Alcohol & Weight Control

Nearly every day on television, advertisements appear with solutions guaranteeing that people can develop the prototypical “six-pack” of abs by following simple and short programs. The term “six-pack” refers to the easily identifiable six separate muscle bellies, which can be seen between the beltline and rib cage when a person is athletic and lean.
This contrasts sharply with the belly most often associated with the other kind of six-pack: the familiar cluster of six cans of beer, lined up in formation within a plastic set of rings, condensing moisture with their frosty coldness. Stand outside any convenience store and you rarely see one “six-pack” associated with the other. Seemingly, a desire for one type of six-pack is exclusive of the other, as most regular drinkers appear to be severely overweight or obese.
This has led most nutrition gurus to the conclusion that ideally, alcohol should be absent from the diet plan of any person serious about losing weight or maintaining a healthy bodyweight.1 However, considering the national obsession with recreational drinking, realistic nutritionists have attempted to compromise, allowing one drink per day. The justification is it doesn’t lead to excess calorie consumption, so it’s ok.2

Alcohol and Regulating Weight
Alcohol, more specifically ethanol, the alcohol contained in beer, wine and distilled spirits, isn’t a calorie-free treat. Alcohol contains approximately seven calories per gram, with most drinks— based upon serving sizes of 12 ounces for beer, four ounces for wine and one ounce for spirits— containing between 10 and 15 grams of alcohol. In addition to the alcohol content, most drinks also have a fair degree of sugar. The sugar may be natural, such as in wine, or may be part of a mixer such as is used in margaritas and daiquiris.
It’s fairly evident that regular, excess consumption of alcoholic drinks can lead to weight gain. One study in England showed that people who regularly drank more than two drinks (30 grams alcohol) per day gained more weight over a five-year period than their moderate-drinking peers.3 Consuming up to two drinks per day doesn’t appear to cause weight gain and in persons not afflicted by problems with addiction, doesn’t appear to be related to any harm.4,5 In fact, moderate alcohol consumption, up to two drinks per day, may be beneficial, as it relates to the lower risk of death in people aged 35-69 years and reduces the risk of coronary heart disease.6 The protection against heart disease appears to be related to a number of factors including: increased HDL (good cholesterol), improved insulin sensitivity and glucose tolerance, reduced clotting risks, lower blood fats (triglycerides) and possibly a lowering of blood pressure.6
One issue frequently arising is the role of moderate drinking in weight control. Due to the many examples of excess, alcohol is frequently associated with the “beer belly.” However, scientific evidence suggests that responsible, regular, moderate drinking may actually improve weight control and may assist with weight loss. Though the evidence is conflicting, it appears that alcohol improves the body’s ability to regulate its weight through a variety of mechanisms.

Alcohol and Insulin Activity
A recent poster presentation at the American Dietetic Association's Food and Nutrition Conference and Expo focused on the relationship between alcohol consumption and body mass index (BMI) in 1,335 healthy young adults (20–38 years of age).7 The authors found non-drinkers have a higher BMI than drinkers, consuming more fat and carbohydrate calories. No difference in physical activity was noted between the groups. This interesting conclusion begs for an explanation, but the authors didn’t include this in the scope of their presentation. This is consistent with other studies, which have found greater weight loss in diets including moderate consumption of alcohol.8  Reviewing the published literature, a number of possible explanations for this effect have been proposed. Of note, most of the weight management effect of alcohol appears to be related to the use of fermented beverages, such as wine and beer. Though distilled alcohol does offer some heart protective effects, these beverages haven’t been studied as thoroughly for their effect on bodyweight.

The most prominent effect of alcohol may be its influence on insulin sensitivity.9-12 Insulin is a hormone produced by the pancreas, which drives sugar into the cells. Another function of insulin is to inhibit fat breakdown and release from fat cells and promote the storage of fat. As people age or suffer from obesity, they become less sensitive to the effects of insulin, requiring greater levels of the hormone to be released. High levels of insulin are associated with many diseases, including the metabolic syndrome.13 High insulin levels, caused by reduced insulin sensitivity, lead to progressive fat accumulation. By reversing the trend and improving the body’s ability to respond to insulin, moderate drinking appears to offer benefit in reducing the risk of excess fat gain and possibly promote fat loss.  Another hormone known to be affected by alcohol consumption is DHEA. This steroid acts as a precursor, being converted to other hormones in the body, but it also directly affects a number of body functions, including functions related to weight gain. When DHEA levels drop, such as is seen in overtraining or aging, a related increase in bodyweight and body fat is seen.14 Moderate alcohol consumption is related to an increase in DHEA (sulfate) of 16.5 percent, which may account for some of its weight management effects.15
The most elementary equation relating to weight gain is defined by the statement that weight gain occurs when calories in exceed calories burned. Calories are burned by three main avenues: basal metabolic rate, thermogenesis and physical activity. Alcohol may increase thermogenesis in moderate drinkers. Regular drinkers may also see a reduction in the available calories from alcohol consumption, as they up-regulate the microsomal ethanol-oxidizing system, a set of enzymes that dispose of alcohol without burning it for energy.16 One study revealed that moderate drinkers are also more active, among older adults.17 This increase in activity is based on daily motion and the difference is seen even on days alcohol isn’t consumed.