Editor’s Note: These entries are part of an ongoing drug-related dissertation bibliography being compiled by Jonathon Erlen, which was formerly published in the Social History of Alcohol and Drugs journal but is now periodically featured on the Points blog. Contact Dr. Erlen through the link above.
Understanding Associations of Alcoholic Beverage Consumption with Weight Status
Author: Butler, Jennie Lauren
Abstract: Contradictory findings exist on associations between alcoholic beverage consumption with Waist Circumference (WC) and Body Mass Index (BMI). Confounding by dietary intake and variation in associations by drinking level and/or alcoholic beverage type likely contribute to mixed literature. The overarching goal of this dissertation was to shed light on inconsistencies in the alcohol and obesity literature by investigating confounding by dietary intake and associations of changes in alcohol intake with WC and BMI change. A pooled cross-sectional analysis of data from 6,018 men and 5,885 women 20 – 79 years of age from the National Nutrition and Health Examination Survey (NHANES), 2003 – 2012 was conducted. Multivariable linear regression models were used to determine associations of alcohol intake with energy (kcal), macronutrient and sugar intakes (% kcal), WC and BMI. Associations of drinking with WC and BMI were examined with and without adjustment for dietary intake. Compared to non-drinkers, binge drinking men consumed less energy from food and heavy drinking women consumed less energy from non-alcoholic beverages. All drinking levels were inversely associated with carbohydrate and sugar intakes compared to non-drinking. Positive associations between binge drinking and WC in men were attenuated and no longer significant after adjustment for carbohydrate and sugar intakes. Negative associations between heavy drinking and WC and BMI in women were strengthened after adjustment for carbohydrate and sugar intakes. Next a prospective study of data from 1,894 men and 2,252 women utilizing 25 years of Coronary Artery Risk Development in Young Adults (CARDIA) study data investigating associations of 5-yr changes in alcohol intake with 5-yr WC and BMI change was conducted. Random effects linear regression models were used to determine whether 5-yr changes in drinking were associated with 5-yr WC and BMI change. In men, decreasing drinking, particularly stopping excessive drinking, was associated with lower 5-yr WC gains. In women, increasing wine intake and decreasing liquor intake was associated with lower 5-yr WC and BMI gains. Our findings highlight dietary confounders of associations of alcohol intake with WC and BMI, and heterogeneity in associations by drinking level and beverage type in US adults.