METHODS: Alcohol consumed per day by Hawaii residents was estimated using the 2014 Hawaii Behavioral Risk Factor Surveillance System. Frequency and quantity of alcoholic drinks consumed was used to parse drinking behavior into heavy drinking (men having greater than 2 drinks per day and women having greater than 1 drink per day) and binge drinking (men having five or more drinks on one occasion and women having four or more drinks on one occasion in the past 30 days) categories. Height and weight data were used to calculate Body Mass Index and parse residents into weight categories (underweight, normal, overweight, and obese). Age was categorized into 10-year age groups. Logistic regression using SAS callable SUDAAN (SAS 9.4, Cary, NC) was used to derive age-adjusted prevalence ratios (aPR) to evaluate the associations between weight status and drinking behaviors.
RESULTS: Half (51.0%) of Hawaii adults report consuming alcohol, and drink 3.3 drinks per week on average; as a result, depending on the drink consumed, alcohol contributes an additional 250-1,600 calories per week on average to half of Hawaii’s adult population. Nearly one in five adults (19.7%) meet criteria for binge drinking and 7.9% meet criteria for heavy drinking. Adults who are overweight or obese are equally likely to report drinking alcohol as those who are underweight or normal weight status (53.2% vs. 49.5%); rates of heavy drinking are comparable by weight status (7.7% vs. 8.8%). However, overweight or obese adults are more likely to report binge drinking than adults with normal or underweight status (22.7% vs. 16.9%). After adjusting for age, heavy drinking was not (aPR = 0.93, 95% CI: 0.83-1.03) whereas binge drinking was found to be positively associated with overweight/obese status (aPR = 1.16, 95% CI: 1.09-1.25).
CONCLUSIONS: Alcohol contributes significantly to overall caloric consumption, but is inconsistently assessed as a risk factor for obesity. Overweight and obese individuals regularly consume similar amounts of alcohol and are equally likely to be heavy drinkers, but are more likely to binge drink than normal weight and underweight individuals. Weight counseling should include recommendations to cut down on alcohol consumption.