Purpose: This is a secondary data analysis carried out to determine the association between alcohol use and obesity (BMI) in US adults aged 20 to 79 while adjusting for confounding factors that are known to affect obesity. Methods: The 2017-2018 National Health and Nutrition Examination Survey (NHANES) was utilized to provide a weighted sample of 16,548 adults between the ages of 20 and 79 with valid information for the BMI and for the average alcohol consumed per day over the past 12 months. Multivariable regression was done to determine the association between obesity, measured by the Body Mass Index (BMI) in kg/m2, and the average number of alcohol drinks taken by respondents in a day during the past year, while controlling for known demographic and socio-economic factors. These factors include age, sex, marital status, race, job, diet, number of people in household, physical activity, depression symptoms, smoking, health status, annual household income, education, sleep, sedentary activity, diabetes, number of meals from fast food and ratio of family income to poverty. Results: The average BMI was higher in those who take heavy amounts of alcohol (5+ drinks) compared to those who take light (1 - 2 drinks) and moderate (3 - 4 drinks) amounts. The overall multivariable regression model showed that BMI was directly associated with the number of alcohol drinks consumed in a day (β = 0.160 kg/m2; p < 0.001) after controlling for known confounding factors. Higher average BMI was seen in respondents who were less than 35 years, engage in vigorous activity, have diabetes and depressive symptoms, have less than $75,000 annual household income and spend more time on sedentary activities while lower BMI was seen in males, those who were less than 3 in their households, people that maintain healthy diet, smokers, people with education not greater than high school, those with jobs and people who have good health and greater hours of sleep every day. Conclusion: The direct association found in this study between obesity measured by BMI and the number of alcohol drinks consumed is similar to findings in existing literature. Alcohol quantity is definitely a significant contributor to the prevalence of obesity.
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