A study has found that people who are underweight and drink excessively have a much higher risk of dying from heart disease, cancer and other causes than people with a healthy weight who drink more moderately.
“We expected to see a link between obesity and alcohol-related mortality, and we were surprised to see that the link was particularly pronounced for underweight people who drink excessively,” said declared Muntasir Masum, PhD, a postdoctoral researcher at the Edna Bennett Pierce Center for Prevention Research at Penn State in University Park, Pennsylvania, in a Press release.
Excessive alcohol consumption in the United States
In 2019, more than half of all men and women in the United States over the age of 18 reported having consumed alcohol in the previous month, 8.3% of men and 4.5% of women drinking heavily, according to the report. National Institute on Alcohol Abuse and Alcoholism.
Heavy drinking is defined as 8 or more drinks per week for women and 15 or more drinks per week for men. Excessive alcohol consumption does not mean that you are abusing alcohol. Most people who drink excessively are not alcoholics or alcohol dependent, according to the Centers for Disease Control and Prevention (CDC).
Excessive alcohol consumption is the third leading cause of preventable death in the United States and is estimated to cause 1 in 10 deaths among working-age adults, according to the Journal of the American Medical Association.
the 2020-2025 Dietary Guidelines for Americans recommends that adult men limit their consumption to 2 drinks or less per day and that women have 1 drink or less per day.
Researchers used national data to examine how alcohol and weight can impact early death
To examine the combined effects of alcohol and weight on mortality, the investigators used data from the National Health Interview Survey (NHIS), a nationally representative sample of 209,317 American adults aged 35 to 85, interviewed between January 1, 2001 and December 31. 2011.
“The NHIS is like a ‘selfie’ for the United States because it’s a snapshot of the health behaviors of people of all background types,” Dr. Masum explained.
Participants were categorized based on their self-reported alcohol consumption. People can be non-drinkers, former drinkers, light or moderate drinkers (less than 7 drinks per week for women and less than 14 drinks per week for men) or heavy drinkers (more than 7 drinks per week for women or more than 14 drinks per week). week for men on average over the previous year).
The researchers analyzed data on mortality risk among drinkers and non-drinkers using the CDC BMI categories to define ‘underweight’, ‘normal weight’, ‘overweight’ and ‘obese’.
The body mass index (BMI) is a person’s weight in kilograms divided by the square of their height in meters. According to CDC definitions, BMI status is defined as follows:
- 5 or less, underweight
- 5–24.9, healthy weight
- 25–29.9, overweight
- 30 years and over, obese
For someone who is 5 feet 6 inches tall, a healthy weight is between 115 and 154 pounds. If that person weighs less than 115 pounds, they are considered underweight; if they weigh between 155 and 194 pounds, they fall into the overweight category and if they weigh 195 pounds or more, they fall into the obese category.
Although measurement is a simple and inexpensive way to bring people together in research, tool review point out that this does not take into account how much fat or muscle a person has. Additionally, BMI was developed and validated primarily in white males, and females and people of other races or ethnicities may have different typical body composition.
Underweight and obese people who drink heavily have a higher risk of death
Researchers found that people who were underweight based on their BMI had a 148% higher risk of death from any cause than people with a healthy BMI and light or moderate consumption of alcohol. Underweight people also had a higher risk of dying from heart disease or cancer than light to moderate drinkers with a healthy BMI.
Obese heavy drinkers were 16% more likely to die from any cause than light to moderate drinkers with a normal BMI.
Previous data has established that people who are underweight or obese have an increased risk of premature death, and this study takes into account the effects of alcohol on top of that, says Michael Fingerhood, MD, director of the division of addiction medicine and associate professor of medicine at Johns Hopkins Medicine in Baltimore.
“There are several known health risks [associated with] drinking too much alcohol,” says Dr. Fingerhood. According to the CDC, the long-term health risks of excessive alcohol consumption can include high blood pressure, heart disease, liver disease, digestive problems, certain types of cancer, dementia, and debilitation. of the immune system.
Too many calories from alcohol can contribute to malnutrition
“A person who is underweight is also very likely not getting all the nutrition they need,” says Dr. Fingerhood.
“A BMI of less than 18.5 is really thin. If someone is underweight, they should focus on using their daily calories to get as much nutrition as possible, and alcohol won’t do any good. nutritional benefit,” he says.
Fingerhood gives the example of someone with a severe alcohol use disorder. “Suppose this person drinks a case of beer a day. That’s 24 cans of beer, and each of those cans has at least 100 calories, probably more. That means that person is consuming 2,400 calories or more per day which has no nutritional benefit,” he says.
It’s no surprise that people of any weight status who drink heavily have nutritional abnormalities, says Fingerhood. “In this case, if your BMI is so low, you’re likely to be taking in very few calories, and if a large portion of those calories are from alcohol, you’re likely to develop vitamin deficiencies that could increase your risk of mortality,” he says.
Additionally, if underweight people drink at the same rate as normal-weight people, their blood alcohol levels will rise more quickly, which can also have a negative effect on health, says Fingerhood.
“Interestingly, people who have had bariatric surgery have an increased risk of developing a new alcohol use disorder. It’s thought to be because after surgery, alcohol consumption raises their blood alcohol levels faster and as a result they are more likely to develop problems,” he says.
These findings are another reason people should be aware of how much alcohol they’re drinking and make sure they’re not drinking excessively, says Fingerhood. “For anyone who drinks alcohol in a concerning way, they may not be getting enough nutrients from their daily caloric intake.”