Study: Heavy Drinkers Eat Poorly

Aug. 24, 2001 -- People who drink heavily, eat more — and often more — of the wrong things, which can in turn put them at risk for myriad health problems, a new study says.

The study, published this week in the American Journal of Clinical Nutrition, finds a direct correlation between the amount a person drinks and her dietary choices.

In the study, researchers analyzed questionnaire answers from about 73,000 French female schoolteachers born between the years 1925 and 1950, and adjusted dietary intake to omit calories from alcohol.

The study, by French scientists and affiliates of a European cancer-prevention organization, split the respondents into groups based on their alcohol intake levels. The heavy drinkers — defined as anyone who drank more than 2 ½ alcoholic drinks a day — consumed almost 30 percent more calories from food than nondrinkers.

Drinkers also tended to consume more cheese, processed meats, vegetable oil and coffee than the nondrinkers, and a lower percentage of their caloric intake was from carbohydrates.

The heavy drinkers' cholesterol intake was 32 percent higher than in the nondrinking group. The heaviest drinkers in the study consumed more vitamins A, E and iron, but fewer foods that are rich in beta carotene.

"Chronic alcoholics tend to have several vitamin deficiencies," said Dr. Arthur Klatsky, senior consultant in cardiology at the Kaiser Permanente Medical Center in Oakland, Calif.

Dr. Joanne Larsen, who runs dietican.com, a Web site that gives nutritional advice, says it's long been known that alcohol is an appetite stimulant.

"That's why they serve wine in nursing homes, to help stimulate appetite," she said. "However, people in nutrition have a very difficult time recommending alcohol, despite all of the studies."

Is All Drinking Bad?

The bottom line: All drinking is not bad, but the more you regularly drink, the worse your lifestyle habits will likely be.

In fact, light drinking can be to some extent be beneficial, especially for preventing heart disease, according to the study's lead author, Dr. Emmanuelle Kesse.

"Moderate alcohol consumption (one to two) drinks daily can beneficially affect life expectancy, notably through a protective effect on coronary artery disease," she wrote.

Previously, researchers blamed alcohol for a variety of health problems, including cancer, but through observation, they're finding that perhaps people who drink heavily make other bad lifestyle decisions.

The study found that among the drinkers, particularly the heaviest drinkers, lower vegetable and fruit consumption was linked to greater risk of cardiovascular disease and also an increased breast cancer risk.

The heaviest drinkers were the ones also most likely to develop cancer, notably of the mouth, esophagus and liver. Most likely, these groups of people were consuming less of the nutrients — notably folate — that are considered to be cancer-preventative foods.

The researchers also found that wine was associated with healthier eating habits. And, in the study, the light to moderate drinkers had the best eating habits of all, even better than the nondrinking group.

Larsen said while the study is important, it should be noted that the study's subjects were all French — not American — women, and their dietary habits are considerably different.

"The research authors are French and this article should be considered within the context of French food and wine culture," she said. "These increased calories should lead to obesity over time, yet the 52-year-old heavy drinkers were not overweight for height."

Plus, she says, "Americans don't eat as much protein and eat more carbohydrates than the French."

Heavy Drinkers Skim on Nutrients

Klatsky, who wrote an editorial about this study, believes some outcomes of dietary choices, such as thiamin deficiency, are directly connected to heavy drinking, while others, such as a genetic predisposition to metabolize alcohol slowly, are unrelated to diet, yet can result in the same negative health effects as dietary choices.

"I think the heavier drinkers have unfavorable lifestyle habits," he said during a recent telephone conversation. "And they tend to smoke more, too."

Larsen said she was a little confused by the study's initial results. Normally, when a person drinks, the liver stops processing carbohydrates and fats, and turns to processing the toxins from the blood that enter the body from the alcohol.

Combine that with the fact that a person may not be eating that much while she is drinking, and the blood sugar drops.

While a person drinks, glycogen stores in the liver are being depleted. By the next day — if not sooner — the person will want to replenish those stores with a high-carb, and often high-fat breakfast, like pancakes or French toast, says Larsen.