Alcohol consumption, weight gain, and risk of becoming overweight in middle-aged and older women

Abstract

Background: 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.

Methods: We conducted a prospective cohort study among 19 220 US women aged 38.9 years or older who were free of cardiovascular disease, cancer, and diabetes mellitus and had a baseline body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) within the normal range of 18.5 to less than 25. Alcoholic beverage consumption was reported on a baseline questionnaire. Body weight was self-reported on baseline and 8 annual follow-up questionnaires.

Results: There was an inverse association between amount of alcohol consumed at baseline and weight gained during 12.9 years of follow-up. A total of 7942 (41.3%) initially normal-weight women became overweight or obese (BMI > or =25) and 732 (3.8%) became obese (BMI > or =30). After adjusting for age, baseline BMI, smoking status, nonalcohol energy intake, physical activity level, and other lifestyle and dietary factors, the relative risks of becoming overweight or obese across total alcohol intake of 0, more than 0 to less than 5, 5 to less than 15, 15 to less than 30, and 30 g/d or more were 1.00, 0.96, 0.86, 0.70, and 0.73, respectively (P( )for trend( )<.001). The corresponding relative risks of becoming obese were 1.00, 0.75, 0.43, 0.39, and 0.29 (P( )for trend( )<.001). The associations were similar by subgroups of age, smoking status, physical activity level, and baseline BMI.

Conclusion: 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.

Figure 1

Multivariate adjusted mean body weight change (in kg) during 13-year follow-up according to baseline total alcohol intake, stratified by baseline age groups. Model adjusted for age, race, baseline weight, randomized treatment, total non-alcohol energy intake, physical activity, smoking status, post-menopausal status, post-menopausal hormone use, multivitamin use, history of hypercholesterolemia and hypertension, intake of fruit and vegetables, whole grains, refined grains, red meats and poultry, low-fat dairy products, high-fat dairy products, energy-adjusted total fat, carbohydrates, and fiber. P for a linear trend of body weight change across levels of total alcohol intake was tested using the median value of each alcohol intake category as an ordinal variable.

Figure 2

Relative risks of becoming overweight or obese according to baseline alcohol intake in subgroups of women. Model adjusted for age, race, baseline BMI, randomized treatment, non-alcohol energy intake, physical activity, smoking status, post-menopausal status, post-menopausal hormone use, multivitamin use, history of hypercholesterolemia and hypertension, intake of fruit and vegetables, whole grains, refined grains, red meats and poultry, low-fat dairy products, high-fat dairy products, energy-adjusted total fat, carbohydrates, and fiber. Interaction was examined using Wald chi-square test.