with body mass index (BMI) (β: 0.03, P=0.001), body fat percentage (β: 0.04, P<0.05), SAD (β: 0.02, P=0.01) and waist circumference (β: 0.09, P<0.01). Also in men only, negative associations between fat intake and BMI (β: -0.03, P<0.01), SAD (β: -0.02, P<0.05) and waist circumference (β: -0.05, P<0.05) were found.
Alcohol intake was inversely associated to relative body fat in women whereas spirits consumption was positively related to central and general obesity in men. Macronutrient intakes, particularly protein and fat, were differently associated with obesity indicators in men versus women. This may reflect a differential effect by gender, or differential obesity related reporting errors in men and women.
... Alcohol intake was modestly associated with DWC BMI among women. Similar results have been observed in previous prospective studies, in which high alcohol intake, especially from beer and spirits, was associated with an increase in waist circumference in women, while in men results were more mixed [29,34,35,36,37,38]. Reason for such divergent effect in men and women are difficult to elucidate, and could be related to the specific effect of different alcohol subtypes, or to the effect of the alcohol drinking pattern. ...
Given the recognized health effects of visceral fat, the understanding of how diet can modulate changes in the phenotype "waist circumference for a given body mass index (WC(BMI))", a proxy measure of visceral adiposity, is deemed necessary. Hence, the objective of the present study was to assess the association between dietary factors and prospective changes in visceral adiposity as measured by changes in the phenotype WC(BMI).
We analyzed data from 48,631 men and women from 5 countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Anthropometric measurements were obtained at baseline and after a median follow-up time of 5.5 years. WC(BMI) was defined as the residuals of waist circumference regressed on body mass index, and annual change in WC(BMI) (DeltaWC(BMI), cm/y) was defined as the difference between residuals at follow-up and baseline, divided by follow-up time. The association between energy, energy density (ED), macronutrients, alcohol, glycemic index (GI), glycemic load (GL), fibre and DeltaWC(BMI) was modelled using centre-specific adjusted linear regression, and random-effects meta-analyses to obtain pooled estimates. Men and women with higher ED and GI diets showed significant increases in their WC(BMI), compared to those with lower ED and GI [1 kcal/g greater ED predicted a DeltaWC(BMI) of 0.09 cm (95% CI 0.05 to 0.13) in men and 0.15 cm (95% CI 0.09 to 0.21) in women; 10 units greater GI predicted a DeltaWC(BMI) of 0.07 cm (95% CI 0.03 to 0.12) in men and 0.06 cm (95% CI 0.03 to 0.10) in women]. Among women, lower fibre intake, higher GL, and higher alcohol consumption also predicted a higher DeltaWC(BMI).
Results of this study suggest that a diet with low GI and ED may prevent visceral adiposity, defined as the prospective changes in WC(BMI). Additional effects may be obtained among women of low alcohol, low GL, and high fibre intake.
... For example, beer may be more favoured by men and the additional energy derived from the carbohydrate in beer may enhance the risk of weight gain in contrast to wine-drinkers who would consume less energy overall per unit of alcohol. Consistent with this suggestion is the observation that waist circumference correlates positively with beer intake in men but not women [88]. Other factors of relevance may be drinking frequency and binge-drinking. ...
The increased recognition that the worldwide increase in incidence of obesity is due to a positive energy balance has lead to a focus on lifestyle choices that may contribute to excess energy intake, including the widespread belief that alcohol intake is a significant risk factor for development of obesity. This brief review examines this issue by contrasting short-term laboratory-based studies of the effects of alcohol on appetite and energy balance and longer-term epidemiological data exploring the relationship between alcohol intake and body weight. Current research clearly shows that energy consumed as alcohol is additive to that from other dietary sources, leading to short-term passive over-consumption of energy when alcohol is consumed. Indeed, alcohol consumed before or with meals tends to increase food intake, probably through enhancing the short-term rewarding effects of food. However, while these data might suggest that alcohol is a risk factor for obesity, epidemiological data suggests that moderate alcohol intake may protect against obesity, particularly in women. In contrast, higher intakes of alcohol in the absence of alcohol dependence may increase the risk of obesity, as may binge-drinking, however these effects may be secondary to personality and habitual beverage preferences.
Total alcohol intake may influence overweight and obesity in some (particularly heavy) drinkers, but the magnitude of weight gain appears clinically marginal. Robust evidence to support that reducing alcohol consumption may address the obesity epidemic is lacking and warrants further research. Study findings nonetheless favour current practice, encouraging clinicians to recognise and address drinking behaviours as one of many lifestyle factors pertinent to individual weight management.
Background:
Fatty liver may be the result of several factors. The two main contributors are nonalcoholic fatty liver disease (NAFLD) and alcoholic liver disease (ALD).
Summary:
NAFLD is the hepatic manifestation of the metabolic syndrome (MetS) and is the major cause of chronic liver disease worldwide as a result of the obesity epidemic. ALD is also a common cause of chronic liver disease. Obesity is a major contributory factor to MetS and is also common in individuals who consume large amounts of alcohol. There is a similar hepatic pathology and both can result in severe fibrosis, cirrhosis, and its complications including hepatocellular carcinoma. This review discusses the etiology, pathogenesis, and genetics of both NAFLD and ALD and their interaction. It is necessary to understand this better in order to prevent and treat these important causes of liver disease worldwide.
Key message:
Obesity, MetS, and alcohol consumption are linked to the development and progression of fatty liver disease. The coexistence of these factors in many patients requires a reassessment of many aspects of treatment of fatty liver disease.
Moderate alcohol consumption has been associated with beneficial effects on human health. Specifically, consumption of red wine and beer has shown a J-shape relation with many important diseases. While a role of ethanol cannot be excluded, the high content of polyphenols in both beverages has been proposed to contribute to these effects, with beer having the advantage over wine that it is lower in alcohol. In addition to ethanol, beer contains a wide variety of compounds with known medicinal potential such as kaempferol, quercetin, tyrosol and phenolic acids, and it is the main dietary source for the flavones xanthohumol and 8-prenylnaringenin, and bitter acids such as humulones and lupulones. Clinical and pre-clinical evidence for the protective effects of moderate beer consumption against cardiovascular disease and other diseases has been accumulating since the 1990s, and the non-alcoholic compounds of beer likely exert most of the observed beneficial effects. In this review, we summarize and discuss the effects of beer consumption in health and disease as well as the clinical potential of its non-alcoholic compounds which may be promising candidates for new therapies against common chronic diseases.
Obesity is multifactorial and complex. Remarkable progress has been made recently in search for polygenic obesity through genome-wide association study (GWAS), but biology of polygenic effects on obesity is largely poor. This review summarizes the available evidence and provides an overview of the links between ALDH2 variants and adiposity, which were firstly and mainly derived from studies of polygenic obesity and also indirectly investigated by using cell lines and mice. The genetic association studies have observed consistent associations of ALDH2 variants with obesity-related traits including BMI, waist circumference (WC), waist-to-hip ratio (WHR), and visceral fat accumulation. In consideration of ALDH2 variants with enzyme activity and alcohol consumption behavior in physiological mechanism studies, we proposed a model by which the physiological and behavioral consequences of alcohol consumption serve as an intermediary process between polymorphisms in ALDH2 and obesity.
Objective:
To assess the occurrence of central obesity and identify its predictors in urban Africans using anthropometric tools. Another objective was to evaluate the anthropometric indices and their interaction with various cardiovascular risk factors.
Methods:
In an obesity survey in a major Nigerian city, we measured the prevalence of central obesity in 998 randomly selected men and women using the IDF (International Diabetes Federation) criteria. Normalized values of three anthropometric indices, waist circumference (WC), WHR (waist-to-hip ratio) and WHtR (waist-to-height ratio) were also employed in assessing central adiposity and its predictors in the population.
Results:
Most (61%) female participants had central obesity compared with 9% of the males based on the IDF waist criteria. Higher income level and physical inactivity were associated with central obesity (p < 0.001). In multivariate analyses, older participants and women were more likely to have central obesity (p < 0.001), but men had higher WHR than women at the same body mass index. WC was a stronger predictor of glucose intolerance than WHR, whereas WHR was more predictive of hypertension than WC. WHR showed a strong relationship with hypertension but not with glucose intolerance. WHtR was predictive of plasma glucose and diastolic blood pressure. WC showed strongest correlation with other indices.
Conclusions:
Central obesity was highly prevalent among women in this sample. It was associated with age, gender, socioeconomic status, physical inactivity, and it predicted glucose intolerance and hypertension. WC was a major determinant of both cardiovascular risk factors. It showed best correlation with other anthropometric indices.
Background
Alcohol intake is widely assumed to contribute to excess body fatness, especially among young men; however, the evidence is inconsistent. We have addressed this research question by investigating associations between reported alcohol consumption and body composition from large representative national surveys in a high alcohol‐consuming country with a high obesity prevalence.
Methods
The present study comprised a secondary analysis of combined cross‐sectional nationally representative Scottish Health Surveys (1995–2010). Reported alcohol‐drinking frequency was divided into five groups: from ‘nonfrequent drinking’ (reference) to daily/‘almost every day’ among 35 837 representative adults [mean (SD) age: 42.7 (12.7) years (range 18–64 years)]. Quantitative alcohol consumption was categorised into seven groups: from ‘1–7 to ≥50 10 g units per week’. Regression models against measured body mass index (BMI) and waist circumference (WC) were adjusted for age, physical activity, income, smoking, deprivation category and economic status.
Results
Among alcohol‐consuming men, heavier drinking (21–28 units per week) was associated with a higher BMI by +1.4 kg m–2 [95% confidence interval (CI) = 1.38–1.43] and higher WC by +3.4 cm (95% CI = 3.2–3.6) than drinking 1–7 units per week. However, those who reported daily drinking frequency were associated with a lower BMI by −2.45 kg m–2 (95% CI = −2.4 to −2.5) and lower WC by −3.7 cm (95% CI = −3.3 to −4.0) than those who reported less‐frequent drinking. Similar associations were found for women. Most of these associations were restricted to subjects aged >30 years. Unexplained variances in BMI and WC are large.
Conclusions
Quantitative alcohol consumption and frequency of consumption were positively and inversely associated, respectively, with both BMI and WC among alcohol‐consuming adults. Surveys are needed that evaluate both the quantity and frequency of consumption. The lowest BMI and WC were associated with a ‘Mediterranean’ drinking style (i.e. relatively little, but more frequently).
Hintergrund und Ziele: Herzinsuffizienz ist ein komplexes Syndrom das eine zunehmende Belastung für die öffentliche Gesundheit darstellt. Ungeachtet der verbesserten therapeutischen Möglichkeiten ist Herzinsuffizienz weiterhin die dritthäufigste Todesursache in Deutschland und mit einer hohen Krankenhausaufenthaltsrate, teuren Behandlungskosten und einer starken Beeinträchtigung der Lebensqualität verbunden. Kardio-protektive Effekte der mediterranen Ernährung wurden bereits vielfach beschrieben: von inversen Assoziationen zwischen der Einhaltung dieser Ernährung und diversen kardiovaskulären Ereignissen wurden berichtet. Die Mediterrane Kost zeichnet sich durch eine hohe Aufnahme von Obst und Gemüse, Getreide, Fisch und Hülsenfrüchte aus. Auf der anderen Seite ist der Anteil der gesättigten Fette in der Regel gering aufgrund der häufigen Verwendung von Olivenöl in Salaten und anderen Gerichten und des geringen Verzehrs von Fleisch. Ein weiterer typischer Bestandteil der Ernährung ist der moderate Konsum von Alkohol, hauptsächlich in Form von Wein, während der Mahlzeiten. Trotz des großen Potenzials für die Herzinsuffizienz-Prävention wurde die Mediterrane Ernährung noch nicht in prospektiven, auf der Allgemeinbevölkerung basierenden, Studien bezüglich ihre Assoziation zur Herzinsuffizienz-Entwicklung untersucht. Das Ziel der vorliegenden Studie war es daher, den Zusammenhang zwischen dem Mediterranen Ernährungsmuster und den Hauptkomponenten auf der Ebene der Lebensmittelgruppen und Nährstoffe und dem Risiko von Herzinsuffizienz zu erforschen. Methoden: Die Studie wurde mit 9.225 Männern und 14.783 Frauen der European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam-Studie durchgeführt. Um das Einhalten der Mediterranen Ernährung zu beurteilen, wurde der erweiterte traditionelle Mediterrane Ernährungs-Score (tMED) unter Verwendung griechischer Grenzwerte (mediane Aufnahmemenge) erzeugt. Durch einen Top-down-Ansatz wurde die Ernährungs-Erkrankungs-Beziehung systematisch untersucht, beginnend mit der Analyse der Assoziation zwischen tMED-Kategorien und dem Risiko von Herzinsuffizienz, über ausgewählte relevante Komponenten des Scores (Lebensmittelgruppen) bis hin zu den repräsentativsten Nährstoffe dieser Komponenten. Eine Cox-Regressionsanalyse wurde durchgeführt, um Hazard Ratios (HRs) und 95% Konfidenzintervalle (95% KI) für Herzinsuffizienz zu berechnen. Drei Methoden wurden angewendet, um die Relevanz der Score-Komponenten zu beurteilen: 1. Die Berechnung der HRs der Herzinsuffizienz für kontinuierliche Aufnahmen der Lebensmittelgruppen jeder Komponente durch „Restricted cubic spline“ Cox-Regressionen, 2. mittels Errechnen der HRs von Herzinsuffizienz nach tMED-Komponenten auf dichotomer Skalierung (Erreichen eines Punktes im Vergleich zu keinem) und 3. Durch die Berechnung der Veränderung der HRs pro zwei tMED-Einheiten vor und nach Ausschluss jeder Score-Komponente. Die so ausgewählten Komponenten wurden dann in ihre Bestandteile zerlegt (d.h. Lebensmittelgruppen und repräsentative Makro- und Mikronährstoffe) und die Risiko-Beziehung zur Herzinsuffizienz wurde weiter auf diesen tieferen Ebenen der Ernährung untersucht. Ergebnisse: Nach einer mittleren Nachbeobachtungszeit von 8,2 Jahren traten 209 Fälle von Herzinsuffizienz auf. Im Allgemeinen war die Einhaltung des Mediterranen Ernährungsmusters eher gering (durchschnittlicher Score: 3,5 Punkte). Eine inverse Beziehung zwischen den erreichten Punkten im tMED und dem Risiko einer Herzinsuffizienz wurde beobachtet. Nach multivariabler Adjustierung wiesen Personen, die fünf oder mehr Punkte erhalten hatten, ein um 37% geringeres Herzinsuffizienz-Risiko auf als Teilnehmer denen null bis zwei Punkte vergeben wurden. Doch diese Assoziation verfehlte knapp das Signifikanzniveau (ptrend = 0,06). Eine weitere Analyse ergab, dass nicht jede der tMED-Komponenten zu der Herzinsuffizienz-Risikoreduktion des Scores beigetragen hat. Drei Komponenten wurden als die wichtigsten Einflussfaktoren für die insgesamt inverse Assoziation identifiziert, nämlich eine hohe Aufnahme von Fettfisch, moderater Alkoholkonsum, sowie ein geringer Konsum von Fleisch und Fleischprodukten, insbesondere verarbeitetem Fleisch. Nach Adjustierung für Alter, Geschlecht, Bildung, körperlicher Aktivität, Rauchverhalten und der Aufnahme der übrigen Score-Komponenten war ein hoher Fleischkonsum verglichen zu geringem Konsum mit einem 2,5-fach erhöhten Risiko für Herzinsuffizienz verbunden. Im Gegensatz dazu wurde moderater Alkoholkonsum mit einem um 33% (95% KI: 49% -11%) niedrigeren Risiko für Herzinsuffizienz in Verbindung gebracht im Vergleich zu niedrigem oder hohem Konsum. Der Verzehr von Fischkonserven (hauptsächlich aus fettem Fisch bestehend) stand ebenfalls in einem inversen Zusammenhang mit dem Herzinsuffizienz-Risiko (HR (95% KI) für das höchste gegenüber dem niedrigsten Quintil der Aufnahme: 0,59 (0,36-0,96)). Die Untersuchungen auf Nährstoff-Ebene deuteten darauf hin, dass besonders die Fettqualität diese Ergebnisse erklären könnte: die Aufnahmen von Cholesterin und vor allem gesättigten Fettsäuren zeigten eine positive Assoziation zum Herzinsuffizienzrisiko, während marine Omega-3-Fettsäuren invers mit dem Herzinsuffizienzrisiko assoziiert waren. Schlussfolgerungen: Die Ergebnisse der vorliegenden Analyse zeigen, dass die Einhaltung eines Mediterranen Ernährungsmusters das Risiko der Entwicklung einer Herzinsuffizienz reduzieren kann. Von den neun Komponenten, die in dem tMED verwendet wurden, spielten nur drei eine wichtige Rolle für das Herzinsuffizienz-Risiko. Diese waren: eine geringe Aufnahme von Fleisch und Fleischprodukten, mäßiger Alkoholkonsum und eine hoher Verzehr von Fisch. Gesättigte Fettsäuren und Cholesterin scheinen höchstwahrscheinlich für die risiko-steigernde Wirkung von Fleischkonsum verantwortlich zu sein, während die enthaltenden Omega-3-Fettsäuren die Schutzwirkung durch Fischkonsum erklären könnten. Weitere Studien sind erforderlich, um die in dieser Arbeit beobachteten Ergebnisse und Schlussfolgerungen zu validieren und zu bekräftigen.
Objectives The preference for a specific alcoholic beverage may be related to an individual's overall lifestyle and health. The objective was to investigate associations between alcoholic beverage preference and several cardiometabolic and lifestyle factors, including adiposity, cholesterol, glycated haemoglobin (HbA1c), liver enzymes and dietary patterns.
Design Cross-sectional study.
Setting The Dutch Longitudinal Nutrition Questionnaires plus (NQplus) Study.
Participants 1653 men and women aged 20–77 years.
Methods Diet, including alcohol, was assessed by Food Frequency Questionnaire. Based on the average number of reported glasses of alcoholic beverage, a person was classified as having a preference for beer, wine, spirit/no specific preference, or as a non-consumer. Mixed linear models were used to calculate crude and adjusted means of cardiometabolic and lifestyle factors across alcoholic beverage preference categories.
Primary outcome measures Anthropometric measures, blood pressure, lipids, HbA1c, albumin, creatinine, uric acid, liver enzymes and dietary patterns.
Results In the study population, 43% had a wine preference, 13% a beer preference, 29% had a spirit or no specific preference, and 15% did not consume alcohol. Men who preferred wine had lowest measures of adiposity; the preference for alcoholic beverages was not associated with adiposity measures in women. Wine consumers had higher high density lipoprotein-cholesterol, lower HbA1c and were more likely to follow the ‘Salad’ pattern. Beer consumers had highest levels of triglycerides and liver enzymes, and had higher scores for the ‘Meat’ and ‘Bread’ pattern.
Conclusions Few differences in dietary patterns across alcoholic beverage preference categories were observed. Those differences in cardiometabolic parameters that were observed according to alcoholic beverage preference, suggested that wine consumers have a better health status than beer consumers.
Increased body weight and, in particular, abdominal obesity is associated with increased cardiovascular disease risk [1]. In many developed countries, the average alcohol intake in those who drink is about 10–30 g/day or 3–9 % of the total energy intake [2], and the efficiency of alcohol for the maintenance of metabolizable energy is the same as for carbohydrate [3]. Alcohol suppresses the oxidation of fat, favouring fat storage and can serve as a precursor for fat synthesis [4, 5]. Moderate alcohol consumers usually add alcohol to their daily energy intake rather than substituting it for food, thus increasing energy balance [5]. On the basis of this, it would seem surprising if alcohol did not contribute directly to body weight. While laboratory studies on energy and nutrient balances show that alcohol is a nutrient that is efficiently utilized by the body and that alcohol calories do count, the epidemiological evidence is conflicting and whether moderate amounts of alcohol is a risk factor for weight gain and obesity is still controversial [6]. Several factors have been proposed which may explain the inconsistencies between studies, including the suggestion that the effect of alcohol on adiposity is influenced by type of drink [5], whether the alcohol is consumed with meals or not [5] and the pattern and amount of drinking in the population study [7]. A review conducted in 2005 concluded that the issue of whether alcohol calories count may be dependent on the characteristic of the drinker and the amount and pattern of drinking [6]. Moreover, evidence from a number of studies suggests that in drinkers, fat is preferentially deposited in the abdominal area [5] and that alcohol may be more associated with abdominal obesity than with general obesity [8–11]. The aim of this chapter is to review the epidemiological evidence for alcohol as a risk factor for overweight and obesity with particular focus on prospective studies. The influence of type of alcohol, pattern of drinking and confounding will also be discussed.
Objectives:
This study provides cross-sectional information on alcoholic beverages as potential sources of moisture and calories for drinkers in the United States. Associations between number of drinks per day and body weight status were also studied.
Methods:
Multivariable regression models were used to ascertain associations while controlling for potential confounders.
Results:
Compared to nondrinkers, daily moisture intake increased as the number of drinks increased. Increase in daily moisture intake of drinkers remained significant even after correcting for diuretic effects of ethanol (men: 270.6 g [95% confidence interval (CI), 115.7-425.4], P = 0.001) and (women: 193.0 g [95% CI, 76.8-309.4], P = 0.002). The increase in daily moisture intake after correcting for diuretic losses were men: 3.9% to 9.6%; and women: 4.1% to 12.8% depending on number of drinks. The increase in calorie intake was 6.7% to 16.2% of men's, and 6.4% to 16.0% of women's daily intake. Compared to nondrinking counterparts, men who consumed 2 or more drinks per day were more likely to be overweight whereas men who consumed 4 or more drinks per day were more likely to be obese (odds ratio: 1.63 [95% CI, 1.10-2.40], P = 0.015). Women at all levels of drinking were less likely to be obese (odds ratio: 0.70 [95% CI, 0.55-0.88], P = 0.004) compared to nondrinking counterparts.
Conclusion:
Alcoholic beverages contribute to moisture intake despite the diuretic effect of their ethanol content. Calorie intake increase with increasing alcohol intake among men and women but only men associate with increased likelihood of overweight and obesity. Women drinkers associate with lower body mass index and are less likely to be overweight or obese.
We investigated the contribution of alcohol-derived calories to the alcohol-obesity relation. Adult alcohol calorie intake was derived from consumption volume and drink type in the Health Survey for England 2006 (n = 8864). We calculated the odds of obesity with survey-adjusted logistic regression. Mean alcohol calorie consumption was 27% of the recommended daily calorie intake in men and 19% in women on the heaviest drinking day in the last week, with a positive association between alcohol calories and obesity. Alcohol calories may be a significant contributor to the rise in obesity. (Am J Public Health. Published online ahead of print February 13, 2014: e1-e3. doi:10.2105/AJPH.2013.301643).
Background/aims:
The impact of alcohol on health depends on both the total amount ingested per week and the drinking pattern. Our goal was to assess the relationship between drinking occasions and anthropometric indicators of adiposity.
Methods:
For this cross-sectional study, 7,855 men aged 50-59 years were recruited between 1991 and 1993 in France. Clinical and anthropometric data were obtained in a standardized clinical examination by trained staff. Alcohol intake was assessed by a questionnaire recording daily consumption of each type of alcohol during a typical week.
Results:
75% of the participants drank alcohol daily (264.7 ml per week). For a given total alcohol intake and after adjustment of confounders, the number of drinking episodes was inversely correlated with body mass index (p < 0.0001) and waist circumference (p < 0.0001). The odds ratio (95% confidence interval) for obesity was 1.8 (1.3-2.4) for occasional (1-2 days/week) and 1.6 (1.2-2.1) for frequent drinkers (3-5 days/week) compared with daily drinkers. This correlation was less pronounced in moderate (<140 ml/week) than intermediate consumers (140-280 ml/week). In heavy consumers (>280 ml/week), the intake was almost always daily. The results were similar for wine and beer consumption.
Conclusion:
Our findings suggest that drinking occasion is a risk indicator of obesity independent of total alcohol intake.
Cross-sectional associations between body fat and its distribution and environmental factors influencing energy balance were examined in 5115 young adults. Protein was directly associated with body mass index (BMI) in all race and sex groups (P less than 0.01) after age, education, cigarette-smoking status, alcohol intake, and physical activity were adjusted for. Carbohydrate intake was inversely associated with BMI in males (P = 0.02). Total physical activity was inversely associated with BMI in white women and with skinfold-thickness measures (P less than 0.01) in all groups. Waist-to-hip-circumference ratio (WHCR) was positively associated with total kilojoules (kilocalories) in women, inversely associated with percent of kilojoules (kilocalories) from carbohydrates in whites, grams of crude fiber/4184 kJ (1000 kcal) (except in black men), and physical activity (except in white women). WHCR was directly associated with cigarette smoking except in black men, and with total alcohol intake in men. Beer was consistently associated with WHCR in all race and sex groups.
This investigation evaluated the effects of alcohol consumption, controlled for the energy in alcohol and chronic effects of smoking, on resting energy expenditure (REE) in college-aged social drinkers. Sixteen women who both smoked and drank alcohol were administered, on 4 separate days in a counterbalanced order, 1) cigarettes alone, 2) alcohol alone, 3) alcohol plus cigarettes, or 4) cigarettes with an energetic control. Each session consisted of a 25-min REE baseline, treatment in a randomly assigned order, and a 105-min assessment of REE. Analysis indicated that alcohol significantly (P < 0.05) increased REE for up to 95 min after ingestion [increases of 29.6-68.4 kJ (124-287 kcal)/24 h], increases that could not be accounted for by the energy content of the drink alone. Smoking and alcohol together also raised REE above baseline but not more than alcohol alone. It was concluded that alcohol intake raises REE, potentially explaining why alcohol interferes with energy utilization. Potential implications for alcohol intake, nutrition, and weight loss are presented.
To identify contrasts between the risk factors associated with abdominal weight gain and those associated with peripheral weight gain.
Prospective mail survey.
44080 white, non-Hispanic, healthy women who were questioned in 1982 (baseline age 40-54 y) and 1992 about weight, diet, alcohol use, smoking, 10 physical activities and other variables.
Self reports in 1992 identified 4261 women who gained weight in the abdomen and 7440 women who gained in the periphery (sites other than the abdomen). Using identical logistic models adjusted for age, baseline body mass index (BMI) and numerous covariates, the abdominal-gain group and the peripheral-gain group were separately compared with 10,888 women who did not gain weight.
The likelihood of abdominal gain exceeded that of peripheral gain (by comparison of estimated odds ratios, abdominal vs peripheral) for high meat eaters (1.50 vs 1.15), frequent users of liquor (1.09 vs 0.54), moderate cigarette smokers (0.86 vs 0.59), heavy cigarette smokers (0.96 vs 0.36), cigarette quitters (2.13 vs 1.63), women with high parity (1.52 vs 1.15) and those who reported major weight gain since age 18 y (1.22 vs 0.65). Abdominal gain was less likely than peripheral gain for high vegetable eaters (0.71 vs 0.91), women who exercised > or = 4 h/wk [(especially aerobics/ calisthenics (0.28 vs 0.91) or walking (0.84 vs 1.06)], women who completed menopause (0.74 vs 0.98) and consistent users of estrogen replacement therapy (0.93 vs 1.22).
A behavior or characteristic may be associated differently with the risks of abdominal and peripheral weight gain. This insight could strengthen recommendations for preventing major chronic diseases.
This study examined cross-sectional and prospective relationships between macronutrient intake, behaviors intended to limit fat intake, physical activity and body weight.
The overall goal was to identify diet and exercise behaviors that predict and/or accompany weight gain or loss over time. Specific questions addressed included: (a) are habitual levels of diet or exercise predictive of weight change; (b) are habitual diet and exercise levels associated cross-sectionally with body weight; and (c) are changes in diet and exercise associated with changes in body weight over time?
Subjects were a sample of community volunteers (n=826 women, n=218 men) taking part in a weight gain prevention project over a 3-year period.
Body weight was measured at baseline and annually over the study period. Self-report measures of diet and exercise behavior were also measured annually.
Among both men and women, the most consistent results were the positive association between dietary fat intake and weight gain and an inverse association between frequency of physical activity and weight gain. Individuals who weighed more both ate more and exercised less than those who weighed less. Individuals who increased their physical activity level and decreased their food intake over time were protected from weight gain compared to those who did not. Frequency of high-intensity physical activity was particularly important for both men and women. Additionally, women who consistently engaged in higher levels of moderate physical activity gained weight at a slower rate compared to women who were less active.
Overall results indicated that both cross-sectionally and prospectively, the determinants of weight and weight change are multifactorial. Attention to exercise, fat intake and total energy intake all appear important for successful long term control of body weight.
To examine the long-term association between the amount and type of alcohol consumed and subsequent high waist circumference.
Prospective population study with baseline assessment of alcohol intake, body mass index, smoking habit, physical activity, education, income and deliveries, and after 10 y, examination of waist circumference.
A sample of 2916 men and 3970 women aged 20-83 y from Copenhagen City Heart Study, Denmark.
A large waist circumference defined as a waist circumference more than 102 cm in men and 88 cm in women.
The odds ratios of having a high waist circumference after 10 y showed a linear increase in both men and women, and they were 1.65 (95% confidence interval (CI) 1.07-2.55) in men and 2.16 (0.86-5.14) in women who drank more than 28 beverages per week of total alcohol compared to those who drank one to six beverages per week. Men drinking more than 21 beers per week had odds ratio of having a large waist circumference after 10 y of 1.63 (0.99-2.67) and women drinking more than 14 beers per week had odds ratio of 2.53 (0.92-6.34), compared to men and women who drank no beer. Also for spirits, there was an increase in both men and women. No linear trend was found for wine in either men or women.
Moderate-to-high consumption of alcohol and of beer and spirits was associated with later high waist circumference, whereas moderate-to-high wine consumption may have the opposite effect.
To describe anthropometric characteristics of participants of the European Prospective Investigation into Cancer and Nutrition (EPIC).
A cross-sectional analysis of baseline data of a European prospective cohort study.
This analysis includes study populations from 25 centres in nine European countries. The British populations comprised both a population-based and a 'health-conscious' group. The analysis was restricted to 83 178 men and 163 851 women aged 50-64 years, this group being represented in all centres.
Anthropometric examinations were undertaken by trained observers using standardised methods and included measurements of weight, height, and waist and hip circumferences. In the 'health-conscious' group (UK), anthropometric measures were predicted from self-reports.
Except in the 'health-conscious' group (UK) and in the French centres, mean body mass index (BMI) exceeded 25.0 kg m-2. The prevalence of obesity (BMI> or =30 kg m(-2)) varied from 8% to 40% in men, and from 5% to 53% in women, with high prevalences (>25%) in the centres from Spain, Greece, Ragusa and Naples (Italy) and the lowest prevalences (<10%) in the French centres and the 'health-conscious' group (UK). The prevalence of a large waist circumference or a high waist-to-hip ratio was high in centres from Spain, Greece, Ragusa and Naples (Italy) and among women from centres in Germany and Bilthoven (The Netherlands).
Anthropometric measures varied considerably within the EPIC population. These data provide a strong base for further investigation of anthropometric measures in relation to the risk of chronic diseases, especially cancer.
The European Prospective Investigation into Cancer and Nutrition (EPIC) is an ongoing multi-centre prospective cohort study designed to investigate the relationship between nutrition and cancer, with the potential for studying other diseases as well. The study currently includes 519 978 participants (366 521 women and 153 457 men, mostly aged 35-70 years) in 23 centres located in 10 European countries, to be followed for cancer incidence and cause-specific mortality for several decades. At enrollment, which took place between 1992 and 2000 at each of the different centres, information was collected through a non-dietary questionnaire on lifestyle variables and through a dietary questionnaire addressing usual diet. Anthropometric measurements were performed and blood samples taken, from which plasma, serum, red cells and buffy coat fractions were separated and aliquoted for long-term storage, mostly in liquid nitrogen. To calibrate dietary measurements, a standardised, computer-assisted 24-hour dietary recall was implemented at each centre on stratified random samples of the participants, for a total of 36 900 subjects. EPIC represents the largest single resource available today world-wide for prospective investigations on the aetiology of cancers (and other diseases) that can integrate questionnaire data on lifestyle and diet, biomarkers of diet and of endogenous metabolism (e.g. hormones and growth factors) and genetic polymorphisms. First results of case-control studies nested within the cohort are expected early in 2003. The present paper provides a description of the EPIC study, with the aim of simplifying reference to it in future papers reporting substantive or methodological studies carried out in the EPIC cohort.
There is a common notion that beer drinkers are, on average, more 'obese' than either nondrinkers or drinkers of wine or spirits. This is reflected, for example, by the expression 'beer belly'. However, the few studies on the association between consumption of beer and abdominal obesity produced inconsistent results. We examined the relation between beer intake and waist-hip ratio (WHR) and body mass index (BMI) in a beer-drinking population.
A cross-sectional study.
General population of six districts of the Czech Republic.
A random sample of 1141 men and 1212 women aged 25-64 y (response rate 76%) completed a questionnaire and underwent a short examination in a clinic. Intake of beer, wine and spirits during a typical week, frequency of drinking, and a number of other factors were measured by a questionnaire. The present analyses are based on 891 men and 1098 women who where either nondrinkers or 'exclusive' beer drinkers (ie they did not drink any wine or spirits in a typical week).
The mean weekly beer intake was 3.1 l in men and 0.3 l in women. In men, beer intake was positively related to WHR in age-adjusted analyses, but the association was attenuated and became nonsignificant after controlling for other risk factors. There appeared to be an interaction with smoking: the relation between beer intake and WHR was seen only among nonsmokers. Beer intake was not related to BMI in men. In women, beer intake was not related to WHR, but there was a weak inverse association with BMI.
It is unlikely that beer intake is associated with a largely increased WHR or BMI.
Although it is known that abdominal obesity increases the risk of chronic diseases, prospective data examining the relation between lifestyle factors and the accumulation of abdominal adipose tissue are sparse.
The objective of the study was to determine the associations of changes in diet, physical activity, alcohol consumption, and smoking with 9-y waist gain among US men.
A prospective cohort comprised 16 587 US men aged 40-75 y at baseline in 1986. Data on lifestyle factors were provided periodically with the use of self-reported questionnaires, and participants measured and reported their waist circumference in 1987 and 1996.
In multivariate analyses, a 2% increment in energy intake from trans fats that were isocalorically substituted for either polyunsaturated fats or carbohydrates was significantly associated with a 0.77-cm waist gain over 9 y (P < 0.001 for each comparison). An increase of 12 g total fiber/d was associated with a 0.63-cm decrease in waist circumference (P < 0.001), whereas smoking cessation and a 20-h/wk increase in television watching were associated with a 1.98-cm and 0.59-cm waist gain, respectively (P < 0.001). Increases of 25 metabolic equivalent tasks (METs) * h/wk in vigorous physical activity and of >/= 0.5 h/wk in weight training were associated with 0.38-cm and 0.91-cm decreases in waist circumference, respectively (P < 0.001 for each comparison). These associations remained significant after further adjustment for concurrent change in body mass index. Changes in total fat and alcohol consumption and in walking volume were not significantly related to waist gain.
Waist gain may be modulated by changes in trans fat and fiber consumption, smoking cessation, and physical activity.
Few studies have investigated the prospective associations between diet or drinking patterns and abdominal obesity; we therefore investigated whether food and beverage groups or patterns predicted 6-year changes in waist circumference (WC) and whether these associations were independent of concurrent changes in BMI as a measure of general obesity. The subjects were 2300 middle-aged men and women with repeated measurements of dietary intake, BMI and WC from 1982 to 1993. Intakes from ten food groups and from coffee, tea, wine, beer and spirits were assessed; gender-specific food factors were identified by factor analyses. Multiple linear regression analyses were done before and after adjustment for concurrent changes in BMI. A high intake of potatoes seemed to prevent gain in WC for men, while a high intake of refined bread was associated with gain in WC for women. The association persisted for refined bread, but not for potatoes, after adjustment for concurrent BMI changes. Among women, but not men, high intakes of beer and spirits were associated with gain in WC in both models. A high intake of coffee for women and moderate to high intake of tea for men were associated with gain in WC, but the associations were weakened, especially for women, after adjustment for BMI changes. None of the food factors was associated with WC changes. Based on the present study, we conclude that very few food items and no food patterns seem to predict changes in WC, whereas high intakes of beer and spirits among women, and moderate to high tea intake among men, may promote gain in WC.
Alcohol consumption may play a role in the development of obesity but the relationship between alcohol and weight is still unclear. The aim of our study was to assess the cross-sectional association of intakes of total alcohol and of specific alcoholic beverages (wine, beer and spirits) with waist-to-hip ratio (WHR) and body mass index (BMI) in a large sample of adults from all over France.
Cross-sectional.
Participants were free-living healthy volunteers of the SU.VI.MAX study (an intervention study on the effects of antioxidant supplementation on chronic diseases).
For 1481 women aged 35-60 years and 1210 men aged 45-60 years, intakes of total alcohol and specific alcoholic beverages were assessed by six 24-hour dietary records. BMI and WHR were measured during a clinical examination the year after.
A J-shaped relationship was found between total alcohol consumption and WHR in both sexes and between total alcohol consumption and BMI in men only (P<0.05). The same relationships were observed with wine (P<0.05); men and women consuming less than 100 g day(-1) had a lower BMI (men only) and WHR than non-drinkers or those consuming more. Spirits consumption was positively associated with BMI (linear regression coefficient beta=0.21, 95% confidence interval (CI): 0.09-0.34 and beta=0.22, 95% CI: 0.06-0.39 for men and women, respectively) and WHR (beta=0.003, 95% CI: 0.001-0.005 and beta=0.003, 95%CI: 0.0002-0.006) in both sexes in a linear fashion. No relationship between beer consumption and BMI or WHR was found.
If confirmed in longitudinal studies, our results indicate that consumption of alcoholic beverages may be a risk factor for obesity.
Serum lipids, blood pressure and body mass may mediate the U-shaped relationship of alcohol consumption with type 2 diabetes mellitus and coronary heart disease. This study examines the cross-sectional and long-term longitudinal relationships of (changes in) alcohol consumption with (changes in) serum lipids, blood pressure and body mass indices.
In this prospective, observational cohort study, two measurements of alcohol consumption, serum total and high-density lipoprotein cholesterol, triglycerides, blood pressure, body weight, the thickness of four skinfolds and waist circumference were performed 4 years apart in healthy volunteers (143 men and 174 women, 32 years old at the first measurement). Alcohol consumption from beer, wine and distilled spirits was assessed using an extensive dietary history interview. Linear regression analyses were performed to study the cross-sectional relationships between the amount of alcohol consumed at the age of 32 years and the levels of the lipids, blood pressure and body weight indices, and to study the longitudinal relationships between the changes in the amount of alcohol consumed over the 4 years of follow-up and the concurrent changes in the lipids, blood pressure and body weight indices. Nonlinearity was investigated for the cross-sectional relationships.
A 10-g/day difference in alcohol consumption was positively related with a 0.05 mmol/L (1.9 mg/dl) difference in high-density lipoprotein cholesterol in both cross-sectional (p = .004), and longitudinal (p < .0001) analyses. This relationship did not differ for men and women or for the consumption of beer, wine or distilled spirits. Relationships with changes in total cholesterol, triglycerides, systolic, diastolic, and pulse pressure, body weight and the sum of four skinfolds were not significant. A borderline significant inverse longitudinal relationship was found with waist circumference. The other lifestyle behaviors (tobacco smoking, physical activity and dietary habits) were major confounders of most cross-sectional relationships between alcohol and serum lipids, blood pressure and body mass indices. The longitudinal relationships, however, were not confounded by changes in the other lifestyle behaviors. A significant nonlinear relationship was found for systolic blood pressure, in which drinkers of about 30 g/day had the lowest values.
Moderate alcohol consumption and moderate long-term changes in alcohol consumption are positively related with the levels and changes in high-density lipoprotein cholesterol in healthy adult men and women. A moderate inverse association between alcohol and waist circumference may be expected. No relationships were found with triglycerides, blood pressure, body weight and the sum of the thickness of four skinfolds. Other lifestyle behaviors confound the cross-sectional, but not the longitudinal, relationships between alcohol consumption and serum lipids, blood pressure and body mass indices. Gender and type of beverage do not modify the relationships between alcohol consumption and these indices.
Objective: Serum lipids, blood pressure and body mass may mediate the U-shaped relationship of alcohol consumption with type 2 diabetes mellitus and coronary heart disease. This study examines the cross-sectional and long-term longitudinal relationships of (changes in) alcohol consumption with (changes in) serum lipids, blood pressure and body mass indices. Method: In this prospective, observational cohort study, two measurements of alcohol consumption, serum total and high-density lipoprotein cholesterol, triglycerides, blood pressure, body weight, the thickness of four skinfolds and waist circumference were performed 4 years apart in healthy volunteers (143 men and 174 women, 32 years old at the first measurement). Alcohol consumption from beer, wine and distilled spirits was assessed using an extensive dietary history interview. Linear regression analyses were performed to study the cross-sectional relationships between the amount of alcohol consumed at the age of 32 years and the levels of the lipids, blood pressure and body weight indices, and to study the longitudinal relationships between the changes in the amount of alcohol consumed over the 4 years of follow-up and the concurrent changes in the lipids, blood pressure and body weight indices. Nonlinearity was investigated for the cross-sectional relationships. Results: A 10-g/day difference in alcohol consumption was positively related with a 0.05 mmol/L (1.9 mg/dl) difference in high-density lipoprotein cholesterol in both cross-sectional (p = .004), and longitudinal (p < .0001) analyses. This relationship did not differ for men and women or for the consumption of beer, wine or distilled spirits. Relationships with changes in total cholesterol, triglycerides, systolic, diastolic, and pulse pressure, body weight and the sum of four skinfolds were not significant. A borderline significant inverse longitudinal relationship was found with waist circumference. The other lifestyle behaviors (tobacco smoking, physical activity and dietary habits) were major confounders of most cross-sectional relationships between alcohol and serum lipids, blood pressure and body mass indices. The longitudinal relationships, however, were not confounded by changes in the other lifestyle behaviors. A significant nonlinear relationship was found for systolic blood pressure, in which drinkers of about 30 g/day had the lowest values. Conclusions: Moderate alcohol consumption and moderate long-term changes in alcohol consumption are positively related with the levels and changes in high-density lipoprotein cholesterol in healthy adult men and women. A moderate inverse association between alcohol and waist circumference may be expected. No relationships were found with triglycerides, blood pressure, body weight and the sum of the thickness of four skinfolds. Other lifestyle behaviors confound the cross-sectional, but not the longitudinal, relationships between alcohol consumption and serum lipids, blood pressure and body mass indices. Gender and type of beverage do not modify the relationships between alcohol consumption and these indices.
Cross-sectional associations between smoking habits, body mass index, and waist-hip ratio (WHR) were examined in 1122 men aged 19 to 102 years. Weight and body mass index were significantly lower in cigarette smokers than in nonsmokers when age was taken into account. The WHR in smokers was significantly higher than in nonsmokers. A graded dose-response relationship was found between the number of cigarettes smoked and the WHR. Longitudinal associations between changes in smoking habits and changes in the WHR were examined during follow-up visits. In the period between these pairs of visits, weight increased when subjects quit smoking and decreased when they started smoking, as expected. The increase in WHR among those who quit smoking was, however, significantly less than the expected increase if smoking had continued. The WHR in those who started smoking actually increased despite their loss of weight. These paradoxical changes in WHR indicate that there are harmful effects of cigarette smoking on the pattern of distribution of body fat. These facts introduce still another reason to suggest that the decision to initiate or to continue smoking to control body weight is unwise.
(JAMA 1989;261:1169-1173)
Specific alcoholic beverage associations with the waist-to-hip ratio were characterized in 12,145 African-American and white men and women ages 45-64 years. Estimated waist-to-hip ratios of those consuming more than six nonwine alcohol drinks/week and more than six wine drinks/week (vs. nondrinkers) were 0.007 larger (p < 0.001) and 0.009 smaller (p < 0.05), respectively. In similar comparisons, the odds ratios for a large waist-to-hip ratio were 1.4 (95% confidence interval 1.1-1.7) for nonwine and 0.45 (95% confidence interval 0.21-0.95) for wine intake. The opposite direction in adjusted associations for wine and nonwine (mainly beer) drinking supports the popular concept of the "beer belly."
To identify predictors of a change in waist circumference in a group of healthy young adults.
Caucasian, 121 women and 109 men, participating in a longitudinal investigation of cardiovascular risk factors in parents and their young children.
Evaluations of body weight, waist and hip circumferences, dietary intake, physical activity, cigarette smoking, and alcohol intake were performed annually. Age was recorded and family history of disease was assessed.
For women, covariates and modifiable predictors accounted for 67% of the variance in waist circumference change from Year 1 to Year 3. Women with lower baseline waist girths, lower baseline hip girths, higher baseline body weight, and a greater change in body weight had larger increases in waist girth. For men, covariates and modifiable predictors accounted for 72% of the variance in waist circumference change. Men with lower baseline waist girth, a greater change in hip girth, higher baseline body weight, greater increases in body weight, and less percent of fat in the diet at baseline had larger increases in waist girth. Other non-modifiable variables did not predict change in either gender.
Reducing excess body weight and decreasing weight gain appear to be the most important factors in preventing the accumulation of upper body fat.
For the German part of the European Prospective Investigation into Cancer and Nutrition (EPIC), a self-administered, optically-readable food frequency questionnaire (FFQ), including 158 food items and 87 coloured portion size photographs, was developed to assess the usual food and nutrient intake of individuals during the past year. In 1991/1992, the reproducibility and validity of the questionnaire measurements were studied according to the EPIC protocol. This article reports the results on reproducibility and relative validity of measurement of food group intake.
A total of 104 men and women aged 35-64 years, who are members of the local health insurance institution, AOK Heidelberg, participated in this study. Reproducibility of the questionnaire measurements was obtained by a repeated administration of the FFQ to the same study subjects at a 6-month interval. The mean of 12 24-hour dietary recalls applied at monthly intervals served as reference method for the estimation of the relative validity of questionnaire measurements. A second version of the FFQ that integrated questions on general food consumption patterns was also investigated.
Spearman test-retest correlations of food group intake ranged from 0.49 for bread to 0.89 for alcoholic beverages (median = 0.70). Spearman correlations between food group intake values derived from the 24-hour diet recalls and the FFQ completed in the summer of 1992 varied from 0.14 for legumes to 0.90 for alcoholic beverages (median = 0.45). Correction for attenuation due to within-person error in the reference method as well as the correction for general consumption patterns improved the correlations.
The results indicate that our newly developed FFQ gives reproducible estimates of food group intake. Large day-to-day variation in food group intake complicated the evaluation of FFQ validity. Overall, moderate levels of relative validity were observed for estimates of food group intake.
To determine the risk of all cause mortality and the incidence of major coronary heart disease (CHD) events in lifelong teetotallers and in ex-drinkers compared with occasional and regular drinkers.
A prospective study of middle-aged men drawn at random from one general practice in each of 24 British towns. Five years after the screening of 7735 men aged 40-59 years, 7167 provided further information on postal questionnaire enabling separation of non-drinkers into lifelong teetotallers and ex-drinkers.
During the follow-up period of 9.8 years after the postal questionnaire there were 929 deaths from all causes and 490 major CHD events. Ex-drinkers exhibited increased cardiovascular and non-cardiovascular mortality; lifelong teetotallers showed the lowest cardiovascular mortality but a significantly increased non-cardiovascular mortality. After adjustment for confounding factors and pre-existing disease, the two non-drinking groups did not differ significantly in all cause mortality from occasional and regular drinkers (light, moderate or heavy) but lifelong teetotallers still showed a significant increase in non-cardiovascular mortality. Adjustment considerably attenuated the risk of both cardiovascular and non-cardiovascular mortality in the ex-drinkers. In men without a diagnosis of CHD, lifelong teetotallers and ex-drinkers showed similar increased relative risk (RR) of heart attacks, with regular drinkers (combined) having a significantly decreased risk compared to occasional drinkers (RR = 0.78, 95% confidence interval [CI] : 0.64-0.96) and non-drinkers (RR = 0.69, 95% CI : 0.52-0.91). This decreased risk was small in absolute terms at around 2-3 major CHD events/1000 person-years.
Lifelong teetotallers and ex-drinkers showed a significantly increased RR of major CHD events compared with regular drinkers, although this risk is small in absolute terms. Lifelong teetotallers have a low risk of overall cardiovascular mortality and an increased risk of non-cardiovascular mortality. Non-drinkers constitute an unsuitable reference group in alcohol-related studies; occasional or even light drinkers may be more appropriate. Overall, there is no convincing evidence that light or moderate drinking has a protective effect on total or cardiovascular mortality in these middle-aged British men.
The goal of the present study was to assess the association between alcohol consumption and abdominal fat deposition in France, a country where wine is the most commonly consumed alcoholic beverage.
We analyzed the association between alcohol consumption and various markers of body weight, in a population sample recruited in three distinct geographical areas of France (MONICA centers). This sample included men (n = 1778) and women (n = 1730) aged 35- 64 y, randomly selected from electoral rolls. Alcohol consumption was assessed with a quantitative frequency questionnaire.
Alcohol intake ranged from 0-1655 ml of alcohol per week. Wine was the main source of alcohol, representing 67% of total alcohol intake in both genders. In men, there was no association between alcohol intake and body mass index (BMI) or body weight, whereas in women, alcohol consumption was inversely correlated with BMI (P < 0.0001) and body weight (P < 0.0002). In men, total alcohol consumption was positively associated with waist-to-hip ratio (WHR, P < 0.0002) and waist girth (P < 0.004), independently of BMI. Similarly, in women, positive associations were found between alcohol intake and WHR (P < 0.0001) as well as waist girth (P < 0.0001), independently of BMI. In a linear regression model including types of beverages and usual confounders, reporting consumption of either wine, beer or spirit was poorly associated with WHR in men, whereas wine (P < 0.0008) and beer (P < 0.0001) consumptions were both positively associated with WHR in women. However, there was no evidence of a statistically significant heterogeneous effect of wine, beer and spirits on WHR in both genders.
In a sample of representative French people, in whom wine is the most common alcoholic beverage, alcohol consumption is associated with greater WHR independently of BMI in both men and women.
Abdominal obesity, as well as psychosocial and socio-economic handicaps are risk factors for serious, prevalent diseases. Connections between these variables have been found in men.
The principal aim of the present study was to analyse the associations between psychosocial and socioeconomic factors with body mass index (BMI) and the waist-to-hip circumference ratio (WHR) in women.
A cohort study of data derived from questionnaires.
1137 women from a population sample of 1464 women born in 1956.
Occupational, social and leisure time conditions, smoking and alcohol habits, as well as height, weight and waist and hip circumferences.
BMI was associated with teetotalism and negatively to wine drinking. WHR correlated directly with cigarette smoking and negatively with consumption of wine and beer. Both BMI and WHR, adjusted for each other and for smoking and alcohol, showed independent associations with low education, unemployment and problems at work when employed, as well as with little physical activity and much TV-watching. In addition, the WHR showed a negative, independent relationship to housing conditions.
These observations suggest psychosocial and socio-economic handicaps as well as a low physical activity in abdominally obese women. Similar observations have been made previously in men, but only with the WHR, suggesting an influence of obesity in these relationships in women only. Another interesting gender difference is the positive relationship between being married with BMI in men, as well as being divorced and living alone with the WHR in men only.
'Stress' embraces the reaction to a multitude of poorly defined factors that disturb homeostasis or allostasis. In this overview, the activation of the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic nervous system have been utilized as objective measurements of stress reactions. Although long-term activation of the sympathetic nervous system is followed by primary hypertension, consequences of similar activation of the HPA axis have not been clearly defined. The focus of this overview is to examine whether or not repeated activation of these two stress centres may be involved in the pathogenesis of abdominal obesity and its comorbidities. In population studies adrenal hormones show strong statistical associations to centralization of body fat as well as to obesity. There is considerable evidence from clinical to cellular and molecular studies that elevated cortisol, particularly when combined with secondary inhibition of sex steroids and growth hormone secretions, is causing accumulation of fat in visceral adipose tissues as well as metabolic abnormalities (The Metabolic Syndrome). Hypertension is probably due to a parallel activation of the central sympathetic nervous system. Depression and 'the small baby syndrome' as well as stress exposure in men and non-human primates are followed with time by similar central and peripheral abnormalities. Glucocorticoid exposure is also followed by increased food intake and 'leptin resistant' obesity, perhaps disrupting the balance between leptin and neuropeptide Y to the advantage of the latter. The consequence might be 'stress-eating', which, however, is a poorly defined entity. Factors activating the stress centres in humans include psychosocial and socioeconomic handicaps, depressive and anxiety traits, alcohol and smoking, with some differences in profile between personalities and genders. Polymorphisms have been defined in several genes associated with the cascade of events along the stress axes. Based on this evidence it is suggested that environmental, perinatal and genetic factors induce neuroendocrine perturbations followed by abdominal obesity with its associated comorbidities.
There is uncertainty as to whether regular alcohol consumption contributes directly to weight gain and the risk of obesity.
We examined the relation between alcohol intake and body weight and the association between changes in alcohol intake and in body weight over 5 y of follow-up.
This was a prospective study of 7608 men aged 40-59 y drawn from general practices in 24 British towns, excluding persons with known diabetes. Five years after screening, 6832 men then aged 45-64 y and without diabetes completed a postal questionnaire on changes in alcohol intake and body weight.
Mean body mass index (BMI; in kg/m(2)) and the prevalence of men with a high BMI (>or= 28; top quintile of the BMI distribution) increased significantly from the light-moderate to the very heavy alcohol intake group even after adjustment for potential confounders. Similar patterns were seen for all types and combinations of alcohol. After 5 y of follow-up, stable and new heavy drinkers (including very heavy drinkers of >or= 30 g/d) showed the greatest weight gain and had the highest prevalence rates of high BMI. Weight change patterns in heavy drinkers at baseline who reduced their intake were not significantly different from those in the stable none-occasional group but showed more weight loss and less weight gain than in the stable or new heavy drinkers.
Heavy alcohol intake (>or= 30 g/d) contributes directly to weight gain and obesity, irrespective of the type of alcohol consumed.
To determine the effects of average alcohol consumption and changes in alcohol intake on the insulin resistance syndrome parameters in a 3-year follow-up study.
Longitudinal study of 1856 and 1529 alcohol drinking men and women in the French DESIR study (Data from an Epidemiological Study on the Insulin Resistance syndrome), aged 30 to 64 years.
In men, fasting glucose, body mass index, waist circumference, systolic blood pressure, and HDL-cholesterol were positively associated with average alcohol consumption while there was no association with insulin or triglycerides concentrations. A change in alcohol intake was positively associated with HDL-cholesterol concentration and systolic blood pressure at follow-up. These effects of alcohol could not be attributed specifically to the intake of wine. In women, while the alcohol HDL-cholesterol relation was similar to that found in the men, the only significant effect of average alcohol intake was an increase in systolic blood pressure, with a spurious decrease in blood pressure related to a 3-year increase in alcohol intake.
Alcohol only provided a beneficial effect on HDL-cholesterol. The beneficial effect seen by other authors of moderate alcohol drinking on diabetes and cardiovascular risk may be due to effects on parameters other than those included in the current definitions of the insulin resistance syndrome.
To examine prospectively the relationship between alcohol and 8-year weight gain in women.
A prospective study of 49,324 women 27 to 44 years old who did not have a history of cardiovascular disease, cancer, or diabetes, who were not pregnant during the study period, and who reported weights in 1991 and 1999.
In cross-sectional analyses, there was a significant inverse relationship between alcohol and BMI even after adjustment for dietary factors and a wide range of confounders. In multivariate prospective analyses, a nonlinear relationship was seen between alcohol and weight gain (>or=5 kg) in all women. Compared with nondrinkers, the adjusted relative odds [95% confidence interval (CI)] of weight gain according to grams per day were 0.94 (0.89, 0.99) for those consuming 0.1 to 4.9 g/d, 0.92 (0.85,0.99) for 5 to 14.9 g/d, 0.86 (0.76, 0.78) for 15 to 29.9 g/d, and 1.07 (0.89,1.28) for those consuming 30+ g/d (p < 0.0001 for quadratic trend). Women who continued to drink heavily and those who became heavy drinkers showed similar increased odds of weight gain. The increased odds of weight gain associated with heavy drinking (30+ g/d) were most marked in the younger women (<35 years) (odds ratio 1.64; 5% CI 1.03 to 2.61). In African-American women, light drinking was associated with increased odds of weight gain compared with nondrinkers (odds ratio = 2.43; 95% CI 1.22 to 4.82).
Our data suggest that light to moderate drinking (up to 30 g/d) is not associated with weight gain in women except possibly in African-American women. Heavier drinking may promote weight gain in women.
It has been suggested that the effects of alcohol on body weight and fat distribution may be influenced by the quantity and type of drink and may differ according to whether the alcohol is consumed with meals or not.
We have examined the cross-sectional association between alcohol intake, patterns of drinking and adiposity (body mass index (BMI), waist-to-hip ratio (WHR), waist circumference (WC) and percentage body fat (%BF)).
We studied 3327 men aged 60-79 y with no history of myocardial infarction, stroke or diabetes drawn from general practices in 24 British towns.
BMI, WHR, WC and %BF increased significantly with increasing alcohol intake even after adjustment for potential confounders (all P < 0.0001), although the effects were stronger for WC and WHR (measures of central adiposity). Men who consumed > or = 21 units/week showed higher levels of central adiposity (WHR, WC) and general adiposity (BMI, %BF) than nondrinkers and lighter drinkers, irrespective of the predominant type of drink consumed (wine, beer, spirits or mixed). The positive association was most clearly seen in beer and spirit drinkers; positive but weaker associations were seen for wine. Among drinkers, a positive association was seen between alcohol intake and the adiposity variables irrespective of whether the alcohol was drunk with or separately from meals.
Higher alcohol consumption (> or = 21 units/week) is positively associated with general and to a greater extent with central adiposity, irrespective of the type of drink and whether the alcohol is drunk with meals or not.
The diet may influence the development of abdominal obesity, but the few studies that have prospectively examined the relations between diet and changes in waist circumference (WC) have given inconsistent results.
Associations between total energy intake, energy intake from macronutrients, and energy intake from macronutrient subgroups based on different food sources and 5-y differences in WC (DWC) were investigated.
A Danish cohort of 22 570 women and 20 126 men aged 50-64 y with baseline data on WC, diet, BMI, and potential confounders reported their WC 5 y later. Associations of baseline diet with DWC were assessed by multiple linear regression analysis.
Neither total energy intake nor energy intake from each of the macronutrients was associated with DWC, except for an inverse association with protein, especially animal protein. In women, positive associations with DWC were seen for carbohydrate from refined grains and potatoes and from foods with simple sugars, whereas carbohydrate from fruit and vegetables was inversely associated and significantly different from any other carbohydrate subgroup. The results for men resembled those for women, although none were significant. Vegetable fat was positively associated with DWC for both men and women in a combined analysis. A U-shaped association between alcohol from wine and DWC was present for both sexes, and alcohol from spirits was positively associated with DWC in women.
Although no significant associations with total energy or energy from fat, carbohydrate, or alcohol were observed, protein intake was inversely related to DWC, and some macronutrient subgroups were significantly associated with DWC.
Moderate and high alcohol intake have been associated with decreased and increased risk of type 2 diabetes, respectively. Insulin resistance, insulin secretion, and abdominal obesity are major predictors of diabetes, but the links with alcohol intake remain contradictory because of limited data.
In a population-based cohort of 807 men (age, 70 years), we studied whether alcohol intake was related to insulin sensitivity, measured with the gold standard technique (euglycemic clamp), insulin secretion (early insulin response), or adiposity [BMI, waist circumference (WC), waist-to-hip ratio]. Alcohol intake was self-reported (questionnaire) and was assessed from a validated 7-day dietary record. The cross-sectional associations were evaluated using multivariable linear regression, adjusting for smoking, education level, physical activity, dietary total energy intake, hypertension, diabetes, triglycerides, and cholesterol.
In multivariable models, self-estimated alcohol intake was not related to insulin sensitivity, early insulin response, or BMI, but was positively related to WC (beta-coefficient, 0.77; 95% confidence interval, 0.15 to 1.39; p=0.02) and waist-to-hip ratio (0.006 [0.002-0.009], p=0.003). The association with WC and waist-to-hip ratio was most pronounced in men in the lowest tertile of BMI. The results using dietary records were similar.
Evaluated in a large sample in elderly men, neither insulin sensitivity measured by clamp technique nor insulin secretion was significantly associated with alcohol intake. However, high alcohol intake was associated with abdominal obesity, which might explain the higher diabetes risk previously observed in high alcohol consumers.
Alcohol and adiposity: effects of quantity and type of drink and time relation with meals
- Wannamethee
- Sg
- Ag Shaper
- Whincup
- Ph
Wannamethee SG, Shaper AG, Whincup PH (2005). Alcohol and adiposity: effects of quantity and type of drink and time relation with meals. Int J Obes (Lond) 29, 1436–1444.
Food Composition and Nutrition Tables Entwicklung des Bierver-brauchs in Deutschland seit 1997 Waist circumference in relation to history of amount and type of alcohol: results from the copenhagen city heart study
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Souci SW, Fachmann W, Kraut H (2000). Food Composition and Nutrition Tables. 6th ed. Stuttgart: Medpharm. Statistisches Bundesamt Deutschland (2007). Entwicklung des Bierver-brauchs in Deutschland seit 1997. Wiesbaden. Vadstrup ES, Petersen L, Sorensen TI, Gronbaek M (2003). Waist circumference in relation to history of amount and type of alcohol: results from the copenhagen city heart study. Int J Obes Relat Metab Disord 27, 238–246.
Entwicklung des Bierverbrauchs in Deutschland seit 1997
- Deutschland Statistisches Bundesamt
Statistisches Bundesamt Deutschland (2007). Entwicklung des Bierverbrauchs in Deutschland seit 1997. Wiesbaden.
Waist circumference in relation to history of amount and type of alcohol: results from the copenhagen city heart study
- E S Vadstrup
- L Petersen
- T I Sorensen
- M Gronbaek
- ES Vadstrup
Vadstrup ES, Petersen L, Sorensen TI, Gronbaek M (2003). Waist
circumference in relation to history of amount and type of
alcohol: results from the copenhagen city heart study. Int J Obes
Relat Metab Disord 27, 238-246.
Alcohol and adiposity: effects of quantity and type of drink and time relation with meals
- S G Wannamethee
- A G Shaper
- P H Whincup
- SG Wannamethee
Wannamethee SG, Shaper AG, Whincup PH (2005). Alcohol and
adiposity: effects of quantity and type of drink and time relation
with meals. Int J Obes (Lond) 29, 1436-1444.
Association of the waist-to-hip ratio is different with wine than with beer or hard liquor consumption. Atherosclerosis Risk in Communities Study Investigators
- B B Duncan
- L E Chambless
- M I Schmidt
- A R Folsom
- M Szklo
- Crouse
- BB Duncan