Heavy drinkers have poor dietary habits

Results will be published in the November 2011 issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.

"Drinking alcohol may reduce maintaining a healthy diet, leading to adverse metabolic effects which in turn add to those directly produced by alcohol," said José Lorenzo Valencia-Martín, a doctor at the Universidad Autónoma de Madrid and corresponding author for the study. "The specific influence of alcohol on diet may depend upon the overall quantity of alcohol ingested, frequency of consumption, beverage preference, and whether alcohol intake takes place during the meals. Alcohol may indirectly contribute to several chronic diseases such as obesity, diabetes mellitus, cardiovascular disease, or cancer."

"Unhealthy lifestyles tend to cluster together, but this is not a 'necessary' association," added Miguel A. Martínez-González, chair of the department of preventive medicine and Public Health at the University of Navarra. "On average, people who drink excessive alcohol are more likely to be careless in their dietary habits. A high alcohol intake is especially unhealthy with respect to liver disease. A high-energy food pattern rich in trans fats -- such as 'fast-foods' or items from a commercial bakery -- is also likely to be related to liver disease. In this sense, if both unhealthy lifestyles cluster together, they can act synergistically to produce very adverse effects."

"In Spain, alcohol is frequently drunk during meals, particularly lunch and dinner," said Valencia-Martín. "Because of this, and the lower prevalence of abstainers, our findings apply to most adults in Spain and in other Mediterranean countries in Europe. Our results are of relevance because they show that drinking at mealtimes is associated with insufficient intake of healthy foods, such as fruits and vegetables, and with excessive intake of animal protein."

From 2000 to 2005, the researchers carried out a telephone survey of 12,037 adults (5850 men, 6187 women) considered representative of 18-to-64-year-olds in the region of Madrid. Binge drinking was defined as equal to or more than 80 grams of alcohol for men and equal to or more than 60 grams for women during one drinking session; the threshold between moderate and heavy drinking was 40 grams of alcohol per day for men and 24 grams per day for women. Food consumption was measured using a 24-hour recall.

"Excessive drinkers, either with or without binge drinking, showed a poor adherence to dietary recommendations," said Valencia-Martín. "Although drinking at mealtimes has traditionally been considered a safe or even a healthy behavior, our results point to some unintended consequences that the general populations should be aware of. In particular, drinking at mealtimes is associated with poor adherence to most of the food consumption guidelines. Also, not all types of alcoholic beverages are equal with regard to their dietary effects; our results suggest that a preference for spirits is associated with a poorer diet. Lastly, the above implications apply to both men and women."

"I believe the key finding of this study is the suggestion of a harmful effect of binge drinking on healthy eating habits," said Martínez González. "Binge drinking prevalence was found to be relatively high -- greater than 10 percent -- in a representative sample of Spanish population. This is very bad news. Alcohol misuse has become a priority public-health problem in Spain, especially because of rising rates of binge drinking and especially because of the abandonment of the traditional Mediterranean pattern of moderate alcohol drinking, in little amounts, generally red wine during meals. Recent changes, especially among young Spanish people, include a pattern of high amounts of spirits during weekends. This excellent study adds another unfortunate consequence of this change: the impairment of eating habits."

Martínez González added that both alcohol researchers and clinicians need to pay more attention to the dietary pattern of binge drinkers, and also consider that some of the detrimental effects attributed to alcohol might in fact be consequences of a poor diet.

"Don't forget that alcohol is addictive, that it replaces healthy calories from other foods by empty calories, meaning these calories are devoid of minerals and vitamins," said Martínez González. "Keep also in mind that the drinking pattern might be more important than the total amount consumed. The unhealthiest pattern is to consume high amounts -- three to four drinks per day -- of spirits or beer exclusively during the weekends. Conversely, the healthiest use of alcohol may be red wine, no more than one glass per day for women and two per day for men, and consumed during meals in a regular daily pattern."

Co-authors of the ACER paper, "The Association between Alcohol Consumption Patterns and Adherence to Food Consumption Guidelines," were: Iñaki Galán of the Department of Preventive Medicine and Public Health in the School of Medicine at the Universidad Autónoma de Madrid, and the National Center of Epidemiology in the Instituto de Salud Carlos III; and Fernando Rodríguez-Artalejo of the Department of Preventive Medicine and Public Health in the School of Medicine at the Universidad Autónoma de Madrid, and CIBER of Epidemiology and Public Health. The study was partly funded by the National Plan on Drug Addictions.