Burden of high-risk phenotype of heavy alcohol consumption among obese US population: results from National Health and Nutrition Examination Survey, 1999–2020

The phenotype of combined heavy alcohol consumption and obesity has the potential to pose as a considerable health burden in the US. No studies using nationally representative data in the US have reported their secular joint prevalence trends. Researchers estimated the prevalence and examined the joint trends of heavy alcohol use and obesity over time among adult US men and women in different age groups and according to race/ethnicity.
Using data from 10 cycles of the US National Health and Nutrition Examination Survey (NHANES) from 1999 to 2020, the researchers examined secular trends in the combined phenotype of heavy drinking and obesity overall and by age-group, sex, and race/ethnicity. The main outcome measures were prevalence of heavy alcohol consumption (>14 drinks/week in men and >7 drinks/week in women) and obesity (BMI ≥30).
In 45,292 adults (22,684 men, mean age 49.26 years; and 22,608 women, mean age 49.86), the overall weighted prevalence of combined heavy alcohol drinking and obesity increased from 1.8% (95% CI: 1.2%, 3.1%) in 1999–2000 to 3.1% (95% CI: 2.7%, 3.7%) in 2017–2020 representing an increase of 72% over time. The combined phenotype of heavy alcohol consumption and obesity increased by 3.25% (95% CI: 1.67%, 4.85%) per year overall from 1999 to 2017. An increasing trend of 9.94% (95% CI: 2.37%, 18.06%) per year was observed among adults aged between 40 and 59 years from 2007 onwards. Prevalence of heavy alcohol consumption in obesity increased at a faster rate among women (APC, 3.96%; 95% CI: 2.14%, 5.82%) than men (APC, 2.47%; 95% CI: 0.63%, 4.35%), and increased among non-Hispanic Whites (APC, 4.12%; 95% CI: 1.50%, 6.82%) and non-Hispanic Blacks (APC, 2.78%; 95% CI: 0.47%, 5.14%), but not Hispanics.
The prevalence of combined heavy alcohol consumption and obesity increased overall in the US, but the rate of increase differed by age, sex, and race/ethnic groups. Given their independent and potential synergistic effects on premature mortality, public health policies on alcohol consumption need to reflect the background obesity epidemic, the researchers argue.
Source: Raza SA, Sokale IO, Thrift AP. Burden of high-risk phenotype of heavy alcohol consumption among obese U.S. population: results from National Health and Nutrition Examination Survey, 1999-2020. Lancet Reg Health Am. 2023 May 30;23:100525.