Skip to main content

Relationship of abdominal obesity with alcohol consumption at population scale



The high energy content of alcohol makes its consumption a potential contributor to the obesity epidemic.

Aim of the study

To determine whether alcohol consumption is a risk factor for abdominal obesity, taking into account energy underreporting.


The subjects were Spanish men (n = 1491) and women (n = 1563) aged 25–74 years who were examined in 1999–2000, in a population-based cross-sectional survey in northeastern Spain (Girona). Dietary intake, including alcohol consumption, was assessed using a food frequency questionnaire. Anthropometric variables were measured.


The mean consumption of alcohol was 18.1 ± 20.7 g/d in men and 5.3 ± 10.4 g/d in women. 19.3% of men and 2.3% of women reported alcohol consumption of more than 3 drinks per day. The consumption of alcohol was directly associated with total energy intake in men (P < 0.001) and women (P = 0.001). The proportion of energy underreporting significantly (P < 0.001) decreased with higher amounts of alcohol drinking in both genders. Multiple logistic regression analysis, controlled for energy underreporting, smoking, educational level, leisure-time physical activity, energy, and diet quality, revealed that consuming more than 3 drinks of alcohol (>30 g ethanol) was significantly associated with the risk of abdominal obesity (Odds ratio 1.80; 1.05, 3.09) and exceeding recommended energy consumption (Odds ratio 1.97; 1.32, 2.93) in men. A very small number (2.13%) of women in this population reported high levels of alcohol consumption.


Alcohol consumption in elevated amounts was associated with risk of abdominal obesity in men, independent of energy underreporting.

This is a preview of subscription content, access via your institution.

Fig. 1


  1. Seidell JC (2005) Epidemiology of obesity. Semin Vasc Med 5:3–14

    Article  Google Scholar 

  2. Okosun IS, Chandra KM, Boev A, Boltri JM, Choi ST, Parish DC, Dever GE (2004) Abdominal adiposity in U.S. adults: prevalence and trends, 1960–2000. Prev Med 39:197–206

    Article  Google Scholar 

  3. Schroder H, Elosua R, Vila J, Martin H, Covas MI, Marrugat J (2007) Secular trends of obesity and cardiovascular risk factors in a Mediterranean population. Obesity 15:557–562

    CAS  Google Scholar 

  4. Bigaard J, Frederiksen K, Tjonneland A, Thomsen BL, Overvad K, Heitmann BL, Sorensen TI (2005) Waist circumference and body composition in relation to all-cause mortality in middle-aged men and women. Int J Obes (Lond) 29:778–784

    Article  CAS  Google Scholar 

  5. Rexrode KM, Carey VJ, Hennekens CH, Walters EE, Colditz GA, Stampfer MJ, Willett WC, Manson JE (1998) Abdominal adiposity and coronary heart disease in women. JAMA 280:1843–1848

    Article  CAS  Google Scholar 

  6. Despres JP (2006) Is visceral obesity the cause of the metabolic syndrome? Ann Med 38:52–63

    Article  CAS  Google Scholar 

  7. Wang Y, Rimm EB, Stampfer MJ, Willett WC, Hu FB (2005) Comparison of abdominal adiposity and overall obesity in predicting risk of type 2 diabetes among men. Am J Clin Nutr 81:555–563

    CAS  Google Scholar 

  8. Zhu S, Wang Z, Heshka S, Heo M, Faith MS, Heymsfield SB (2002) Waist circumference and obesity-associated risk factors among whites in the third National Health and Nutrition Examination Survey: clinical action thresholds. Am J Clin Nutr 76:743–749

    CAS  Google Scholar 

  9. Weinbrenner T, Schroder H, Escurriol V, Fito M, Elosua R, Vila J, Marrugat J, Covas MI (2006) Circulating oxidized LDL is associated with increased waist circumference independent of body mass index in men and women. Am J Clin Nutr 83:30–35

    CAS  Google Scholar 

  10. Koh-Banerjee P, Wang Y, Hu FB, Spiegelman D, Willett WC, Rimm EB (2004) Changes in body weight and body fat distribution as risk factors for clinical diabetes in US men. Am J Epidemiol 159:1150–1159

    Article  Google Scholar 

  11. Trichopoulou A, Gnardellis C, Lagiou A, Benetou V, Naska A, Trichopoulos D (2001) Physical activity and energy intake selectively predict the waist-to-hip ratio in men but not in women. Am J Clin Nutr 74:574–578

    CAS  Google Scholar 

  12. Henley on Thames, World Avertising Research Center LTD. World Drink Trends 2003

  13. Halkjaer J, Sorensen TI, Tjonneland A, Togo P, Holst C, Heitmann BL (2004) Food and drinking patterns as predictors of 6-year BMI-adjusted changes in waist circumference. Br J Nutr 92:735–748

    Article  CAS  Google Scholar 

  14. Wannamethee SG, Shaper AG (2003) Alcohol, body weight, and weight gain in middle-aged men. Am J Clin Nutr 77:1312–1317

    CAS  Google Scholar 

  15. Vadstrup ES, Petersen L, Sorensen TI, Gronbaek M (2003) Waist circumference in relation to history of amount and type of alcohol: results from the Copenhagen City Heart Study. Int J Obes Relat Metab Disord 27:238–246

    Article  CAS  Google Scholar 

  16. Lukasiewicz E, Mennen LI, Bertrais S, Arnault N, Preziosi P, Galan P, Hercberg S (2005) Alcohol intake in relation to body mass index and waist-to-hip ratio: the importance of type of alcoholic beverage. Public Health Nutr 8:315–320

    Article  Google Scholar 

  17. Wannamethee SG, Shaper AG, Whincup PH (2005) Alcohol and adiposity: effects of quantity and type of drink and time relation with meals. Int J Obes (Lond) 29:1436–1444

    Article  CAS  Google Scholar 

  18. Laitinen J, Pietilainen K, Wadsworth M, Sovio U, Jarvelin MR (2004) Predictors of abdominal obesity among 31-y-old men and women born in Northern Finland in 1966. Eur J Clin Nutr 58:180–190

    Article  CAS  Google Scholar 

  19. Johansson G, Wikman A, Ahren AM, Hallmans G, Johansson I (2001) Underreporting of energy intake in repeated 24-hour recalls related to gender, age, weight status, day of interview, educational level, reported food intake, smoking habits and area of living. Public Health Nutr 4:919–927

    CAS  Article  Google Scholar 

  20. Schroder H, Covas MI, Marrugat J, Vila J, Pena A, Alcantara M, Masia R (2001) Use of a three-day estimated food record, a 72-hour recall and a food-frequency questionnaire for dietary assessment in a Mediterranean Spanish population. Clin Nutr 20:429–437

    Article  CAS  Google Scholar 

  21. Trichopoulou A, Kouris-Blazos A, Wahlqvist ML, Gnardellis C, Lagiou P, Polychronopoulos E, Vassilakou T, Lipworth L, Trichopoulos D (1995) Diet and overall survival in elderly people. BMJ 311:1457–1460

    CAS  Google Scholar 

  22. Willett W (2007) Nutritional Epidemiology. Oxford University Press 1998

  23. Standing Committee on the Scientific Evaluation of Dietary Reference Intakes FaNBIoM2 (2007) Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids. National Academy Press, Washington DC

    Google Scholar 

  24. FAO/WHO/UNU (2007) Energy and protein requirements. Technical Report Series No 724, World Health Organization, Geneva, 1985

  25. Elosua R, Garcia M, Aguilar A, Molina L, Covas MI, Marrugat J (2000) Validation of the Minnesota leisure time physical activity questionnaire in Spanish women. Investigators of the MARATDON Group. Med Sci Sports Exerc 32:1431–1437

    Article  CAS  Google Scholar 

  26. Elosua R, Marrugat J, Molina L, Pons S, Pujol E (1994) Validation of the Minnesota leisure time physical activity questionnaire in Spanish men. The MARATHOM Investigators. Am J Epidemiol 139:1197–1209

    CAS  Google Scholar 

  27. Haslam DW, James WP (2005) Obesity. Lancet 366:1197–1209

    Article  Google Scholar 

  28. Obesity: preventing, managing the global epidemic (2000) Report of a WHO consultation. World Health Organ Tech Rep Ser 894:i-253

  29. Yeomans MR (2004) Effects of alcohol on food and energy intake in human subjects: evidence for passive and active over-consumption of energy. Br J Nutr 92 Suppl 1:S31-S34

    Article  CAS  Google Scholar 

  30. Yeomans MR, Caton S, Hetherington MM (2003) Alcohol and food intake. Curr Opin Clin Nutr Metab Care 6:639–644

    Article  Google Scholar 

  31. Koh-Banerjee P, Chu NF, Spiegelman D, Rosner B, Colditz G, Willett W, Rimm E (2003) Prospective study of the association of changes in dietary intake, physical activity, alcohol consumption, and smoking with 9-y gain in waist circumference among 16 587 US men. Am J Clin Nutr 78:719–727

    CAS  Google Scholar 

  32. Greenfield JR, Samaras K, Jenkins AB, Kelly PJ, Spector TD, Campbell LV (2003) Moderate alcohol consumption, estrogen replacement therapy, and physical activity are associated with increased insulin sensitivity: is abdominal adiposity the mediator? Diabetes Care 26:2734–2740

    Article  Google Scholar 

  33. Gonzalez CA, Pera G, Agudo A, Amiano P, Barricarte A, Beguiristain JM, Chirlaque MD, Dorronsoro M, Martinez C, Navarro C, Quiros JR, Rodriguez M, Tormo MJ (2000) Factors associated with the accumulation of abdominal fat estimated with anthropometric indexes. Med Clin (Barc) 114:401–406

    CAS  Google Scholar 

  34. Buemann B, Astrup A (2001) How does the body deal with energy from alcohol? Nutrition 17:638–641

    Article  CAS  Google Scholar 

  35. Gianoulakis C (1998) Alcohol-seeking behavior: the roles of the hypothalamic-pituitary-adrenal axis and the endogenous opioid system. Alcohol Health Res World 22:202–210

    CAS  Google Scholar 

  36. Bjorntorp P (2001) Do stress reactions cause abdominal obesity and comorbidities? Obes Rev 2:73–86

    Article  CAS  Google Scholar 

Download references


We appreciate the English revision made by Dr. Elaine M. Lilly (Writers First Aid).

This research was supported by grant 2FD097-0297-CO2-01 from Fondo Europeo de Desarrollo Regional (FEDER) and by parts of the Ministerio de Sanidad y Consumo, Instituto de Salud Carlos III, Red HERACLES RD06/0009, CIBER: Epidemiología y salud pública CB06/02/0029, CIBER: Fisiopatología de la obesidad y nutrición CB06/03/0028, Fondo de Invesigación Sanitaria ISCIII CP 03/00115.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Helmut Schröder.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Schröder, H., Morales-Molina, J.A., Bermejo, S. et al. Relationship of abdominal obesity with alcohol consumption at population scale. Eur J Nutr 46, 369–376 (2007).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:


  • waist
  • alcoholic beverages
  • energy underreporting