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Light-to-Moderate Drinking Isn't Associated with Excessive Weight Gain
Normal-weight middle-aged-to-older women who were light-to-moderate drinkers were less likely to become overweight or obese than were their abstinent counterparts.
Light-to-moderate alcoholic beverage consumption has been associated with both beneficial (e.g., lower coronary heart disease risk [JW General Medicine Jul 4 2006]) and adverse (e.g., higher breast cancer risk [JW Womens Health Mar 26 2009]) effects in women. But do calories derived from alcohol promote weight gain? Researchers analyzed data from the Women's Health Study (WHS) of middle-aged or older female healthcare professionals (age range, 38.9–89.0). A total of 19,220 WHS participants (>90% white) had normal self-reported baseline weights (body-mass index [BMI], 18.5–25.0 kg/m2). Mean daily alcohol and total nutrient intakes were calculated from responses to periodic food frequency questionnaires. Adjusted analyses considered baseline BMI, smoking status, nonalcohol energy intake, physical activity, and other lifestyle and dietary factors.
During 12.9 years of follow-up, 41.3% of participants became overweight and 3.8% became obese. Nondrinkers (38% of participants) were most likely to gain weight. Multivariate adjusted relative risks for overweight and obesity were 0.96, 0.86, 0.70, and 0.73 for increasingly higher quartiles of alcohol intake compared with no alcohol use (P for trend, <0.001); RRs for obesity were 0.75, 0.43, 0.39, and 0.29 compared with no alcohol use (P for trend, <0.001). Total caloric intake rose with increasing alcohol use, but caloric intake from other nutrients decreased. Low-to-moderate drinkers (mean, <1 to 2 drinks daily) had higher physical activity–related energy expenditures than did either women who drank no alcohol or those who consumed >2 drinks daily; this relation was U-shaped.
Comment: In this large, primarily white cohort of women in the healthcare profession with initially normal BMIs, amount of alcohol use generally was associated inversely with progression to overweight or obesity. The authors cite evidence that women might substitute alcohol for other foods without much increase in total caloric intake or that they might metabolize alcohol by mechanisms that minimize weight gain. The WHS questionnaire did not differentiate between daily consumption of 
1 drink and consumption of multiple drinks in a single day. Although interesting, these results do not imply that women should drink alcohol to maintain normal weight. In discussing alcohol use with women, we should continue to take into account its potential beneficial and adverse effects.
Published in Journal Watch Women's Health March 11, 2010
Citation(s):
Wang L et al. Alcohol consumption, weight gain, and risk of becoming overweight in middle-aged and older women. Arch Intern Med 2010 Mar 8; 170:453.
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