Alcohol, Nutrition, and Health Consequences

Part of the series Nutrition and Health pp 371-381


Alcohol, Overweight and Obesity

  • Sasiwarang Goya WannametheeAffiliated withPrimary Care and Population Health, University College London Medical School Email author 


Increased body weight and, in particular, abdominal obesity is associated with increased cardiovascular disease risk [1]. In many developed countries, the average alcohol intake in those who drink is about 10–30 g/day or 3–9 % of the total energy intake [2], and the efficiency of alcohol for the maintenance of metabolizable energy is the same as for carbohydrate [3]. Alcohol suppresses the oxidation of fat, favouring fat storage and can serve as a precursor for fat synthesis [4, 5]. Moderate alcohol consumers usually add alcohol to their daily energy intake rather than substituting it for food, thus increasing energy balance [5]. On the basis of this, it would seem surprising if alcohol did not contribute directly to body weight. While laboratory studies on energy and nutrient balances show that alcohol is a nutrient that is efficiently utilized by the body and that alcohol calories do count, the epidemiological evidence is conflicting and whether moderate amounts of alcohol is a risk factor for weight gain and obesity is still controversial [6]. Several factors have been proposed which may explain the inconsistencies between studies, including the suggestion that the effect of alcohol on adiposity is influenced by type of drink [5], whether the alcohol is consumed with meals or not [5] and the pattern and amount of drinking in the population study [7]. A review conducted in 2005 concluded that the issue of whether alcohol calories count may be dependent on the characteristic of the drinker and the amount and pattern of drinking [6]. Moreover, evidence from a number of studies suggests that in drinkers, fat is preferentially deposited in the abdominal area [5] and that alcohol may be more associated with abdominal obesity than with general obesity [8–11]. The aim of this chapter is to review the epidemiological evidence for alcohol as a risk factor for overweight and obesity with particular focus on prospective studies. The influence of type of alcohol, pattern of drinking and confounding will also be discussed.


Alcohol intake Body mass index Fat distribution Type of drink Weight gain