Abstract
Introduction: The detrimental effects of alcohol abuse on human health and injury are well known. Less well documented is the relationship between alcohol consumption and the diet. As alcohol is an energy dense macronutrient, it can significantly increase total energy intakes while also influencing food intakes. Many countries have looked at alcohol consumption in relation to energy and macronutrient intakes, however no research has been done in New Zealand.
Objective: To examine the cross-sectional relationship between alcohol consumption in relation to macronutrient, total and food energy intakes in New Zealand adults aged 15 years and over, and to describe the characteristics that are associated with habitual drinking patterns (non- drinkers, former, light to moderate and heavy drinkers).
Design: We analysed data from the 2008/09 Adult Nutrition Survey, a nationally representative, cross- sectional survey of 4,721 New Zealand adults aged 15 years and over. A total of 4,720 participants comprising of 2,065 men and 2,655 women were included in this study. Habitual alcohol consumption was assessed via a semi quantitative questionnaire and categorized into four groups: non-drinkers, former drinkers, light to moderate drinkers (≤10 drinks/week for women and ≤15 drinks/week for men) and heavy drinkers (>10 drinks/week for women and >15 drinks/week for men). Demographic variables associated with drinking habits were examined using multivariate logistic regression. Food and alcohol consumption was collected via a multiple pass 24-hour dietary recall. Alcohol consumption was categorised into three groups (0, 1-2, ≥ 3). Energy and macronutrient intakes (protein, carbohydrate, fat) from the 24-hour recall were compared between the three drinking groups using multiple linear regressions. Survey commands were used to allow for the complex sampling design and to provide representative estimates of the New Zealand population.
Results: The majority of New Zealand adults were light to moderate drinkers with 82.9% of males and 74.1% of females. Māori males were more likely to be heavy drinkers than New Zealand European and other (NZEO) men (OR 2.51; p<0.01). Pacific females were more likely to be non-drinkers than non-pacific females (OR 4.59; p<0.01). A large proportion of 15-17 year olds were habitual light to moderate drinkers (69.6% of males and 71.3% of females). Body mass index (BMI) was 4% lower in male light to moderate drinkers and 7% higher in male heavy drinkers compared to all other habitual consumption categories (non-drinkers, former and heavy drinkers). Increasing alcohol consumption during the 24-hour recall was associated with higher total energy intakes (Males: 9,988kJ for 0 drinks to 13,618kJ for ≥3 drinks; females: 7312kJ for 0 drinks to 9845kJ for ≥3 drinks). Men and women who consumed three or more alcoholic drinks during the recall period had higher food derived energy intakes than those who consumed no alcohol, by 1,386 kJ (p<0.01) for men and 675kJ (p<0.01) for women.
Conclusion: The high prevalence of regular adolescent drinkers may have detrimental short and long term health outcomes. Addressing the alcohol purchasing age is one way to reduce the opportunity for adolescents to purchase large amounts of inexpensive alcoholic drinks for binge-drinking sessions. The increases in energy intakes on single heavy drinking occasions that we found are cause for concern on a population level in relation to weight gain. Targeting drinking days as a public health strategy may help to increase people’s awareness of how much alcohol and food they are consuming on any drinking occasion.