Beverage Consumption: Are Alcoholic and Sugary Drinks Tipping the Balance towards Overweight and Obesity?

Abstract

The role that energy-containing beverages may play in the development of overweight and obesity remains highly controversial, in particular the alcoholic and sugar-sweetened beverages (SSB). Both of these beverage formats have been increasing as a percentage of the westernized diet over the past 20 years, and both have contributed significantly to an increase in energy consumed in liquid form. Data from epidemiology and intervention studies however have long been contradictory, despite mechanistic evidence pointing towards poor compensation for addition of "liquid" energy from these two sources into the diet providing a strong rational for the balance to be tipped towards weight gain. Regulatory and government intervention has been increasing globally, particularly with respect to intake of SSBs in children. This narrative review presents evidence which both supports and refutes the link between alcohol and carbohydrate-containing liquids and the regulation of body weight, and investigates mechanisms which may underpin any relationship between increased beverage consumption and increased energy intake, body weight and adiposity.

Keywords: alcoholic beverages; body weight; obesity; sugar-sweetened beverages.

Figure 1

Change in macronutrient oxidation over 15.5 h in response to addition (ADD) or substitution (SUB) of alcohol into a test meal, relative to a no alcohol control. SUB (), 50en% from CHO substituted for alcohol; ADD (), 50en% from CHO added as alcohol. Both addition and substitution of alcohol within a meal has an immediate suppressive effect on CHO and fat oxidation (from Murgatroyd et al., 1996 [46], with permission).

Figure 2

Relationship of soft drink consumption to the prevalence of (a) overweight, (b) obesity, (c) type 2 diabetes in adults from 75 countries, based on data from EuroMonitor Passport Global Market Information Database on beverage intake and World Health Organization’s Global Database on overweight and obesity (from Basu et al, 2013 [24], with permission).

Figure 3

Mean BMI z scores of children aged 2, 4, and 5 years showing daily consumption of sugar sweetened beverages (SSBs), which was significantly different versus nondrinkers of SSBs (from de Boer et al., 2013 [85], with permission).