Association Between Alcohol Intake and Overweight and Obesity: A Systematic Review and Dose-Response Meta-Analysis of 127 Observational Studies

Abstract

Background: Several studies have assessed the relationship between alcohol intake and overweight/obesity; however, results are inconsistent. Therefore, the present systematic review and dose-response meta-analysis of observational studies was designed to examine the association between alcohol intake with general and abdominal obesity among adults. Methods: Literature search were conducted in PubMed/Medline and Web of Sciences up to August 2020. Odds ratio (OR), prevalence ratio (PR) or hazard ratio (HR) with 95% confidence interval (95% CI) were used to pool effect size. To conduct dose-response meta-analysis, we stratified amount of alcohol intake into three categories including light ( 28 g/d). Results: In the present study, 127 eligible studies were included. In cohort studies, there was no significant association between alcohol drinking and odds of overweight (OR: 0.93, 95% CI: 0.46 to 1.89), obesity (OR: 0.84, 95% CI: 0.52 to 1.37), overweight/obesity (OR: 1.15, 95% CI: 0.84 to 1.58), and abdominal obesity (OR: 1.13, 95% CI: 0.90 to 1.41). In cross-sectional studies, alcohol intake was associated with increased odds of overweight (OR: 1.11, 95% CI: 1.05 to 1.18), overweight/obesity (OR: 1.23, 95% CI: 1.11 to 1.37), and abdominal obesity (OR: 1.19, 95% CI: 1.09 to 1.29); but not obesity (OR: 1.03, 95% CI: 0.94 to 1.12). Results of dose-response analysis indicated that heavy alcohol drinking was positively associated with odds of overweight (OR: 1.11, 95% CI: 1.01 to 1.23), overweight/obesity (OR: 1.40, 95% CI: 1.24 to 1.57), and abdominal obesity (OR: 1.24, 95% CI: 1.12 to 1.38) compared with non- or light drinkers. Interpretation: The analysis of cross-sectional studies revealed a positive association between alcohol intake and odds of overweight, overweight/obesity, and abdominal obesity; but not obesity. According to dose-response analysis, this association was significant between heavy alcohol drinking and odds of overweight, overweight/obesity, and abdominal obesity. However, no significant association was observed between alcohol intake and body weight in cohort studies. Funding Statement: No separate funding was necessary for undertaking this systematic review. Declaration of Interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.