Alcohol could contribute to obesity. The authors examined the relation between drinking patterns and body mass index (BMI) (weight (kg)/height (m)(2)) by pooling cross-sectional data from the 1997-2001 National Health Interview Surveys. Weighted analyses included 45,896 adult never smokers who were current alcohol drinkers. Height and weight were self-reported. In adjusted analyses, alcohol quantity and frequency had opposite associations with BMI. As quantity increased from 1 drink/drinking day to > or =4 drinks/drinking day, BMI significantly increased; in men, it increased from 26.5 (95% confidence interval (CI): 26.3, 26.6) to 27.5 (95% CI: 27.4, 27.7), and in women, it increased from 25.1 (95% CI: 25.0, 25.2) to 25.9 (95% CI: 25.5, 26.3). As frequency increased from low quintiles of drinking days/year to high quintiles, BMI significantly decreased; in men, it decreased from 27.4 (95% CI: 27.2, 27.6) to 26.3 (95% CI: 26.2, 26.5), and in women, it decreased from 26.2 (95% CI: 26.0, 26.5) to 24.3 (95% CI: 24.2, 24.5). In stratified analyses of frequency trends within quantity categories, BMI declines were more pronounced in women than in men, but all linear trends were inverse and significant (p trend < 0.001). In all respondents combined, persons who consumed the smallest quantity the most frequently were leanest, and those who consumed the greatest quantity the least frequently were heaviest. Alcohol may contribute to excess body weight among certain drinkers.

Estimated rates of detection, inpatient intervention, and treatment referral of alcohol use disorders in hospital admissions were low. Current-drinking hospital admissions should be screened for alcohol problems as part of the admission routine, with further professional evaluation, intervention, and treatment referral as indicated.

Associations between alcohol drinking and cardiovascular disease mortality could be confounded by diet if alcohol drinking and diet are related. Depending on the alcohol measure, alcohol-diet relations may or may not be observed. The authors examined associations between alcohol and diet quality (Healthy Eating Index (HEI) scores) using cross-sectional, nationally representative data from the 1999-2000 National Health and Nutrition Examination Survey. Weighted analyses included 3,729 participants aged > or =20 years. In adjusted analyses among current alcohol drinkers, as quantity increased from 1 to > or =3 drinks/drinking day, the mean HEI score decreased from 65.3 (95% confidence interval (CI): 63.4, 67.1) to 61.9 (95% CI: 60.5, 63.2). As frequency increased from the lowest quartile to the highest, the mean HEI score increased from 60.9 (95% CI: 58.7, 63.2) to 64.9 (95% CI: 63.4, 66.4). As average volume ((quantity x frequency)/365.25) increased from <1 drink/day to > or =3 drinks/day, the mean HEI score increased from 62.9 (95% CI: 61.2, 64.5) to 65.2 (95% CI: 62.7, 67.8). In stratified analyses, the lowest HEI score, 58.5 (95% CI: 55.5, 61.5), occurred among drinkers who consumed the highest quantity at the lowest frequency. Average volume of alcohol consumed is driven by and masks the contributions of its components. These results suggest the importance of measuring drinking patterns (quantity, frequency, and stratified combinations) in epidemiologic alcohol-diet studies.

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The prevalence of alcohol abuse or dependence in current-drinking admissions was substantial, suggesting that hospitalization offers a unique opportunity to identify alcohol use disorders. Further research is needed to determine factors that may be associated with significant pairwise results, especially for race or ethnicity. We recommend alcohol screening of all hospitalized drinkers, followed, as appropriate, by diagnostic evaluation and referral or intervention.

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This study estimated the prevalence and explored the management of illicit drug use, illicit drug use associated with alcohol use disorder (AUD), and AUD without reported illicit drug use in a national sample of 2040 admissions to general hospitals in the United States. Surveyed in 1994, admissions were diagnosed with past 12-month DSM-IV AUD according to the Alcohol Use Disorders and Associated Disabilities Interview Schedule. Information about drug use was also included in the interview. Entries in hospital records were used to operationalize management. Prevalence of chronic drug use in hospital admissions was 5%, 14% in 18-44-year-old admissions, and 31% in admissions with an AUD. In admissions with an AUD, 45% reported no drug use. Detection rates were 82% for admissions with comorbid AUD and chronic drug use (where detection of either problem was assessed); detection rates hovered around 50% in admissions with one or the other condition. Low rates of treatment and referral (33% and 42%, respectively) were observed in the comorbid group; rates were 13-17% in admissions with AUD alone or illicit drug use alone. Findings indicate the need for increased attention to drug use and to AUD with and without other drug use among general hospital admissions.