Lu Wang, MD, PhD, from Brigham and Women’s Hospital in Boston, MA, and colleagues write, “The obesity epidemic is a major health problem in the United States….
Alcohol consumption is a source of energy intake that may contribute to body weight gain and development of obesity. However, previous studies of this relationship have been limited, with inconsistent results.”
The study cohort consisted of 19,220 US women 38.9 years or older with no baseline cardiovascular disease, cancer, or diabetes mellitus and who had a normal baseline body mass index (BMI). Normal range of BMI was defined as 18.5 to less than 25 kg/m2 (calculated as weight in kilograms divided by height in meters squared), overweight or obese as a BMI of 25 kg/m2 or more, and obese as a BMI of 30 kg/m2 or more. A baseline questionnaire determined self-reported alcoholic beverage intake and body weight. In addition, body weight was assessed on 8 yearly follow-up questionnaires.
Amount of alcohol consumed at baseline was inversely related to weight gain during 12.9 years of follow-up. Overweight or obesity developed in 7,942 women (41.3%) and obesity in 732 (3.8%).
The relative risk of becoming overweight or obese was 1.00 for total alcohol intake of 0; then 0.96 for more than 0 to less than 5 g/day; 0.86 for 5 to less than 15 g/day; 0.70 for 15 to less than 30 g/day; and 0.73 for 30 g/day or more (P for trend < .001), after adjustment for age, baseline BMI, smoking status, nonalcohol energy intake, physical activity level, and other lifestyle and dietary factors. For developing obesity, the respective relative risks were 1.00, 0.75, 0.43, 0.39, and 0.29 (P for trend < .001). Subgroups defined by age, smoking status, physical activity, and baseline BMI all had similar associations.
“Compared with nondrinkers, initially normal-weight women who consumed a light to moderate amount of alcohol gained less weight and had a lower risk of becoming overweight and/or obese during 12.9 years of follow-up,” the study authors write. “An inverse association between alcohol intake and risk of becoming overweight or obese was noted for all four types of alcoholic beverages [red wine, white wine, beer and liquor], with the strongest association found for red wine and a weak yet significant association for white wine after multivariate adjustment.”
“The study results suggest that women who have normal body weight and consume a light to moderate amount of alcohol could maintain their drinking habits without gaining excessive weight,” the study authors conclude.
“However, taking into account the potential medical and psychosocial problems related to drinking alcohol, any recommendation on alcohol use should be made for the individual after carefully evaluating both adverse and beneficial effects of the drinking behaviour in a broad context. Further investigations are warranted to elucidate the role of alcohol intake and alcohol metabolism in energy balance and to identify behavioral, physiological, and genetic factors that may modify the alcohol effects.”
Arch Intern Med. March 8, 2010;170:453-461.