ABSTRACT
In many developed countries the average alcohol intake among those who drink is about 10 to 30 g/d or 3 to 9% of the total energy intake,1 and the efficiency of alcohol for the maintenance of metabolizable energy is the same as for carbohydrate.2 Alcohol suppresses the oxidation of fat, favoring fat storage, and can serve as a precursor for fat synthesis.3,4 Moderate alcohol consumers usually add alcohol to their daily energy intake rather than substituting it for food, thus increasing energy balance.4 On the basis of this it would seem surprising if alcohol did not contribute directly to body weight. However, the relationship between alcohol consumption and body weight “remains an enigma to nutritionists and in many instances paradoxical.”5 The epidemiological evidence is inconsistent, with numerous studies suggesting absent or positive associations in men and strong inverse relationships in women.1,4,6,7 A comprehensive review of representative studies of the relationship between alcohol intake and body weight found remarkable inconsistency between studies which is explained to some degree by confounding factors.4 Another recent review concludes that “there is no consensus on the relationship
between moderate alcohol intake and body weight,”1 and the issue of whether or not alcohol calories “count” has been the topic of recent editorials.5 Most epidemiological studies of this issue have been cross-sectional in nature. There have been relatively few prospective studies of the relation between alcohol and weight gain. The aim of this chapter is to review the epidemiological evidence in population studies for alcohol as a risk factor for overweight and obesity with particular focus on prospective studies.
