Self-administered questionnaires were collected from 72,904 French women aged 40-65 years in 1990. The women were divided into 7 categories based on their alcohol consumption, which ranged from nondrinkers (13% of subjects) to heavy drinkers who consumed more than 2-1/2 drinks of alcohol daily (7%), while 35% consumed up to 2-1/2 drinks daily. The questionnaire included portion size and frequency data for 238 food items, which were then correlated with the subjects’ alcohol intake level. Total calorie intake increased progressively in all groups consuming alcohol, and heavy drinkers consumed 29.5% more calories than nondrinkers. Protein made up a 6% larger portion of drinker’s diets, and cholesterol intake was 32% higher in heavy drinkers than in nondrinkers. Intakes of cheese, processed meats, vegetable oil, and coffee increased among alcohol drinkers. While wine was consumed by 62% of drinkers, the results were not affected by the choice of alcoholic beverage. Also of note was the fact that heavy drinkers were 4 times as likely to be smokers when compared to nondrinkers.
The authors conclude that, "Part of the detrimental effect of alcohol on health may be due to the less healthy dietary habits of drinkers," and that the positive effects of moderate drinking may not be attributable to dietary factors. An accompanying editorial by Klatsky points out that some outcomes of dietary choices, such as thiamin deficiency, are directly connected to heavy drinking, while others, such as a genetic predisposition to metabolize alcohol slowly, are unrelated to diet, yet can result in the same negative health effects as dietary choices.
Kesse, Emmanuelle et al. Do eating habits differ according to alcohol consumption? Results of a study of the French cohort of the European Prospective Investigation into Cancer and Nutrition (E3N-EPIC). Am J Clin Nutr 2001;74:322-7.
Klatsky, Arthur L. Diet, alcohol, and health: a story of connections, confounders, and cofactors. Am J Clin Nutr 2001;74:279-80.
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http://faseb.org/ajcn/September/12480-Kesse.pdf
http://faseb.org/ajcn/September/12939-Klatsky.pdf
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American Journal of Clinical Nutrition