Research
Original Research
Alcoholic Beverage Consumption, Nutrient Intakes, and Diet Quality in the US Adult Population, 1999-2006

https://doi.org/10.1016/j.jada.2009.12.026Get rights and content

Abstract

Background

Little is known about associations between alcoholic beverage consumption, nutrient intakes, and diet quality, although each has been independently associated with chronic disease outcomes.

Objective

This study examines cross-sectional relationships between alcoholic beverage consumption, nutrient intakes, and diet quality (Healthy Eating Index-2005 [HEI-2005] scores) in the US adult population.

Methods

Data were from four cycles of the National Health and Nutrition Examination Survey (1999-2006). Weighted multiple regression analyses, adjusted for age, race/ethnicity, education, smoking status, and body mass index included 8,155 men and 7,715 women aged ≥20 years who reported their past-year alcoholic beverage consumption and 24-hour dietary intake. Alcoholic beverage consumption was defined by drinking status (never, former, current drinker) and, among current drinkers, by drinking level (number of drinks per day, on average: men <1 to ≥5; women <1 to ≥3).

Results

Among men, there was no association between drinking status and intakes of energy, most nutrients, or total HEI-2005 score. Among women, former and current (compared to never) drinkers had significantly higher intakes of energy and several nutrients, and current drinkers had significantly lower total HEI-2005 scores (current drinkers 58.9; never drinkers 63.2). Among current drinkers of both sexes, as drinking level increased, intakes of energy and several nutrients significantly increased, whereas total HEI-2005 scores significantly decreased (from 55.9 to 41.5 in men, and from 59.5 to 51.8 in women).

Conclusions

Among men and women, increasing alcoholic beverage consumption was associated with a decline in total diet quality as measured by the HEI-2005, apparently due to higher energy intake from alcohol as well as other differences in food choices. Educational messages should focus on nutrition and chronic disease risk associated with high consumption of alcoholic beverages and poor food choices, including excessive energy intake.

Section snippets

Data Source

Data for this study were provided by participants in four cycles of NHANES: 1999-2000, 2001-2002, 2003-2004, and 2005-2006 (NHANES 1999-2006). NHANES is a continuing, cross-sectional, nationally representative survey of the US noninstitutionalized civilian population, conducted by the National Center for Health Statistics. It employs a complex, stratified, multistage probability sample design. In NHANES 1999-2006, a total of 41,474 individuals completed an in-person home interview, and 39,352

Characteristics

Because the NHANES is designed to provide estimates for the US population, the majority of the inferred population was non-Hispanic white (Table 1), had at least a high school education, did not currently smoke, and had a mean body mass index ≥25. In 1999-2006, 76% of men and 65% of women were current drinkers. Based on χ2 tests, unadjusted percentage distributions of all demographic and lifestyle characteristics differed significantly by drinking status (never, former, and current drinker) (P

Discussion

In this nationally representative study, diet quality was poorer among women who were current drinkers than among women who had never consumed alcoholic beverages. Among both men and women who were current drinkers, diet quality declined with increasing consumption of alcoholic beverages.

Although higher levels of alcoholic beverage consumption were associated with higher intakes of energy, protein, and some vitamins and minerals among current drinkers, they were also associated with lower diet

Conclusions

Regardless of drinking status, American adults' diet quality is relatively poor on average when compared to the recommendations of the 2005 DGA. During 1999-2006, the majority of Americans (76% of men and 65% of women) were current drinkers. This study found numerous associations between alcoholic beverage consumption and dietary intake. Increasing levels of alcoholic beverage consumption were associated with increasing intakes of some nutrients, but poorer diet quality, as indicated by

R. A. Breslow is an epidemiologist, Division of Epidemiology and Prevention Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD.

References (38)

  • A.G. Shaper et al.

    Alcohol and mortality in British men: Explaining the U-shaped curve

    Lancet

    (1988)
  • P.F. Jacques et al.

    Moderate alcohol intake and nutritional status in nonalcoholic elderly subjects

    Am J Clin Nutr.

    (1989)
  • L.S. Freedman et al.

    A population's mean Healthy Eating Index-2005 scores are best estimated by the score of the population ratio when one 24-hour recall is available

    J Nutr.

    (2008)
  • P.A. Cotton et al.

    Dietary sources of nutrients among US adults, 1994 to 1996

    J Am Diet Assoc.

    (2004)
  • Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III)

    (2002)
  • Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 2005

    (2005)
  • Food, Nutrition, Physical Activity, and the Prevention of Cancer: A Global Perspective

    (2007)
  • C.S. Lieber

    Alcohol: Its metabolism and interaction with nutrients

    Annu Rev Nutr.

    (2000)
  • G. Danaei et al.

    The preventable causes of death in the United States: Comparative risk assessment of dietary, lifestyle, and metabolic risk factors

    PLoS Med.

    (2009)
  • Cited by (103)

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    R. A. Breslow is an epidemiologist, Division of Epidemiology and Prevention Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD.

    P. M. Guenther is a nutritionist, Center for Nutrition Policy and Promotion, US Department of Agriculture, Alexandria, VA.

    W. Juan is a nutritionist, Office of Nutrition, Labeling, and Dietary Supplements, Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD; at the time of the study, she was a nutritionist, Center for Nutrition Policy and Promotion, US Department of Agriculture, Alexandria, VA.

    B. I. Graubard is a senior investigator, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD.

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