Little or no weight gain from light to moderate drinking

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DrinkingDespite thousands of studies spanning decades, Jane Brody writes in The New York Times that alcohol remains one of the most controversial and confusing topics for people concerned about controlling their weight. The critical ingredient is self-monitoring.

Brody writes: “I plowed through more than two dozen research reports, many with conflicting findings on the relationship between alcohol and weight, and finally found a thorough review of the science that can help people determine whether drinking might be compatible with effective weight management.

“The review, published in 2015, was prepared by Gregory Traversy and Jean-Philippe Chaput of the Healthy Active Living and Obesity Research Group at the Children’s Hospital of Eastern Ontario Research Institute in Ottawa, Ontario.”

Brody writes that the reviewers first examined so-called cross-sectional studies, studies that assessed links between alcohol intake and body mass index among large groups of people at a given moment in time. The most common finding was that in men, on average, drinking was “not associated” with weight, whereas among women, drinking either did not affect weight or was actually associated with a lower body weight than among non-drinkers.

She says their summary of the findings was: Most such studies showed that “frequent light to moderate alcohol intake” – at most two drinks a day for men, one for women – “does not seem to be associated with obesity risk.” However, binge drinking (consuming five or more drinks on an occasion) and heavy drinking (more than four drinks in a day for men, or more than three for women) were linked to an increased risk of obesity and an expanding waistline.

And in a departure from most of the other findings, some of the research indicated that for adolescents and (alas) older adults, alcohol in any amount may “promote overweight and a higher body fat percentage.”

Brody writes that prospective studies, which are generally considered to be more rigorous than cross-sectional studies and which follow groups of people over time, in this case from several months to 20 years, had varied results and produced “no clear picture” of the relationship between alcohol and weight. Several found either no relationship or a negative relationship, at least in women, while others found that men who drank tended to risk becoming obese, especially if they were beer drinkers.

The conclusion from the most recent such studies: While heavy drinkers risked gaining weight, “light to moderate alcohol intake is not associated with weight gain or changes in waist circumference.”

Unlike protein, fats and carbohydrates, alcohol is a toxic substance that is not stored in the body. Alcohol calories are used for fuel, thus decreasing the body’s use of other sources of calories. That means people who drink must eat less or exercise more to maintain their weight.

According to Brody, Chaput said he is able to keep from gaining weight and body fat despite consuming “about 15 drinks a week” by eating a healthy diet, exercising daily and monitoring his weight regularly. Big differences in drinking patterns between men and women influence the findings of alcohol’s effects on weight, he said. “Men are more likely to binge drink and to drink beer and spirits, whereas women mostly drink wine and are more likely than men to compensate for extra calories consumed as alcohol.”

Genetics are also a factor, Chaput said, suggesting that alcohol can be more of a problem among people genetically prone to excessive weight gain. “People who are overweight to begin with are more likely to gain weight if they increase their alcohol intake,” he said.
Furthermore alcohol has a “disinhibiting” effect and can stimulate people to eat more when food is readily available. “The extra calories taken in with alcohol are stored as fat,” he reminded drinkers.

Here’s the bottom line, says Brody: “Everyone is different. The studies cited above average the results among groups of people and thus gloss over individual differences. Even when two people start out weighing the same and eat, drink and exercise the same amount, adding alcohol to the mix can have different consequences.

“The critical ingredient is self-monitoring: weighing yourself regularly, even daily, at the same time of day and under the same circumstances. If you’re a moderate drinker and find yourself gradually putting on weight, try cutting down on, or cutting out, alcohol for a few months to see if you lose, gain or stay the same.

“Or, if you’re holding off on drinking but gradually gaining weight and have no medical or personal reason to abstain from alcohol, you might try having a glass of wine on most days to see if your weight stabilises or even drops slightly over the coming months.

Abstract
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.

Authors
Gregory Traversy, Jean-Philippe Chaput

The New York Times report
Current Obesity Reports review


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