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



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


      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.


      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).


      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).


      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.
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      1. 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).
        National Cholesterol Education Program, National Heart, Lung, and Blood Institute, Bethesda, MD2002 (NIH Pub No. 02-5215)
      2. Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 2005.
        US Department of Agriculture, Agricultural Research Service, Beltsville, MD2005
        • World Cancer Research Fund
        Food, Nutrition, Physical Activity, and the Prevention of Cancer: A Global Perspective.
        American Institute for Cancer Research, Washington, DC2007
        • Lieber C.S.
        Alcohol: Its metabolism and interaction with nutrients.
        Annu Rev Nutr. 2000; 20: 395-430
        • Danaei G.
        • Ding E.L.
        • Mozaffarian D.
        • Taylor B.
        • Rehm J.
        • Murray C.J.
        • Ezzati M.
        The preventable causes of death in the United States: Comparative risk assessment of dietary, lifestyle, and metabolic risk factors.
        PLoS Med. 2009; 6: e1000058
        • Rehm J.
        • Mathers C.
        • Popova S.
        • Thavorncharoensap M.
        • Teerawattananon Y.
        • Patra J.
        Global burden of disease and injury and economic cost attributable to alcohol use and alcohol-use disorders.
        Lancet. 2009; 373: 2223-2233
        • Moeller S.M.
        • Reedy J.
        • Millen A.E.
        • Dixon L.B.
        • Newby P.K.
        • Tucker K.L.
        • Krebs-Smith S.M.
        • Guenther P.M.
        Dietary patterns: Challenges and opportunities in dietary patterns research, an Experimental Biology workshop, April 1, 2006.
        J Am Diet Assoc. 2007; 107: 1233-1239
        • Kennedy E.T.
        • Ohls J.
        • Carlson S.
        • Fleming K.
        The Healthy Eating Index: Design and applications.
        J Am Diet Assoc. 1995; 95: 1103-1108
        • Guenther P.M.
        • Reedy J.
        • Krebs-Smith S.M.
        Development of the Healthy Eating Index-2005.
        J Am Diet Assoc. 2008; 108: 1896-1901
        • Guenther P.M.
        • Reedy J.
        • Krebs-Smith S.M.
        • Reeve B.B.
        Evaluation of the Healthy Eating Index-2005.
        J Am Diet Assoc. 2008; 108: 1854-1864
      3. Nutrition and Your Health: Dietary Guidelines for Americans 2005.
        6th ed. US Government Printing Office, Washington, DC2005
        • Colditz G.A.
        • Giovannucci E.
        • Rimm E.B.
        • Stampfer M.J.
        • Rosner B.
        • Speizer F.E.
        • Gordis E.
        • Willett W.C.
        Alcohol intake in relation to diet and obesity in women and men.
        Am J Clin Nutr. 1991; 54: 49-55
        • Gruchow H.W.
        • Sobocinski K.A.
        • Barboriak J.J.
        • Scheller J.G.
        Alcohol consumption, nutrient intake and relative body weight among US adults.
        Am J Clin Nutr. 1985; 42: 289-295
        • Windham C.T.
        • Wyse B.W.
        • Hansen R.G.
        Alcohol consumption and nutrient density of diets in the Nationwide Food Consumption Survey.
        J Am Diet Assoc. 1983; 82 (373): 364-370
        • D'Avanzo B.
        • La Vecchia C.
        • Braga C.
        • Franceschi S.
        • Negri E.
        • Parpinel M.
        Nutrient intake according to education, smoking, and alcohol in Italian women.
        Nutr Cancer. 1997; 28: 46-51
        • Kesse E.
        • Clavel-Chapelon F.
        • Slimani N.
        • van Liere M.
        Do eating habits differ according to alcohol consumption?.
        Am J Clin Nutr. 2001; 74: 322-327
        • La Vecchia C.
        • Negri E.
        • Franceschi S.
        • Parazzini F.
        • Decarli A.
        Differences in dietary intake with smoking, alcohol, and education.
        Nutr Cancer. 1992; 17: 297-304
        • Ruf T.
        • Nagel G.
        • Altenburg H.P.
        • Miller A.B.
        • Thorand B.
        Food and nutrient intake, anthropometric measurements, and smoking according to alcohol consumption in the EPIC Heidelberg study.
        Ann Nutr Metab. 2005; 49: 16-25
        • Schroder H.
        • Marrugat J.
        • Elosua R.
        • Covas M.I.
        Tobacco and alcohol consumption: Impact on other cardiovascular and cancer risk factors in a southern European Mediterranean population.
        Br J Nutr. 2002; 88: 273-281
        • Thomson M.
        • Fulton M.
        • Elton R.A.
        • Brown S.
        • Wood D.A.
        • Oliver M.F.
        Alcohol consumption and nutrient intake in middle-aged Scottish men.
        Am J Clin Nutr. 1988; 47: 139-145
        • Veenstra J.
        • Schenkel J.A.
        • Erp-Baart A.M.
        • Brants H.A.
        • Hulshof K.F.
        • Kistemaker C.
        • Schaafsma G.
        • Ockhuizen T.
        Alcohol consumption in relation to food intake and smoking habits in the Dutch National Food Consumption Survey.
        Eur J Clin Nutr. 1993; 47: 482-489
        • Walmsley C.M.
        • Bates C.J.
        • Prentice A.
        • Cole T.J.
        Relationship between alcohol and nutrient intakes and blood status indices of older people living in the UK: Further analysis of data from the National Diet and Nutrition Survey of people aged 65 years and over, 1994/5.
        Public Health Nutr. 1998; 1: 157-167
        • Shaper A.G.
        • Wannamethee G.
        • Walker M.
        Alcohol and mortality in British men: Explaining the U-shaped curve.
        Lancet. 1988; 2: 1267-1273
        • Jacques P.F.
        • Sulsky S.
        • Hartz S.C.
        • Russell R.M.
        Moderate alcohol intake and nutritional status in nonalcoholic elderly subjects.
        Am J Clin Nutr. 1989; 50: 875-883
        • Toniolo P.
        • Riboli E.
        • Cappa A.P.
        A community study of alcohol consumption and dietary habits in middle-aged Italian women.
        Int J Epidemiol. 1991; 20: 663-670
        • Breslow R.A.
        • Guenther P.M.
        • Smothers B.A.
        Alcohol drinking patterns and diet quality: The 1999-2000 National Health and Nutrition Examination Survey.
        Am J Epidemiol. 2006; 163: 359-366
      4. National Health and Nutrition Examination Survey: Response rates and CPS population totals.
        (National Center for Health Statistics Web site) (Accessed August 2, 2009)
      5. Food and nutrient database for dietary studies.
        (US Department of Agriculture Agricultural Research Service Web site) (Accessed August 13, 2009)
        • Kim S.Y.
        • Breslow R.A.
        • Ahn J.
        • Salem Jr, N.
        Alcohol consumption and fatty acid intakes in the 2001-2002 National Health and Nutrition Examination Survey.
        Alcohol Clin Exp Res. 2007; 31: 1407-1414
      6. Healthy Eating Index Support Files—2001-2002.
        (US Department of Agriculture, Center for Nutrition Policy and Promotion Web site) (Updated July 16, 2009)
        • Graubard B.I.
        • Korn E.L.
        Predictive margins with survey data.
        Biometrics. 1999; 55: 652-659
        • Freedman L.S.
        • Guenther P.M.
        • Krebs-Smith S.M.
        • Kott P.S.
        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; 138: 1725-1729
        • Korn E.L.
        • Graubard B.I.
        Analysis of Health Surveys.
        John Wiley & Sons, New York, NY1999
        • Merrill A.L.
        • Watt B.K.
        Energy Value of Foods—Basis and Derivation.
        US Department of Agriculture, Agricultural Research Service, Washington, DC1973 (Agricultural Handbook No. 74)
        • Cotton P.A.
        • Subar A.F.
        • Friday J.E.
        • Cook A.
        Dietary sources of nutrients among US adults, 1994 to 1996.
        J Am Diet Assoc. 2004; 104: 921-930
        • Guenther P.M.
        • Juan W.Y.
        • Lino M.
        • Hiza H.A.
        • Fungwe T.
        • Lucas R.
        Diet Quality of Low-Income and Higher Income Americans in 2003-04 as Measured by the Healthy Eating Index-2005: Nutrition Insight 42.
        US Department of Agriculture, Center for Nutrition Policy and Promotion, Alexandria, VA2008
      7. NCHS linked mortality files.
        (National Center for Health Statistics Web site) (Accessed August 2, 2009)
        • National Institute on Alcohol Abuse and Alcoholism
        Rethinking Drinking: Alcohol and Your Health.
        US Department of Health and Human Services, Washington, DC2009 (NIH Publication No. 09-3770)


      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.