Over the past few decades, we’ve seen a tremendous increase in the obesity rates, not only in the United States, but around the world as well. In the United States, roughly 34% of the population is obese, with at least 30 other countries having obesity rates of at least 10% or more. In 1985, only a handful of states in the United States had obesity rates over 15%. As of 2010, every single state had obesity rates of at least 20%.
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This growing epidemic raises countless health concerns, and many causes have been blamed (e.g. increase in Fast Food restaurant chains and mass production of food with poor nutritional content). Alcohol consumption has been frequently linked to instances of obesity in some studies, therefore may be a major player in the epidemic we see today. Alcohol is an enery-providing “food”, containing approximately 7.1kcal/gram (or just about 100 calories for one serving of your standard alcoholic drink of choice). Most consumers usually add alcohol into their daily routine, instead of substituting something else for it; therefore the total number of calories ingested in a day is theoretically larger for an alcohol consumer versus a no alcohol consumer.
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Studies of alcohol consumption and effects on obesity rates to date have been contradictory, though it may be that those studies were lumping all types of alcoholic beverages together and assuming they all acted the same, whereas in reality, it’s possible that different types of alcoholic beverages would show very different results. The goal of the study I am focusing on today was to examine the role of different types of alcoholic beverages separately, to determine what effect they may or may not have on weight gain and obesity risk in Mediterranean people.
Methods
A baseline questionnaire was given to participants, which asked questions related to sociodemographics and lifestyle choices, as well as food and alcohol intake. Questions related to alcohol intake broke down into four categories: red wine; other wines; beer; and spirits. A second follow-up was performed on participants, in order to determine any lifestyle changes in, or to determine any weight gain or loss. Follow-up questionnaires were given every two years. A total of 9,318 individuals from the Mediterranean region participated in this study.
Results
Baseline characteristics
- The mean age of participants was 37.9 years (+/- 11.4 years).
- The mean BMI (body mass index) of participants was 23.6 kg/m2 (+/-3.3 kg/m2).
- Alcohol consumers having at least 7 drinks per week were primarily men (77.8%), had the highest BMI (25.1 +/- 3.2 kg/m2), and had the highest percentage of current smokers (31%).
- Average caloric intake increased with increasing alcohol consumption.
- The highest energy intake (calories) and lowest dietary fiber intake corresponded to those consuming at least 7 drinks per week.
Alcohol consumption and changes in body weight
- For beer and spirit drinkers, the weight gain difference for those consuming at least 7 drinks per week was +119 grams per year, or a range of +27 to + 212 grams per year (so, a positive weight gain).
- For wine drinkers, no weight gain was found.
Alcohol consumption and risk of obesity
- Out of 6,480 participants (2838 were excluded due to them already being obese), at the follow-up appointments, 1,006 were identified as overweight/obese.
- Those consuming at least 7 drinks per week of beer and spirits had a significantly higher risk of gaining weight and becoming obese.
- There was no association found between wine consumption and increased risk of obesity.
- Those participants who changed their consumption habits toward drinking more showed a 30% higher risk of obesity than those who did not change their consumption habits.
- The risk for obesity was slightly (but significantly) higher in women than in men.
So, why does alcohol make you gain weight?
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There are many reasons why it makes sense that with higher alcohol consumption, weight gain is a likely outcome. First, alcohol contains calories! If one simply adds alcohol to his/her diet, without replacing something else, the sheer number of calories consumed in a day increases, and ultimately weight increases. Second, alcohol has been shown to be an appetite stimulant, so the more one drinks, the more one gets cravings to eat. Third, alcohol does not provide the filling effect that other foods have when consumed, so no matter how much one drinks, one still feels hungry. Finally, it has been shown that alcohol affects certain neurotransmitters in the brain that control feeding, therefore the more one drinks, the more “confused” the neurotransmitters become and the individual continues to feed.
Breaking it down by beverage type
This study clearly showed that when consuming beer or spirits at least 7 times per week, there was significant weight gain among participants, and the risk for obesity was increased as well. However, an interesting result showed that individuals consuming red or other wines at least 7 times per week gained less weight or even lost weight compared to those drinking beer or spirits.
How can wine consumption result in this opposite result than beer or spirit consumption?
Studies have shown that red wine increases aromatase expression in adipose tissue, which leads to lower weight gain through an increase in local estradiol concentrations. Red wine has also been shown to be capable of decreasing adipocyte size, which is beneficial for metabolic mechanisms that control obesity.
Another mechanism by which red wine shows lesser weight gain or even weight loss is through the commonly studied phenol, resveratrol. Studies have shown that in vitro (in a laboratory setting), resveratrol can inhibit de novo lipogenesis in concert with a downregulation of lipogenic genes. In plain English, resveratrol may act to restrict the number of calories absorbed into the system.
Finally, the results of this study showing lower weight gain or weight loss by red wine consumers could be confounded by the fact that in general, red wine drinkers choose a healthier lifestyle to begin with, and may be significant to this result.
What does this all mean?
In a nutshell, it appears that beer and spirit consumption is associated with higher weight gain and higher obesity rates and that wine consumption is not. Wine consumption is associated with much less weight gain, and in some cases, weight loss. Of course, it is likely other factors are involved as well, such as dietary choice and other lifestyle decisions, which may be confounding the results shown here. More studies should be done teasing these factors apart, to get a more accurate understanding of how different alcohol beverages affect weight gain and obesity rates in adults.
I think the results of this study are promising, in that not only does red wine provide many apparent health benefits (e.g. cardiovascular health, bone health, etc), but it does not appear to be involved in the obesity epidemic that continues to grip the world. Just don’t forget to exercise!!
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I’d love to hear from you! Feel free to comment below!
Full citation for the article discussed today:
Sayon-Orea, C., Bes-Rastrollo, M., Nuñez-Cordoba, J.M., Basterra-Gortari, F.J., Beunza, J.J., and Martinez-Gonzalez, M.A. 2011. Type of alcoholic beverage and incidence of overweight/obesity in a Mediterranean cohort: The SUN project. Nutrition 27: 802-808.
I am not a health professional, nor do I pretend to be. Please consult your doctor before altering your alcohol consumption habits. Do not consume alcohol if you are under the age of 21. Do not drink and drive. Enjoy responsibly!