European Journal of Epidemiology

, Volume 13, Issue 8, pp 893–898 | Cite as

Relation of total and beverage-specific alcohol intake to body mass index and waist-to-hip ratio: A study of self-defense officials in Japan

  • Yutaka Sakurai
  • Takashi Umeda
  • Koichi Shinchi
  • Satoshi Honjo
  • Kazuo Wakabayashi
  • Isao Todoroki
  • Hiroshi Nishikawa
  • Shinsaku Ogawa
  • Mitsuhiko Katsurada


We investigated the independent associations of total and beverage-specific ethanol consumption with body mass index (BMI) and waist-to-hip ratio (WHR) in middle-aged Japanese males, because of the scarcity of epidemiologic data in Japan. The subjects were 2227 male self-defense officials who received a pre-retirement health examination at the Self-Defense Forces Fukuoka, Kumamoto, and Sapporo Hospitals. Data on alcohol intake, smoking, physical activity, and past medical history were obtained from a self-reported questionnaire. Height, weight, and waist and hip girth measurements were obtained at the examination. Multiple linear regression analysis was employed. Alcohol intake was positively and strongly associated with WHR (p = 0.0001), but not associated with BMI after adjustment for lifestyle variables, including either BMI or WHR. Subjects who consumed 15 ml per day or more of shochu ethanol showed a larger WHR than never drinkers, and a dose-response relationship was found. Dose-response relationships to other beverages were not found. Dose-response relationships to other beverages were not found. These findings suggest that alcohol intake is strongly and independently associated with WHR, but not with BMI. Abdominal obesity was positively associated with shochu ethanol, but not with other types of alcohol.

Alcohol intake Beverage Body mass index Waist-to-hip ratio 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    National Institutes of Health Consensus Development Panel on the Health Implications of Obesity. Health implications of obesity. Ann Intern Med 1985; 103: 147–151.Google Scholar
  2. 2.
    Vague J. The degree of masculine differentiation of obesities: A factor determining predisoposition to diabetes, atherosclerosis, gout, and uric calculous disease. Am J Clin Nutr 1956; 4: 20–34.Google Scholar
  3. 3.
    Bengtsson C, Björkelund C, Lapidus L, et al. Associations of serum lipid concentrations and obesity with mortality in women: 20 year follow up of participants in prospective population study in Gothenburg, Sweden. Br Med J 1993; 307: 1385–1388.Google Scholar
  4. 4.
    Hartz AJ, Rupley DC, Rimm AA. The association of girth measurements with disease in 32,856 women. Am J Epidemiol 1984; 119: 71–80.Google Scholar
  5. 5.
    Hellerstedt WL, Jeffery RW, Murray DM. The association between alcohol intake and adiposity in the general population (review). Am J Epidemiol 1990; 132: 594–611.Google Scholar
  6. 6.
    Leibel RL, Dufour M, Hubbard VS, et al. Alcohol and calories: A matter of balance. Alcohol 1993; 10: 429–434.Google Scholar
  7. 7.
    Gutiérrez-Fisac JL, Rodrínguez-Artalejo F, Rodríguez-Blas C, et al. Alcohol consumption and obesity in the adult population of Spain. J Epidemiol Community Health 1995; 49: 108–109.Google Scholar
  8. 8.
    Slattery ML, McDonald A, Bild DE, et al. Associations of body fat and its distribution with dietary intake, physical activity, alcohol, and smoking in blacks and whites. Am J Clin Nutr 1992; 55: 943–949.Google Scholar
  9. 9.
    Colditz GA, Giovannucci E, Rimm EB, et al. Alcohol intake in relation to diet and obesity in women and men. Am J Clin Nutr 1991; 54: 49–55.Google Scholar
  10. 10.
    Marti B, Tuomilehto J, Salomaa V, et al. Body fat distribution in the Finnish population: Environmental determinants and predictive power for cardiovascular risk factor levels. J Epidemiol Community Health 1991; 45: 131–137.Google Scholar
  11. 11.
    Troisi RJ, Heinold JW, Vokonas PS, et al. Cigarette smoking, dietary intake, and physical activity: Effects on body fat distribution — the normative aging study. Am J Clin Nutr 1991; 53: 1104–1111.Google Scholar
  12. 12.
    Laws A, Terry RB, Barrett-Connor E. Behavioral covariates of waist-to-hip ratio in Rancho Bernardo. Am J Public Health 1990; 80: 1358–1362.Google Scholar
  13. 13.
    Williamson DF, Forman MR, Binkin NJ, et al. Alcohol and body weight in United States adults. Am J Public Health 1987; 77: 1324–1330.Google Scholar
  14. 14.
    Liu S, Serdula MK, Williamson DF, et al. A prospective study of alcohol intake and change in body weight among US adults. Am J Epidemiol 1994; 140: 912–920.Google Scholar
  15. 15.
    Krombout D. Energy and marconutrient intake in lean and obese middle-aged men (the Zutphen study). Am J Clin Nutr 1983; 37: 295–299.Google Scholar
  16. 16.
    Haffner SM, Stern MP, Hazuda HP, et al. Upper body and centralized adiposity in Mexican Americans and non-Hispanic whites: Relationship to body mass index and other behavioral and demographic variables. Int J Obes 1986; 10: 493–502.Google Scholar
  17. 17.
    Keenan NL, Strogatz DS, James SA, et al. Distribution and correlates of waist-to-hip ratio in black adults: The Pitt county study. Am J Epidemiol 1992; 135: 678–684.Google Scholar
  18. 18.
    Armellini F, Zamboni M, Frigo L, et al. Alcohol consumption, smoking habits and body fat distribution in Italian men and women aged 20–60 years. Eur J Clin Nutr 1993; 47: 52–60.Google Scholar
  19. 19.
    Shinchi K, Kono S, Honjo S, et al. Obesity and adenomatous polyps of the sigmoid colon. Jpn J Cancer Res 1994; 85: 479–484.Google Scholar
  20. 20.
    Kono S, Ikeda N, Yanai F, et al. Alcoholic beverages and adenomatous polyps of the sigmoid colon: A study of male self-defence officials in Japan. Int J Epidemiol 1990; 19: 848–852.Google Scholar
  21. 21.
    Sakurai Y, Kono S, Shinchi K, et al. Relation of waisthip ratio to glucose tolerance, blood pressure, and serum lipids in middle-aged Japanese males. Int J Obes 1995; 19: 632–637.Google Scholar
  22. 22.
    Istvan J, Murray R, Voolker H. The relationship between patterns of alcohol consumption and body weight. Int J Epidemiol 1995; 24: 543–546.Google Scholar
  23. 23.
    Ministry of Health and Welfare. A Report of National Nutrition Survey in 1991 (in Japanese). Dai-ichi press: Tokyo, 1993.Google Scholar
  24. 24.
    SAS Institute. SAS/STAT user's guide, release 6.03 edn. SAS Institute Inc.: Cary, NC, 1988.Google Scholar
  25. 25.
    Duncan BB, Chambless LE, Schmidt MI, et al. Association of the waist-to-hip ratio is different with wine than with beer or hard liquor consumption. Am J Epidemiol 1995; 142: 1034–1038.Google Scholar
  26. 26.
    Grinker JA, Tucker K, Vokonas PS, Rush D. Body habitus changes among adults males from the Normative Aging Study: Relations to aging, smoking history and alcohol intake. Obes Res 1995; 3: 435–446.Google Scholar
  27. 27.
    Iso H, Kiyama M, Naito Y, et al. The relation of body fat distribution and body mass with haemoglobin A1c, blood pressure, and blood lipids in urban Japanese men. Int J Epidemiol 1991; 20: 88–94.Google Scholar
  28. 28.
    Prentice AM. Alcohol and obesity. Int J Obes 1995; 19Suppl 5: S44–S50.Google Scholar
  29. 29.
    Suter PM, Jequier E, Schutz Y. Effect of alcohol on energy expenditure. Am J Physiol 1994; 266: 1204–1212.Google Scholar
  30. 30.
    Björntrop P. The associations between obesity, adipose tissue distribution and disease. Acta Med Scand Suppl 1988; 723: 121–134.Google Scholar

Copyright information

© Kluwer Academic Publishers 1997

Authors and Affiliations

  • Yutaka Sakurai
    • 1
  • Takashi Umeda
    • 1
  • Koichi Shinchi
    • 2
  • Satoshi Honjo
    • 1
  • Kazuo Wakabayashi
    • 1
  • Isao Todoroki
    • 1
  • Hiroshi Nishikawa
    • 3
  • Shinsaku Ogawa
    • 4
  • Mitsuhiko Katsurada
    • 4
  1. 1.Department of Public HealthNational Defense Medical CollegeTokorozawa, SaitamaJapan
  2. 2.Self-Defense Forces Fukuoka HospitalKasuga-shi, FukuokaJapan
  3. 3.Self-Defense Forces Kumamoto HospitalKumamotoJapan
  4. 4.Self-Defense Forces Sapporo HospitalSapporo, HokkaidoJapan

Personalised recommendations