Counting Calories

The press of late has been obsessed with discussions of calories in alcoholic beverages and the adverse effect of consumption on weight. The reports have targeted women, despite epidemiological studies that have not shown alcohol consumption to be a risk factor for obesity. A typical headline ran in The Washington Post (January 9, 2013), “When counting calories, you need to think before you drink.” The CDC has warned that alcoholic beverages may add extra calories and reported that men consume on average 150 calories worth of alcohol a day compared to a little over 50 calories for women, with younger adults consuming more than older adults (www.cdc.gov/nchs/data/databriefs/db110.htm).

Alcohol is likened to a sugared beverage akin to soda since it is similarly high in calories (one 5 ounce standard drink of Pinot Noir has 121 calories while the other most popular varietals contain between 118 and 129 calories according to the USDA National Nutrient Database), but no more than commonly ingested “healthy” juices from oranges or apples. There have been no studies published looking at the effects on weight of calories from different food sources such as wine versus apple juice.

An important study published in 2012 “Alcohol Consumption, weight gain, and risk of becoming overweight in middle-aged and older women” JAMA Internal Med 170 (5) found that compared with abstainers, initially normal-weight women who consumed a light to moderate amount of alcohol gained less weight and had a lower risk of becoming overweight and/or obese during the 12.9 years of followup. This was the first study to look at the risk of becoming overweight or obese among initially normal-weight individuals. See page 18 for a full description of this study.

While it is true that alcohol is a nontrivial energy source (7.1 calories per gram or slightly less than a gram of fat) that theoretically can contribute to a positive energy balance and long-term weight gain and obesity, evidence from prospective studies shows that if the energy from alcohol consumption is added to a diet high in protein, low in carbohydrates, the effect would not be as high a risk factor. Data from the first National Health and Nutrition Examination Survey (NHANES I, American Journal of Clinical Nutrition 42 1985)) found that even though alcohol consumers had significantly higher intakes of total calories than nondrinkers, drinkers were not more obese than nondrinkers. In fact, women drinkers had significantly lower body weight than nondrinkers. As alcohol intake among men increased, their body weight decreased. Data from the second National Health and Nutrition Examination Survey (NHANES II, American Journal of Clinical Nutrition 54 1991) and other large national studies have found similar results for women, although the relationship between drinking and body weight for men is inconclusive with heavy drinking possibly associated with abdominal obesity. Some studies have shown weight gain when alcohol is added to the diets of overweight persons.

A recent study published in Nutrition Reviews (Alcohol Consumption and Body Weight: A Systematic Review, July 26, 2011) reviewed thirty-one publications. The overall results did not confirm a positive association between alcohol consumption and weight gain. The authors concluded that light-to-moderate alcohol intake, especially wine intake, may be more likely to protect against weight gain, whereas consumption of spirits has been positively associated with weight gain.

When alcohol enters the body, it is detoxified quickly in the liver with top priority. A small amount is metabolized in the stomach, and the less than 10% that escapes metabolism is excreted through sweat, saliva, urine and breath. Alcohol and wine are processed differently than other dietary energy sources such as sugars and starch so their effect on weight cannot be strictly compared. It has been found that alcohol induces an increase in the sensitivity of muscle to insulin and down-regulates the effect of insulin on fat tissue so fat mass decreases. Alcohol does increase the production of triglycerides within the liver but it is not clear that this translates into weight gain when alcohol is consumed in moderation.

A low-calorie line of wines from Treasury Wine Estates, The Skinny Vine, has 95 calories per 5 ounce serving or about 25% to 35% less calories than traditional wine. The winery claims the wines have the taste and quality of full-calorie wines and carry names like Slim Chardonnay, Mini Moscato and Thin Zin ($11 a bottle). Promoted by Christine Avanti, author of Skinny Chicks Eat Real Food, these wines are offered at www.cellar360.com. A wine label called Skinnygirl was launched by Bethenny Frankel, a reality TV star and former Real Housewives cast member. The three wines offered, with an initial production of 200,000 cases, have 100 calories per 5 ounce serving, 12 percent alcohol and sell for $15 a bottle. Weight Watchers has partnered with McWilliams Wines to produce a line of lower-alcohol wines that are currently available in the UK.

I believe low-calorie wine is silly since women who pursue these wines are only saving about 25 calories each time they drink a glass which is no big deal, and for reasons described above, this savings does not translate into significant avoidance of weight gain. Women should not be consuming more than one glass of wine a day anyway. That said, women are frequently buying wine on visits to grocery stores and any product that promotes less calories or weight loss grabs their attention. Sensible portions and proper food choice is unquestionably important to health, but the low-calorie wine idea is an affront to women. This was pointed out by Mary Orlin, the WineFashionista on Huff Post Food, “Would anyone make a Skinnyboy wine?”

Further research is needed toward assessing the specific roles of different types of alcohol beverages in weight gain, especially concerning consumption patterns. In the meantime, it is mindless to wring our hands over moderate wine drinking since a glass or two a day appears to have little real effect on weight in those drinkers who are not already obese.