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Associations of alcoholic beverage consumption with dietary intake, waist circumference and BMI in US adults, NHANES 2003-2012

Butler, Lauren, Popkin, Barry M., Poti, Jennifer M.
Journal of the Academy of Nutrition and Dietetics 2017
National Health and Nutrition Examination Survey, adults, alcohol drinking, alcoholic beverages, alcohols, body mass index, energy, food intake, men, obesity, regression analysis, sugars, waist circumference, women, United States
Findings from studies of alcohol and obesity measures (e.g. waist circumference (WC) and body mass index (BMI)) are conflicting. Residual confounding by dietary intake, inconsistent definitions of alcohol consumption across studies and the inclusion of former drinkers in the non-drinking comparison group may contribute to mixed literature.This study examines associations of alcoholic beverage consumption with dietary intake, WC and BMI.Cross-sectional data from the 2003-2012 National Health and Nutrition Examination Survey were analyzed.Adults 20 – 79 years of age (n=7,436 men; n=6,939 women) were studied.Associations of alcoholic beverage consumption with energy (kcal), macronutrient and sugar intakes (% kcal), WC and BMI were determined.Multivariable linear regression models were used to determine associations of average daily volume and drinking quantity (i.e., drinks per drinking day) with dietary intake and obesity measures. Former and never drinkers were analyzed as distinct categories; associations of drinking with WC and BMI were examined with and without adjustment for dietary intake variables.Heavier drinking men (≥ 3 drinks/d) and women (≥ 2 drinks/d) consumed less non-alcoholic energy (β: -252 kcal/d; 95% CI: -346,-159 and β: -159 kcal/d; 95% CI:-245,-73, respectively) than moderate drinkers (1 to 2 drinks/d in men; 1 drink/d in women). By average daily drinking volume, differences in WC and BMI between former and moderate drinkers were + 1.78 cm (95% CI: 0.51, 3.05) and + 0.65 kg/m2 (95% CI: 0.12, 1.18) in men, and + 4.67 cm (95% CI: 2.95, 6.39) and +2.49 kg/m2 (95% CI: 1.64, 3.34) in women. Compared with moderate drinking, heavier drinking volume was not associated with WC or BMI among men or women. In men, drinking ≥ 5 drinks/drinking day was associated with higher WC (β: 3.48 cm; 95% CI: 1.97, 5.00) and BMI (β: 1.39 kg/m2; 95% CI: 0.79,2.00) as compared to men who consumed 1 to 2 drinks/drinking day. In women, WC and BMI were not significantly different for women drinking ≥4 compared to 1 drink/drinking day.Differences in dietary intake across drinking subgroups and separation of former drinkers from non-drinkers should be considered in studies of alcohol intake in relation to WC and BMI.