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Alcohol and adiposity: effects of quantity and type of drink and time relation with meals



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 ≥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 (≥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.

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  1. Rimm EB, Stampfer MJ, Giovannucci E, Ascherio A, Spiegelman D, Colditz GA, Willett WC . Body size and fat distribution as predictors of coronary heart disease among middle-aged men and older US men. Am J Epidemiol 1995; 141: 1117–1127.

    Article  CAS  Google Scholar 

  2. Folsom AR, Stevens J, Schreiner PJ, McGovern PG . Body mass index, waist/hip ratio, and coronary heart disease incidence in African Americans and whites. Atherosclerosis Risk in Communities Study Investigators. Am J Epidemiol 1998; 148: 1187–1194.

    Article  CAS  Google Scholar 

  3. Lakka HM, Lakka TA, Tuomilehto J, Salonen JT . Abdominal obesity is associated with increased risk of acute coronary events in men. Eur Heart J 2002; 23: 706–713.

    Article  Google Scholar 

  4. Suter PM, Schutz Y, Jequier E . The effect of ethanol on fat storage in healthy subjects. N England J Med 1992; 326: 983–987.

    Article  CAS  Google Scholar 

  5. Hellerstedt WL, Jeffery RW, Murray DM . The association between alcohol intake and the general population. Reviews and commentary. Am J Epidemiol 1990; 132: 594–611.

    Article  CAS  Google Scholar 

  6. McDonald I, Debry G, Westerterp K . Alcohol and overweight. In: Verschuren PM (ed). Health issues related to alcohol consumption. ILSI Europ: Brussels; 1993. pp 263–279.

    Google Scholar 

  7. Suter PM, Hasler E, Vetter W . Effects of alcohol on energy metabolism and body weight regulation: is alcohol a risk factor for obesity? Nutr Rev 1997; 55: 157–171.

    Article  CAS  Google Scholar 

  8. Westerterp KR, Prentice AM, Jequier E . Alcohol and body weight. In: McDonald I (ed). Health issues related to alcohol consumption 2nd edn. ILSI Europe, Brussels; 1999. pp 103–123.

    Google Scholar 

  9. Duncan BB, Chambless LE, Schmidt MI, Folsom AR, Szklo M, Crouse III JR, Carpenter MA . Association of the waist-to-hip ratio is different with wine than with beer or hard liquor consumption. Atherosclerosis Risk in Communities Study Investigators. Am J Epidemiol 1995; 142: 1034–1038.

    Article  CAS  Google Scholar 

  10. Suter PM, Maire R, Vetter W . Alcohol consumption: a risk factor for abdominal fat accumulation in men. Addiction Biol 1997; 2: 101–103.

    Article  CAS  Google Scholar 

  11. Sakurai Y, Umeda T, Shinchi K, Honjo S, Wakabayashi K, Todoroki I, Nishikawa H, Ogawa S, Kitsurada M . Relation of total and beverage-specific alcohol intake to body mass index and waist-to- hip ratio: a study of self-defense officials in Japan. Eur J Epidemiol 1997; 13: 893–898.

    Article  CAS  Google Scholar 

  12. Dallongeville J, Marecaux N, Ducimetiere P, Ferrieres J, Arveiler D, Bingham A, Ruidavets JB, Simon C, Amouyel P . Influence of alcohol consumption and various beverages on waist girth and waist-to-hip ratio in a sample of French men and women. Int J Obes Relat Metab Disord 1998; 22: 1178–1183.

    Article  CAS  Google Scholar 

  13. Wannamethee SG, Shaper AG . Alcohol, body weight and weight gain in middle-aged men. Am J Clin Nutr 2003; 77: 1312–1317.

    Article  CAS  Google Scholar 

  14. Vadstrup ES, Petersen L, Sorensen TIA, Gronbaek M . Waist circumference in relation to history of amount and typr of alcohol: results from the Copenhagen City heart Study. Int J Obes Realt Metab Disord 2003; 27: 238–246.

    Article  CAS  Google Scholar 

  15. Slattery ML, McDonald A, Bild DE, Caan BJ, Hilner JE, Jacobs DR, Liu K . Associations of body fat and its distribution with dietary intake, physical activity, alcohol, and smoking in blacks and whites. Am J Clin Nutr 1992; 55: 943–949.

    Article  CAS  Google Scholar 

  16. Shaper AG, Pocock SJ, Walker M, Cohen NM, Wale CJ, Thomson AG . British Regional Heart Study: cardiovascular risk factors in middle-aged men in 24 towns. BMJ 1981; 282: 179–186.

    Article  Google Scholar 

  17. Shaper AG, Wannamethee SG . The J-shaped curve and changes in drinking habit. Novartis Foundation Symp 1998; 216: 173–188.

    CAS  Google Scholar 

  18. Bolton-Smith C, Casey CE, Gey GF, Smith WCS, Tunstall Pedoe H . Anti-oxidant vitamin intakes assessed using a food frequency questionnaire: correlation with biochemical status in smokers and non-smokers. Br J Nutr 1991; 65: 337–346.

    Article  CAS  Google Scholar 

  19. Yarnell JWG, Fehily AM, Milbank JE, Kubicki AJ, Eastham R, Hayes TM . A short dietary questionnaire for use in an epidemiological survey: comparisons with weighed dietary record. Hum Nutr Appl Nutr 1983; 37: 103–112.

    CAS  PubMed  Google Scholar 

  20. Bolton-Smith C, Milne AC . Food frequency v weighed intake data in Scottish men. Proc Nutr Soc 1991; 50: 35A.

    Google Scholar 

  21. Holland B, Welch AA, Unwin ID, Buss DH, Paul AA, Southgate DAT . McCance and Widdowson's the composition of foods 5th edn. Royal Society of Chemistry and MAFF: London; 1991.

    Google Scholar 

  22. Shaper AG, Wannamethee G, Weatherall R . Physical activity and ischaemic heart disease in middle-aged British men. Br Heart J 1991; 66: 384–394.

    Article  CAS  Google Scholar 

  23. Deurenberg P, van der Kooij K, Evers P, Hulshof T . Assessment of body composition by bioelectrical impedance in a population aged &gt;60 years. Am J Clin Nutr 1990; 51: 3–6.

    Article  CAS  Google Scholar 

  24. National Institutes of Health. National Heart Lung and Blood Institute. Clinical guidelines on the identification, evaluation and treatment of overweight and obesity in adults: the evidence report. Obes Res 1998; 6 (suppl 2): S51–S210.

  25. Colditz GA, Giovannucci E, Rimm EB, Stampfer MJ, Rosner B, Speizer FE, Gordis E, Willett WC . Alcohol in relation to diet and obesity in women and men. Am J Clin Nutr 1991; 54: 49–55.

    Article  CAS  Google Scholar 

  26. Wannamethee G, Shaper AG . Blood lipids: the relationship with alcohol intake, smoking and body weight. J Epidemiol Comm Health 1992; 46: 197–202.

    Article  CAS  Google Scholar 

  27. Suter PM, Maire R, Vetter W . Is an increased waist:hip ratio the cause of alcohol-induced hypertension: The AIR94 study. J Hypertens 1995; 13: 1857–1862.

    Article  CAS  Google Scholar 

  28. Laws A, Terry RB, Barrett-Connor E . Behavioural covariates of waist-to-hip ratio in Rancho Bernardo. Am J Public Health 1990; 80: 1358–1362.

    Article  CAS  Google Scholar 

  29. Armellini F, Zamboni M, Frigo L, Mandragona R, Robbi R, Micciolo R, Bosello O . Alcohol consumption, smoking habits and body fat distribution in Italian men and women aged 20–60 years. Eur J Clin Nutr 1993; 47: 52–60.

    CAS  PubMed  Google Scholar 

  30. Gronbaek M, Deiss A, Sorensen TIA, Becker U, Schnohr P, Jensen G . Mortality associated with moderate intakes of wine beer or spirits. BMJ 1995; 310: 1165–1169.

    Article  CAS  Google Scholar 

  31. Gutierrez-Fisac JL, Rodriguez-Artalejo F, Rodriguez-Blas C, del Rey-Calero J . Alcohol consumption and obesity in the adult population of Spain. J Epidemiol Community Health 1995; 49: 108–109.

    Article  CAS  Google Scholar 

  32. Barefoot JC, Gronbaek M, Feagenes JR, Mcpherson RS, Williams RB, Siegler IC . Alcoholic beverage preference, diet and health habits in the UNC Alumni Heart Study. Am J Clin Nutr 2002; 76: 466–472.

    Article  CAS  Google Scholar 

  33. Wannamethee SG, Shaper AG . Type of alcoholic drink and risk of major coronary heart disease events and all-cause mortality. Am J Public Health. 1999; 89: 685–690.

    Article  CAS  Google Scholar 

  34. Zakhari S . Alcohol and the endocrine system. Research Monograph No. 23, National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism (NIH-NIAAA), Bethesda, MD; 1993. pp 411.

    Google Scholar 

  35. Kissebah A, Krakower GR . Regional adiposity and morbidity. Physiol Rev 1994; 74: 761–811.

    Article  CAS  Google Scholar 

  36. Thomas MC, Walker M, Lennon LT, Thomson AG, Lampe FC, Shaper AG, Whincup PH . Non-attendance at re-examination 20 years after screening in the British Regional Heart Study. J Pub Health Med 2002; 24: 285–291.

    Article  CAS  Google Scholar 

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The British Regional Heart Study is a British Heart Foundation Research Group and receives support from the Department of Health (England). We are grateful to Dr Caroline Bolton-Smith for making available the food frequency questionnaire and analysis package. The views expressed in this publication are those of the authors and not necessarily those of the Department of Health (England).

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Wannamethee, S., Shaper, A. & Whincup, P. Alcohol and adiposity: effects of quantity and type of drink and time relation with meals. Int J Obes 29, 1436–1444 (2005).

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