Experimental and observational studies on alcohol use and dietary intake: a systematic review

The scientific literature on links among alcohol use, total energy intake, cardiometabolic disease and obesity is conflicting. To clarify the link between alcohol use and cardiometabolic health, this systematic review (PROSPERO CRD42016039308A) uses PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to synthesize how alcohol use affects dietary intake (carbohydrate, fat and protein intake) in humans. A search of Google Scholar, PsycINFO and PubMed from June 2016-March 2019 yielded 30 qualified studies. Experimental and observational studies allowed for inferences about effects of a single drinking occasion and of frequent drinking, respectively. Alcohol quantities were standardized according to the 2015-2020 Dietary Guidelines for Americans. On average, methodological quality of the studies was medium strength. Results indicated that a single occasion of light and moderate drinking as well as frequent light and moderate drinking were linked to greater fat and protein intake, albeit the majority of studies did not detect differences in dietary intake due to these drinking behaviours. Frequent heavy drinking, on the other hand, was linked to less carbohydrate intake in the majority of studies. Overall, alcohol use does not appear to uniformly affect diet but instead appears to affect intake of specific macronutrients in a dose-dependent manner, most consistently decreasing carbohydrate intake with heavier use.