Gender and Racial/Ethnic Differences in the Association Between Alcohol Drinking Patterns and Body Mass Index—the National Health and Nutrition Examination Survey, 1999–2010

  • Jaesin Sa
  • Marcia Russell
  • Miranda Ritterman Weintruab
  • Dong-Chul Seo
  • Jean-Philippe Chaput
  • Mohammad Habib



Racial/ethnic variations in both alcohol consumption and obesity prevalence are well established. However, previous research indicates that drinking patterns influence the relation of alcohol intake to body mass index (BMI), and information on racial/ethnic differences in the relation of drinking pattern to BMI is lacking.


Multi-year cross-sectional data extracted from the 1999–2010 National Health and Nutrition Examination Survey for adults ≥ 20 years (N = 25,816) were used. Effects of drinking patterns were analyzed using a linear dose–response model that considered the joint effects of frequency (number of days in the past year that at least one drink was consumed) and dosage (the number of drinks consumed in excess of the first drink on days when more than one drink was consumed).


For all racial/ethnic groups except Mexican Americans, current drinkers had a lower mean BMI than non-drinkers. Mean BMI differences were − 0.721 kg/m2 for non-Hispanic white (white) men and − 1.292 kg/m2 for white women. Among drinkers, drinking frequency was negatively associated with BMI for all racial/ethnic groups; however, this effect was significantly smaller for Mexican American men and other Hispanic men than white men. Dosage was positively associated with BMI among all racial/ethnic groups except Mexican American women and other Hispanic women; this effect was significantly stronger among black women than white women.


Gender and racial/ethnic differences in the relation of drinking patterns to BMI should be taken into consideration when investigating factors that influence the effect of alcohol consumption on BMI.


Alcohol drinking patterns Body mass index Racial/ethnic differences Gender 


Compliance with Ethical Standards

Conflicts of Interest

The authors declare that they have no conflict of interest.

Research Involving Human Participants

All procedures performed in this study involving human participants were in accordance with the ethical standards of the Institutional Review Board and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was exempted from the review of the Institutional Review Board at the authors’ institution because of the public availability of the data.


  1. 1.
    Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the United States, 2011–2012. JAMA. 2014;311(8):806–14.CrossRefGoogle Scholar
  2. 2.
    Flegal KM, Kruszon-Moran D, Carroll MD, Fryar CD, Ogden CL. Trends in obesity among adults in the United States, 2005 to 2014. JAMA : the journal of the American Medical Association. 2016;315(21):2284–91.CrossRefGoogle Scholar
  3. 3.
    National Institutes of Health. What are the health risks of overweight and obesity? Accessed May 24, 2014.
  4. 4.
    Centers for Disease Control and Prevention. The benefits of physical activity. Accessed December 6, 2015.
  5. 5.
    Centers for Disease Control and Prevention. Overweight & obesity. Accessed July 7, 2015.
  6. 6.
    Jolliffe D. Overweight and poor? On the relationship between income and the body mass index. Econ Hum Biol. 2011;9(4):342–55.CrossRefGoogle Scholar
  7. 7.
    Gearhardt AN, Corbin WR. Body mass index and alcohol consumption: family history of alcoholism as a moderator. Psychol Addict Behav. 2009;23(2):216–25.CrossRefGoogle Scholar
  8. 8.
    Chartier K, Caetano R. Ethnicity and health disparities in alcohol research. Alcohol Res Health. 2010;33(1–2):152–60.PubMedPubMedCentralGoogle Scholar
  9. 9.
    Flegal KM, Carroll MD, Kit BK, Ogden CL. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010. JAMA. 2012;307(5):491–7.CrossRefGoogle Scholar
  10. 10.
    Traversy G, Chaput JP. Alcohol consumption and obesity: an update. Curr Obes Rep. 2015;4(1):122–30.CrossRefGoogle Scholar
  11. 11.
    Arif AA, Rohrer JE. Patterns of alcohol drinking and its association with obesity: data from the third National Health and Nutrition Examination Survey, 1988–1994. BMC Public Health. 2005;5:126.CrossRefGoogle Scholar
  12. 12.
    Rohrer JE, Rohland BM, Denison A, Way A. Frequency of alcohol use and obesity in community medicine patients. BMC Fam Pract. 2005;6(1):17.CrossRefGoogle Scholar
  13. 13.
    French MT, Norton EC, Fang H, Maclean JC. Alcohol consumption and body weight. Health Econ. 2010;19(7):814–32.CrossRefGoogle Scholar
  14. 14.
    Breslow RA, Smothers BA. Drinking patterns and body mass index in never smokers: National Health Interview Survey, 1997–2001. Am J Epidemiol. 2005;161(4):368–76.CrossRefGoogle Scholar
  15. 15.
    Breslow RA, Guenther PM, Smothers BA. Alcohol drinking patterns and diet quality: the 1999–2000 National Health and Nutrition Examination Survey. Am J Epidemiol. 2006;163(4):359–66.CrossRefGoogle Scholar
  16. 16.
    Gruenewald PJ, Johnson FW, Light JM, Lipton R, Saltz RF. Understanding college drinking: assessing dose response from survey self-reports. J Stud Alcohol. 2003;64(4):500–14.CrossRefGoogle Scholar
  17. 17.
    Russell M, Chu BC, Banerjee A, Fan AZ, Trevisan M, Dorn JM, et al. Drinking patterns and myocardial infarction: a linear dose-response model. Alcohol Clin Exp Res. 2009;33(2):324–31.CrossRefGoogle Scholar
  18. 18.
    Rollins BY, Belue RZ, Francis LA. The beneficial effect of family meals on obesity differs by race, sex, and household education: the national survey of children's health, 2003–2004. J Am Diet Assoc. 2010;110(9):1335–9.CrossRefGoogle Scholar
  19. 19.
    Brondolo E, Monge A, Agosta J, Tobin JN, Cassells A, Stanton C, et al. Perceived ethnic discrimination and cigarette smoking: examining the moderating effects of race/ethnicity and gender in a sample of Black and Latino urban adults. J Behav Med. 2015;38(4):689–700.CrossRefGoogle Scholar
  20. 20.
    Centers for Disease Control and Prevention. NHANES response rates and population totals. Accessed December 15, 2015.
  21. 21.
    Centers for Disease Control and Prevention. National health and nutrition examination survey: analytic guidelines, 1999–2010. Accessed October 1, 2014.
  22. 22.
    Centers for Disease Control and Prevention. NHANES web tutorial frequently asked questions. Accessed December 30, 2014.
  23. 23.
    Centers for Disease Control and Prevention. Glossary: general concepts. Accessed October 1, 2014.
  24. 24.
    Centers for Disease Control and Prevention. Overview of NHANES survey design and weights. Accessed December 14, 2013.
  25. 25.
    Centers for Disease Control and Prevention. Survey orientation. Accessed December 6, 2015.
  26. 26.
    National Center for Health Statistics. Specifying weighting parameters. Accessed December 14, 2013.
  27. 27.
    Yeomans MR. Alcohol, appetite and energy balance: is alcohol intake a risk factor for obesity? Physiol Behav. 2010;100(1):82–9.CrossRefGoogle Scholar
  28. 28.
    Rose AK, Hardman CA, Christiansen P. The effects of a priming dose of alcohol and drinking environment on snack food intake. Appetite. 2015;95:341–8.CrossRefGoogle Scholar
  29. 29.
    Suter PM. Is alcohol consumption a risk factor for weight gain and obesity? Crit Rev Clin Lab Sci. 2005;42(3):197–227.CrossRefGoogle Scholar
  30. 30.
    Kokavec A. Is decreased appetite for food a physiological consequence of alcohol consumption? Appetite. 2008;51(2):233–43.CrossRefGoogle Scholar
  31. 31.
    Scott DM, Taylor RE. Health-related effects of genetic variations of alcohol-metabolizing enzymes in African Americans. Alcohol Res Health. 2007;30(1):18–21.PubMedPubMedCentralGoogle Scholar
  32. 32.
    Ehlers CL, Liang T, Gizer IR. ADH and ALDH polymorphisms and alcohol dependence in Mexican and Native Americans. Am J Drug Alcohol Abuse. 2012;38(5):389–94.CrossRefGoogle Scholar
  33. 33.
    Breslow RA, Guenther PM, Juan W, Graubard BI. Alcoholic beverage consumption, nutrient intakes, and diet quality in the US adult population, 1999–2006. J Am Diet Assoc. 2010;110(4):551–62.CrossRefGoogle Scholar
  34. 34.
    Breslow RA, Chen CM, Graubard BI, Jacobovits T, Kant AK. Diets of drinkers on drinking and nondrinking days: NHANES 2003–2008. Am J Clin Nutr. 2013;97(5):1068–75.CrossRefGoogle Scholar
  35. 35.
    Cook WK, Caetano R. Ethnic drinking cultures, gender, and socioeconomic status in Asian American and Latino drinking. Alcohol Clin Exp Res. 2014;38(12):3043–51.CrossRefGoogle Scholar
  36. 36.
    Batis C, Hernandez-Barrera L, Barquera S, Rivera JA, Popkin BM. Food acculturation drives dietary differences among Mexicans, Mexican Americans, and Non-Hispanic Whites. J Nutr. 2011;141(10):1898–906.CrossRefGoogle Scholar
  37. 37.
    McCann SE, Sempos C, Freudenheim JL, Muti P, Russell M, Nochajski TH, et al. Alcoholic beverage preference and characteristics of drinkers and nondrinkers in western New York (United States). Nutr Metab Cardiovasc Dis. 2003;13(1):2–11.CrossRefGoogle Scholar
  38. 38.
    Butler L, Poti JM, Popkin BM. Trends in energy intake from alcoholic beverages among US adults by sociodemographic characteristics, 1989–2012. J Acad Nutr Diet. 2016;116(7):1087–100 e6.CrossRefGoogle Scholar
  39. 39.
    Caetano R, Vaeth PA, Ramisetty-Mikler S, Rodriguez LA. The Hispanic Americans baseline alcohol survey: alcoholic beverage preference across Hispanic national groups. Alcohol Clin Exp Res. 2009;33(1):150–9.CrossRefGoogle Scholar
  40. 40.
    Mulia N, Karriker-Jaffe KJ, Witbrodt J, Bond J, Williams E, Zemore SE. Racial/ethnic differences in 30-year trajectories of heavy drinking in a nationally representative U.S. sample. Drug Alcohol Depend. 2017;170:133–41.CrossRefGoogle Scholar
  41. 41.
    Fazzino TL, Fleming K, Sher KJ, Sullivan DK, Befort C. Heavy drinking in young adulthood increases risk of transitioning to obesity. Am J Prev Med. 2017;53(2):169–75.CrossRefGoogle Scholar
  42. 42.
    Greenfield TK. Ways of measuring drinking patterns and the difference they make: experience with graduated frequencies. J Subst Abus. 2000;12(1–2):33–49.CrossRefGoogle Scholar

Copyright information

© W. Montague Cobb-NMA Health Institute 2018

Authors and Affiliations

  1. 1.College of Education and Health SciencesTouro UniversityVallejoUSA
  2. 2.Pacific Institute for Research and EvaluationOaklandUSA
  3. 3.Kaiser Permanente Oakland Medical CenterOaklandUSA
  4. 4.Department of Applied Health ScienceIndiana University School of Public HealthBloomingtonUSA
  5. 5.Healthy Active Living and Obesity Research GroupChildren’s Hospital of Eastern Ontario Research InstituteOttawaCanada

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