Beer and Spirits Have More Detrimental Effects on the Waistline and on Cardiovascular Disease Risk than Red or White Wine

Yves here. This post is cheery news. Yours truly must confess that elder care, then Covid, and now Covid plus the war has driven me to drink, albeit as a carefully controlled wine drinker. But how about roses?

And some still say that any alcohol is bad for your brain….although one of the smartest people I know is a recovered alcoholic who in her 60s still does extremely difficult work (as in high end of the intellectual spectrum for her field, which requires an advanced degree) and to regular deadlines too. But then again, the plural of anecdote is not data…

Nevertheless, the problem with any studies on diet is that there are many confounding variables, and there’s not enough money to do long-term studies well. There have been some done with nurses as subjects, and they can be relied upon to keep accurate records of what they ate (normal people lie and/or fudge them from memory later). But medical professionals are healthier than the public at large, due in part to having better knowledge as to how to care for themselves and when to seek professional help.

Interestingly, a study done a while back found that heath care practitioners were having their general health levels fall at the same rate as the public at large. They were also heavier drinkers on average, but also exercised more and smoked less than laypeople.

By Brittany Larsen, Ph.D. Candidate in Neuroscience & Graduate Assistant, Iowa State University. Originally published in The Conversation

The Big Idea

Drinking beer and spirits is linked to elevated levels of visceral fat – the harmful type of fat that is associated with an increased risk of cardiovascular disease, metabolic syndrome, and other health complications – whereas drinking wine shows no such association with levels of this harmful fat and may even be protective against it, depending on the type of wine consumed. In fact, we found that drinking red wine is linked to having lower levels of visceral fat. These are some of the key takeaways of a new study that my colleagues and I recently published in the Obesity Science & Practice journal.

Although white wine consumption did not influence levels of visceral fat, our study did show that drinking white wine in moderation might offer its own unique health benefit for older adults: denser bones. We found higher bone mineral density among older adults who drank white wine in moderation in our study. And we did not find this same link between beer or red wine consumption and bone mineral density.

Our study relied on a large-scale longitudinal database called the U.K. Biobank. We assessed 1,869 white adults ranging in age from 40 to 79 years who reported demographic, alcohol, dietary and lifestyle factors via a touchscreen questionnaire. Next, we collected height, weight and blood samples from each participant and obtained body composition information using a direct measure of body composition called dual-energy X-ray absorptiometry. Then, we used a statistical program to examine the relationships among the types of alcoholic beverages and body composition.

Why It Matters

Aging is often accompanied by an increase in the problematic fat that can lead to heightened cardiovascular disease risk as well as by a reduction in bone mineral density. This has important health implications given that nearly 75% of adults in the U.S. are considered overweight or obese. Having higher levels of body fat has been consistently linked to an increased risk for acquiring many different diseases, including cardiovascular disease, certain types of cancer, and a higher risk of death. And it’s worth noting that national medical care costs associated with treating obesity-related diseases total more than US$260.6 billion annually.

Considering these trends, it is vital for researchers like us to examine all the potential contributors to weight gain so that we can determine how to combat the problem. Alcohol has long been considered one possible driving factor for the obesity epidemic. Yet the public often hears conflicting information about the potential risks and benefits of alcohol. Therefore, we hoped to help untangle some of these factors through our research.

What Still Isn’t Known

There are many biological and environmental factors that contribute to being overweight or obese. Alcohol consumption may be one factor, although there are other studies that have not found clear links between weight gain and alcohol consumption.

One reason for the inconsistencies in the literature could stem from the fact that much of the previous research has traditionally treated alcohol as a single entity rather than separately measuring the effects of beer, cider, red wine, white wine, Champagne and spirits. Yet, even when broken down in this way, the research yields mixed messages.

For example, one study has suggested that drinking more beer contributes to a higher waist-to-hip ratio, while another study concluded that, after one month of drinking moderate levels of beer, healthy adults did not experience any significant weight gain.

As a result, we’ve aimed to further tease out the unique risks and benefits that are associated with each alcohol type. Our next steps will be to examine how diet – including alcohol consumption – could influence diseases of the brain and cognition in older adults with mild cognitive impairment.

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37 comments

  1. rick shapiro

    Not exactly a surprise. Rising above confounding variables, it is clear that, per ounce of alcohol, beer delivers an order of magnitude more carbohydrates.
    Spirits? Harder to explain, but spirits are generally consumed specifically to get a buzz. Drinkers are more likely to underreport consumption, as well as to eat things that they otherwise wouldn’t or would be reluctant to report.

      1. Janie

        Yeah, when was the last time you heard someone order bourbon and branch (water, from the branch of the stream)? I gave that order to a not-young bartender a few decades ago and got a blank look.

  2. PlutoniumKun

    I’m always a little sceptical about these studies, there are so many potential confounding issues. Not least that wine drinkers usually drink with food while beer drinkers are later evening drinkers, which could have an impact on insulin sensitivity.

    When you take the big picture, the countries with the longest average lifespans – Japan, South Korea, Spain, Australia, Switzerland, Italy, are regular drinking cultures. If you compare say the north and south sides of the Mediterranean, despite similar diets, the northern (wine) countries seem to have significant longer lifespans than the non-drinking north African/Arabic countries. And yes, of course there are other factors involved. But I don’t think it counts significantly compared to the proven health and lifespan variables – i.e. smoking, diet, exercise and maintaining low levels of body fat along with muscle bulk.

    1. wolfepenguin

      I agree with you that non randomized control trial studies of this type are full of confounders. The most common one, especially for these crappy cross-sectional studies is that selection is the most likely driver. This is the weakest type of causal evidence since they are doing self-reported intake of different alcohol (beer, wine, etc.). Since they’re not assigning treatment, the common confounder is that sample under study is capturing different populations (i.e., beer drinkers vs. wine drinkers). I looked up the study and wine drinkers consume less meat and less grains compared to beer drinkers. Since this is a lifestyle choice among the sample, no amount of variables that you chuck in a regression will fix this problem. This is so similar to those studies that say that sitting is associated with lower life expectancy (the results were true but it had more to do with physical activity and its correlation with life expectancy rather than the actual act of sitting), which spawned a whole dumb industry on standing desks.

      1. Irrational

        Agree with both of PK and wolfepenguin that it is very hard to disentangle effects and more granular studies would be welcome. However, I have long ago adopted the middle of the road attitude, since it seems what is bad for you one day is good for you the next and vice versa. I rarely miss my red wine with my dinner, but also exercise regularly and eat healthily. So far, so good – and, if not, it might be no bad thing what with accelerating climate change and for-profit wars.

  3. Jeff N

    I had recently got back into drinking (and thankfully have stopped again.) One thing I learned is that the cheapest wine/spirits can, on some occasions, give you a headache that can last 20 hours.

  4. Brunches with Cats

    Just speculating here, but rose probably would be similar to white for the purposes of this study. Even though it’s made from red wine grapes, the skins are removed from the vat early on and so it doesn’t have the compounds in red wine that, depending on current research and marketing trends, are either are good for your heart or will send you to an early grave.

    I lived on a winery in the south of France on and off for several years from mid-1990s. One of their two specialties was a lovely pale, dry rose, which they drank only in the summer and, believe it or not, with an ice cube. They even created their own version of kir, the classic French aperitif made with dry white wine, substituting orange syrup for the traditional creme de cassis. I wasn’t too crazy about it, though, as to my tastes, their rose was exquisite on its own.

      1. Brunches with Cats

        The winery where I lived used no herbicides at all, one of the few in the area, which put the vintner on the wrong side of the locals more than once. He did use pesticides, because the government required some for certain diseases that can wipe out entire wine-growing regions, but he used only the minimum required. Likewise, some preservatives are necessary in commercial winemaking, but he used the absolute minimum necessary.

        It was a shock, though, to see how much the French rely on pesticides and herbicides. As a generalization, it seems to me that the Italians are more judicious in that regard.

        1. PlutoniumKun

          The good news about organic wines is that they are exceptional value if you buy the better quality ones.

          Apparently, consumers assume that the ‘organic’ label on good wines is an indicator that they are overpriced, when the opposite is the case. Repeated studies have shown that based on blind tasting, good organic wines are cheaper than the pesticide enhanced ones.

  5. Mark

    I’ve wondered, is there a differentiation between a shot of tequila and a margarita? Both are in the spirit camp but one contains an unhealthy amount of sugar. Do these studies make that differentiation? Need to know, I enjoy a shot of whiskey on the weekends.

    1. Brunches with Cats

      Margaritas don’t have to have a lot of sugar, better in fact if they don’t.

      Tequila and gin are the only two spirits I can drink that don’t cause migraines — with the caveat that they can’t be used with a mix, which rules out nearly all restaurant margaritas. I’ve been making my own from scratch for years, always to rave reviews by guests. Ingredients for one: 1 to 1-1/2 shots of gold tequila, 2 TBSP fresh pressed lime juice, grated lime peel (outer skin only), 1 teas Morena sugar. Put in blender with ice, add ice cubes as desired for a slushy (how I make mine) or frozen drink. If you want a double, you can use two shots of tequila without adding more sugar.

      1. Brunches with Cats

        Some tequilas are made with 100% blue agave. It should say so on the bottle. They tend to be pricier, but if you’re worried about what’s in it, it’s worth either paying more or doing some research.

        And no, they can’t contain up to 49% of added sugar, LOL. If they did, you’d be drinking syrup! The 49% reg refers to the origin of the alcohol; in other words, the bottle could contain 51% or more alcohol fermented from agave sugar and 49% fermented from other plants, typically sugar cane, since it’s so plentiful and cheap. Rum is 100% distilled from alcohol from fermented sugar cane. Colorants are barely a blip, the most common being caramel coloring in cheaper tequilas to impart a more “aged” appearance. Many other spirits, including beer and whiskey, contain caramel coloring.

        I’ve never tried mezcal, but from what I’ve read, the variations due to the wide variety of agave species would make it difficult to know before buying whether it would work well in a margarita, which is virtually all I do with tequila (just as gin is for G&T, period). Oh, and BTW, tequila is a type of mezcal. Maybe another way to put it is that all tequila is mezcal, but not all mezcal is tequila, which can be derived from only blue agave and produced only in the state of Jalisco; whereas mezcal can come from many species of agave over a wider geographical area. Also, I just did a quick search for the regs; it can be up to 20% alcohol derived from plants other than agave. Better than 49%, but still no guarantee, unless the bottle says it’s 100% derived from agave.

  6. Robert Hahl

    The heaviest drinker I ever knew neglected nutrition to the point that e was living on vodka and saltines, collapsed in the hallway outside er doctor’s office (feeling sick for some reason), and needed a blood transfusion. One nurse at the hospital pointed to a dark area on the brain scan, and said authoritatively, “she is never coming back,” but that was bullshit. Near total recovery after one year off alcohol, and then one drink before dinner forevermore. Lived to >100 years. I think poor nutrition (and loneliness) does a lot of damage to excessive drinkers because they often substitute drink for food. Ever spend any time in a Liverpool pub?

    1. Arizona Slim

      To your point, I am acquainted with the co-founder of one of Tucson’s largest breweries. When the place first opened, he was a medical student.

      What, what? A med student co-founding a brewery?

      He was there because he started out as a homebrewer and wanted to turn pro. So he did. That was back in 2011.

      Shortly before the place opened, we had several conversations about the community aspects of the brewery, which still has one of the most popular tasting rooms in town. The word I used to describe it was “conviviality,” and he agreed.

      1. Howard Beale IV

        Studies like these make me question whether or not social factoring comes into play. As for me, I’m now down 10 lbs since the first of the year, and part of that comes from visiting my local cigar/bar (yes, it’s a bar that touts premium cigars.) Ignoring the social factor dooms studies like these.

    2. anon y'mouse

      part of that is the systemic effect of alcohol on all bodily systems including the brain, endocrine and digestive.

      many heavy drinkers have little appetite and suffer from gastro-side effects when they do eat much alongside their drinking.

      the documentary “My Name Was Bette” goes into all of this. drinking is especially detrimental to women. our higher body fat percentage makes us drunker sooner and for longer on less, is my oversimplified understanding.

    3. Bazarov

      The heaviest drinkers I’ve known died in their mid-thirties.

      One of liver failure, the other due to the interaction between opioids and alcohol.

      Mormons and Adventists avoid alcohol. They have long life spans. But the “togetherness” that light drinking provides in some cultures is also provided by religious gregariousness.

      I would also add that the Adventists encourage vegetarianism as part of the healthy lifestyle that’s a tenant of their religion.

      I doubt that alcohol itself is very good for you, but if light drinking permits sociality, it’s a net benefit because sociality seems to promote wellbeing.

      I don’t think there’s much doubt that heavy drinking is extremely dangerous over the medium and long term.

      1. Robert Hahl

        Agreed. My point was the argument that each drink causes some permanent brain damage seems overdone.

  7. Fit-for-Purpose

    “Our next steps will be to examine how diet – including alcohol consumption – could influence diseases of the brain and cognition in older adults with mild cognitive impairment.”

    No need to research this. Mild cognitive impairment is the point of alcohol consumption. Nobody would ever drink if that didn’t happen.

  8. Bugs

    What are ya going to do, really? How much can we give up from being human to just live longer? Heavy drinking and being an alcoholic is obviously going to hit your brain and general health hard but, please, allow me my end of the day break from reality.

    1. johnherbiehancock

      Yeah, I think the health detriments due to stress justify accepting some of those due to heavy/heavier drinking.

      In a more perfect country, we’d be able to moderate our drinking by pairing it with moderate recreational drug use.

  9. johnherbiehancock

    I like to drink pretty much everything in moderation.

    I’ve tried to move away from beer and cocktails because of the calories though, and more in to wine.

    But one thing I’ve noticed is that despite coming out as the most beneficial choice, red wine gives me terrible heartburn. White wine occasionally does as well. I don’t have the same issue with beer, or most liquors. Especially ones with purportedly digestive benefits, like fernet branca (though they have more sugar). I feel better when I drink those though…

    So I’m wondering if what one should drink depends more on individual body chemistry.

  10. Dwight

    Another confounding factor which may not be controlled is that many people who don’t drink are people who formerly drank to excess, which is why they don’t drink. Depending on how long and how much they used to drink, they could be less healthy than current moderate drinkers who are more generally lifelong moderate drinkers. Seems like this effect would be pronounced for people above fifty.

  11. Anthony G Stegman

    Say it isn’t so!!! My daily beer is my daily vitamin. :)

    I recall reading a few years ago in a men’s health magazine that drinking beer can strengthen bones because beer contains silicon which increases bone density. I wonder if this latest study is akin to the eggs bad, – eggs good, shrimp bad – shrimp good studies.

    Red win exacerbates many skin conditions. So I guess it is all a matter of choosing your poison.

  12. Maritimer

    What is never mentioned is that:

    “Alcohol is a drug. It is classified as a Central Nervous System (CNS) depressant, which means that drinking alcohol slows down brain functioning, neural activity, and further reduces the functioning of various vital functions in the body.”

    https://www.addictioncenter.com/community/is-alcohol-a-drug/

    I have often heard alcohol drinkers say “Oh, I never do drugs.”

    Anecdottaly, in my jurisdiction, one of the first things our esteemed Public Health Experts did was to allow takeout booze while at the same time preventing addiction support meetings, lockdown you know. Yes, Public Health Experts!

  13. George

    I’m just loving all the denials, because the entire first year of rehab you hear a lot of these. So, here is my credence to the only thing worse than one is an ex-one after forty some years of sobriety. The mild cognitive impairment mentioned by the poster above admonishes most things alcohol culpable. After a couple of years of out-patient treatment for alcoholism/substance abuse the takeaway for me was an eleven-ounce beer, five-ounce glass of wine or a one ounce shot of whiskey all break down in the dopamine department as equal. Believe me, rehabilitation will ruin your drinking experiences forever and you will still get fat.

  14. ChetG

    Throughout my seventy-plus years of life, spirits, beer, and wine have been commonplace. Beginning (as far as I’ve noticed) in the 1980s was the introduction of truly obese people, the introduction of whom may be correlated with the rise of fast foods.

    I’ve no doubt that alcohol can increase the problems (i.e., weight gain and other types of abuse), but I can’t help but feel the true problem is dietary: The available food is, for the most part, wretched.

    That said, please pass me the vodka.

  15. Antagonist Muscles

    I only read the abstract and the introduction to Larsen’s study, but my own subjective experience drinking wine is at odds with the suggestion that wine is less correlated with “harmful fat”. As far as I can tell, wine does very little when it comes to satiation despite the relatively high caloric content of alcohol. (And measuring satiety in terms of calories is fraught with risk.) Considering the lack of satiety, I am concerned people would end up eating equal or possibly more portion sizes if wine was consumed with a meal. I don’t dispute a correlation between wine and “less visceral adipose mass”, but I wish this article offered more practical advice. If obesity is a concern, can you emphasize exercise and eating well instead of weighing whatever risk and benefit that is inherent to alcohol consumption?

    Bone mineral density (BMD) is not important. What should be important to the elderly is lowering the risk of a broken bone, which is not strictly correlated with BMD. Focusing on increasing your BMD is as counter-productive as a vendetta against blood cholesterol. Even worse than this is deliberately using drugs to increase BMD or lower cholesterol. Can you consider regular exercising and weight lifting to strengthen your bones? And please don’t do some [family blog] exercise like water aerobics where the stress placed on your musculoskeletal system is so low that your body doesn’t even bother building more muscles or stronger bones. So please exercise and eat well. (The astute reader might notice a trend here.) This is far more practical than figuring out the relative risk and benefits of alcohol.

    I need to sleep so I will save how and why I haven’t drank alcohol in ten years for another comment.

    Here is some ironic criticism of Larsen. She is apparently affiliated with Iowa State Neuroscience. I too have been submitting my research to neuroscience PhD programs. (Nobody is interested yet.) Why does a neuroscientist have things to say about alcohol, body mass, and BMD?

  16. ChrisRUEcon

    It’s true … and I’ve lived it … LOL

    Although I have slipped back to beer a bit.

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