Alcohol consumption in the
Greek population: is it related
to abdominal obesity?
M. Kaklamanou, D. Kaklamanou, I. Ioannidis, C. Loupa, E. Kapantais
Hellenic Medical Association for Obesity (HMAO), Athens, Greece
First National Epidemiological Large Scale Survey on the
Prevalence of Obesity in Greek Adults
2
Introduction I
The metabolic syndrome is characterised by a group of metabolic risk factors. They include:
Central obesity
Atherogenic dyslipidemia
Raised blood pressure
BMI is a tool for measuring obesity, but when
measuring abdominal obesity waist-to-hip ratio
and waist circumference are used
In this study waist-to-hip ratio measurements were used
http://www.mayoclinic.com/
George A. Bray, Claude Bouchard, W.P.T. James; Handbook of Obesity, Marcel Dekker, New York, 1998
Hellenic Medical Association for Obesity (HMAO), Athens, Greece
First National Epidemiological Large Scale Survey on the Prevalence of Obesity in Greek Adults
Insulin resistance
Prothrombotic state
Proinflammatory state
3
Introduction II
Chronic alcohol consumption has both
adverse effects (e.g. hypertension,
cardiomyopathy and liver cancer, etc.)
beneficial effects (the French paradox, etc.)
http://www.mayoclinic.com/
Hellenic Medical Association for Obesity (HMAO), Athens, Greece
First National Epidemiological Large Scale Survey on the Prevalence of Obesity in Greek Adults
4
Aim of this study
is to explore a potential relation of alcohol
consumption to abdominal obesity
Hellenic Medical Association for Obesity (HMAO), Athens, Greece
First National Epidemiological Large Scale Survey on the Prevalence of Obesity in Greek Adults
5
Patients / Sample
The data analysed were
obtained from the first
national epidemiological
large scale survey on
the prevalence of
obesity in Greek adults,
conducted by the Hellenic
Medical Association for
Obesity.
Hellenic Medical Association for Obesity (HMAO), Athens, Greece
First National Epidemiological Large Scale Survey on the Prevalence of Obesity in Greek Adults
6
First national epidemiological
survey on the prevalence of
obesity in Greece
Public schools throughout Greece were
randomly chosen and questionnaires were
filled by the students and all the members of
their households
The subpopulation used in the adult
HMAO study were Greek men and women,
20 to 70 years old
Hellenic Medical Association for Obesity (HMAO), Athens, Greece
First National Epidemiological Large Scale Survey on the Prevalence of Obesity in Greek Adults
7
Methods I
WHR was calculated from waist and hipcircumference and the following categories wereused:
SPSS version 12.0 was used for statistical analysis, student’s t-test and non parametric tests were used
Normal
Pathologic
<1.00 <0.85
>1.00 >0.85
Hellenic Medical Association for Obesity (HMAO), Athens, Greece
First National Epidemiological Large Scale Survey on the Prevalence of Obesity in Greek Adults
http://www.eiep.gr/
8
Methods II
Alcohol consumption was calculated by adding the number of units consumed weekly, multiplied by the alcohol comprehensiveness of beverages (in this case beer, wine, whiskey and liqueur). The following categories were applied:
0 mg <50 mg50 - 150 mg150 - 300 mg>300 mg
Hellenic Medical Association for Obesity (HMAO), Athens, Greece
First National Epidemiological Large Scale Survey on the Prevalence of Obesity in Greek Adults
moderate alcohol consumption
heavy alcohol consumption
no alcohol
9
Results
8090 men, age 44.6+10.5 years (x+SD),
and 9313 women, 41.5+11.1 years,
were included
WHR was 0.97+0.3 and 0.87+0.3 in
men and women, respectively
Hellenic Medical Association for Obesity (HMAO), Athens, Greece
First National Epidemiological Large Scale Survey on the Prevalence of Obesity in Greek Adults
10
Waist-to-hip ratio
in men and women
67,8
32,2
57,7
42,3
0%
20%
40%
60%
80%
100%
men women
Above normal
values (>1,00 in
men and >0,85 in
women)
Normal w/h (<1,00
in men and <0,85
in women)
Hellenic Medical Association for Obesity (HMAO), Athens, Greece
First National Epidemiological Large Scale Survey on the Prevalence of Obesity in Greek Adults
11
How much alcohol do
men drink?
21,5
31,2
12,85,9
28,6
no alcohol
<50 mg
51-150 mg
151-300 mg
>300 mg
Hellenic Medical Association for Obesity (HMAO), Athens, Greece
First National Epidemiological Large Scale Survey on the Prevalence of Obesity in Greek Adults
%%
%
%
%
12
How much alcohol do
women drink?
10,0 1,2 0,3
54,633,9
no alcohol
<50 mg
51-150 mg
151-300 mg
>300 mg
Hellenic Medical Association for Obesity (HMAO), Athens, Greece
First National Epidemiological Large Scale Survey on the Prevalence of Obesity in Greek Adults
%
%%
%
13
In men, WHR was associated to alcohol
consumption (Kendall’s tau-b, p=0.044,
statistically significant)
This was not the case with women
(p=0.823, N.S.)
Results
Hellenic Medical Association for Obesity (HMAO), Athens, Greece
First National Epidemiological Large Scale Survey on the Prevalence of Obesity in Greek Adults
14
Waist-to-hip ratio varies with alcohol
consumption in men and women
p=0.044 , p=0.823, Kendall’s tau-b
0,75
0,8
0,85
0,9
0,95
1
1,05
no alcohol <50 mg 51-150 mg 151-300
mg
<300 mg
Alcohol consumption
Wa
ist-t
o-h
ip r
atio
men
women
Hellenic Medical Association for Obesity (HMAO), Athens, Greece
First National Epidemiological Large Scale Survey on the Prevalence of Obesity in Greek Adults
15
Waist-to-hip ratio Vs alcohol
consumption in men
Hellenic Medical Association for Obesity (HMAO), Athens, Greece
First National Epidemiological Large Scale Survey on the Prevalence of Obesity in Greek Adults
0,8
0,85
0,9
0,95
1
1,05
no alcohol <50 mg 51-150 mg 151-300
mg
<301 mg
Alcohol consumption
Wai
st-t
o-h
ip r
atio
in
20-35 yrs
35-50 yrs
>50 yrs
16
Waist-to-hip ratio Vs alcohol
consumption in women
0,7
0,8
0,9
1
1,1
1,2
no alcohol <50 mg 51-150 mg 151-300
mg
<301 mg
Alcohol consumption
20-35 yrs
35-50 yrs
>50 yrs
Hellenic Medical Association for Obesity (HMAO), Athens, Greece
First National Epidemiological Large Scale Survey on the Prevalence of Obesity in Greek Adults
Wais
t-to
-hip
rati
o
17
Waist-to-hip ratio compared
with consumption of specific
types of alcohol
0,99
0,88
0,96
0,87
0,98
0,90
0,97
0,89
0,80
0,85
0,90
0,95
1,00
only beer only wine only liquer only whiskey
Men
Women
Hellenic Medical Association for Obesity (HMAO), Athens, Greece
First National Epidemiological Large Scale Survey on the Prevalence of Obesity in Greek Adults
Wa
ist-
to-h
ip r
ati
o
Alcohol consumption
18
Conclusions I
In the Greek population, men drink
more alcohol than women
Women are more likely to have
abnormal WHR than men
Hellenic Medical Association for Obesity (HMAO), Athens, Greece
First National Epidemiological Large Scale Survey on the Prevalence of Obesity in Greek Adults
19
Conclusions II
In addition to the effects of alcohol
consumption to risk factors of various
diseases, alcohol is related to
abdominal obesity in men only
Hellenic Medical Association for Obesity (HMAO), Athens, Greece
First National Epidemiological Large Scale Survey on the Prevalence of Obesity in Greek Adults
20
Discussion I
Jequier introduced the alcohol paradox,
which suggests increased alcohol induced
energy intake without weight gain
Other studies suggest that alcohol intake
promotes leanness in women , but not in men
This study shows that there is an association
between waist-to-hip ratio to alcohol
consumption in Greek men, but not in Greek
women
Hellenic Medical Association for Obesity (HMAO), Athens, Greece
First National Epidemiological Large Scale Survey on the Prevalence of Obesity in Greek Adults
Am J Epidemiol 1991;133:810-817
American Journal of Clinical Nutrition, Vol. 69, No. 2, 173-174, February 1999
21
Discussion II
A survey conducted in Japan, which
studied male self-defense officials,
showed that alcohol consumption is
strongly and independently associated
with waist-to-hip ratio in men
Eur J Epidemiol. 1997 Dec;13(8):893-8
Hellenic Medical Association for Obesity (HMAO), Athens, Greece
First National Epidemiological Large Scale Survey on the Prevalence of Obesity in Greek Adults
22
Discussion III
Simply looking at the total quantity of alcohol consumed over time obscures the importance of the pattern of alcohol consumption. 1-2 drinks each day is associated with better health and greater longevity whereas consuming the same quantity (7-14 drinks) once a week is associates with negative health. The same quantity of alcohol can have either beneficial or harmful consequences depending on the pattern of its consumption.
National Health Interview Study (NHIS), American Journal of Epidemiology
Hellenic Medical Association for Obesity (HMAO), Athens, Greece
First National Epidemiological Large Scale Survey on the Prevalence of Obesity in Greek Adults