Bellies from Beer?

When was the last time you saw your six-pack? If you have one right now, kudos to you, but many men struggle because they are carrying a keg around. A sexy ripped midsection is what motivates many of us to go to the gym. In reality, it is the response from our “would be” mates that really motivates.

What should probably motivate you more is how carrying weight around your mid-section actually correlates negatively with your long-term health. In fact, higher measurements of abdominal circumference correlates more with adverse health than comparing height to weight as in the body mass index (BMI). Increased belly fat and thus abdominal circumference is associated with metabolic lifestyle diseases such as type 2 diabetes and cardiovascular disease1,2,3. Why belly fat or the “beer belly” correlates so well to cardiovascular disease and diabetes isn’t well known but new research is giving us some insight.

Interestingly, fat distribution differs in men and women, but in both, a predominant thigh and buttock distribution is associated with lower metabolic risk than a belly fat distribution. This is where one might say the pear shape is better than the apple shape. The metabolic activity of these two types of fat visceral (abdominal) or subcutaneous (in the extremities) has been shown to be very different. Recent research from Boston University shows that the genes expressed by these types of fat are unique and ingrained from early development4. That is to say that these fat cells don’t become different in their functions because you drank too much beer.

But is the “beer belly” really a result from drinking too much beer? There is a widespread belief that alcoholic beverages, beer in particular, promote abdominal fat deposition. The scientific data for this is quite mixed, but some studies do show correlations between beer consumption and increased abdominal circumference5. In an analysis of multiple studies Bendsen and colleagues noted that most studies point toward a positive association between higher levels of beer intake and abdominal obesity in men6. They concluded that consuming more than 17oz of beer per day was definitely associated with the beer belly. However, at lower levels of consumption below 17oz they could not definitively make a correlation.

So why exactly might beer cause a beer belly? Well, it is obvious that beer contains calories. A 12oz beer has around 150 Calories. This includes about 12g of carbs and 12g of alcohol. When you drink more beer you are basically drinking empty calories. To make things worse energy consumed as liquids do not curb your appetite as well as energy consumed as a solid food7.

Furthermore, the alcohol in beer not only adds calories to the belly problem it makes your appetite worse. The alcohol content of beer somehow makes it less satiating than other sources of liquid energy. Alcohol is very inefficient at triggering satiety mechanisms involved in immediate control of food intake. Consuming alcohol with meals tends to increase food intake. Beer actually increases tendency to eat even at other times throughout the day. If you take more calories in than you burn, you will end up storing some extra fat.

Unfortunately, the fat storage problems with beer and alcohol consumption don’t end there. Alcohol has distinct effects on fat metabolism. Alcohol is metabolized mostly by alcohol dehydrogenase with a small fraction being metabolized by the microsomal ethanol-oxidizing system (MEOS). With higher consumption the MEOS becomes more involved and is less efficient, but this varies greatly from one individual to another. Regardless, alcohol intake decreases fat oxidation during the time the ingested alcohol is being metabolized and if alcohol is consumed in excess of energy needs, fat accumulation will result.

The next question might be, “Why does beer become belly fat?” This is less well understood, but may be explained by alcohol’s effects on the hypothalamic-pituitary-adrenal axis (HPA axis). Chronic alcohol intoxication has been shown to increase release of cortisol from the adrenal glands8. Cortisol mobilizes fat from the extremities and leads to deposition in the abdomen. Throw in the inhibition of fat oxidation from the alcohol and you have a set up to deposit more fat in the abdomen. Nonetheless, how much alcohol is required to boost cortisol levels isn’t known and probably differs from person to person. One might also wonder if the beer drinker has a more stressful life leading him to drink and eat more with greater elevations in daily cortisol. As stressful life with too many calories and too little exercise equals a fat belly.

As you might have already noticed, a lot of the data we have presented is related to the alcohol content of beer. Thus, other alcoholic beverages may lead to the “beer belly”. In fact studies from France, where wine drinking is more common than beer, suggest a significant correlation between wine consumption and abdominal obesity9. Per ounce, wine often has more than 2x the alcohol content and the calories that come with it. However, wine may have some advantages over beer in the form of the polyphenols it contains.

Science supports that alcohol, particularly wine, consumed in moderation may actually be beneficial to your health. Epidemiological data suggests that moderate alcohol intake is associated with a reduced risk of coronary heart disease and cardiovascular disease mortality10. Additionally, ~20g of alcohol per day correlates with a reduction in risk of diabetes which is a significant risk factor for coronary heart disease11. The reduction in insulin resistance of diabetes is also retained when the alcohol is taken out of red wine12. Other than alcohol and carbohydrates red wine is rich in polyphenols that appear to confer beneficial effects on insulin resistance and HDL cholesterol.

Laboratory studies have also brought attention to another potential health promoting mechanism of red wine polyphenols. The polyphenols caffeic acid, gallic acid, and particularly quercetin may boost testosterone levels, at least in the test tube13. An enzyme called UGT2B17 attaches a molecule to testosterone which allows it to be excreted by the kidneys. In the test tube, quercetin was particularly strong at preventing UGT2B17 from working on testosterone. It is theorized that this enzyme inhibition may lead to less testosterone from being excreted by the kidneys and thus higher levels in the blood. This is completely theoretical as this research is in its infancy.

Other phytochemicals in red wine have been shown to effect testosterone and estrogen levels. Red wine contains compounds like soflavone phytoestrogens, flavones, and procyanidin B dimers which all have aromatase inhibitory effects. Aromatase is an enzyme that converts androstenedione and testosterone to estrogen. Inhibition of aromatase can raise testosterone levels, decrease estrogen levels, and increase free testosterone by decreasing the levels of sex hormone binding globulin (SHBG). A study performed at UCLA and Cedars-Sinai Medical Center demonstrated that red wine exhibited more aromatase activity than white wine14. In a cohort of premenopausal women drinking 8oz of wine for one month, the researchers found that red wine increased testosterone and luteinizing hormone (hormone that stimulates androgen production) while lowering SHBG levels greater than white wine. Estrogen levels showed a trend toward being lower in the red wine drinkers, but this lacked statistical significance.

In summary, the beer belly is probably more of a function of over consumption of calories and alcohol with too little exercise to make up for the caloric surplus. Moderate alcohol consumption with a healthy diet and exercise can have significant benefits for your health and longevity. Control stress in your life in healthy ways like exercise, meditation, and massage, not through comfort foods and alcohol. Perform cardio and weight training to maximize your cardiovascular health by building fat burning muscle. If you want to burn off that beer belly, keep your drinking to one small glass per day and make fit lifestyle changes as presented in The G.A.I.N. Plan.

References:

1) Carey VJ, Walters EE, Colditz GA, et al. Body fat distribution and risk of noninsulin-dependent diabetes mellitus in women – the Nurses’ Health Study. Am J Epidemiol. 1997;145:614–619.

2) Rexrode KM, Carey VJ, Hennekens CH, et al. Abdominal adiposity and coronary heart disease in women. JAMA. 1998;280:1843–1848.

3) Ulijaszek SJ, et al. One reason why waist-to-height ratio is usually better related to chronic disease risk and outcome than body mass index. Int J Food Sci Nutr. 2013 May;64(3):269-73

4) Karastergiou K, et al. Distinct developmental signatures of human abdominal and gluteal subcutaneous adipose tissue depots.J Clin Endocrinol Metab. 2013 Jan;98(1):362-71

5) Schütze M, Schulz M, Steffen A, et al. Beer consumption and the “beer belly”: scientific basis or common belief? Eur J Clin Nutr. 2009;63:1143–1149.

6) Bendsen NT, et al. Is beer consumption related to measures of abdominal and general obesity? A systematic review and meta-analysis. Nutrition Reviews Dec 2012; 71:67-87

7) Leidy HJ, Apolzan JW, Mattes RD, et al. Food form and portion size affect postprandial appetite sensations and hormonal responses in healthy, nonobese, older adults. Obesity 2010;18:293–299.

8) Adinoff B, et al. Increased salivary cortisol concentrations during chronic alcohol intoxication in a naturalistic clinical sample of men. Alcohol Clin Exp Res. 2003;27:1420–1427.

9) Dallongeville J, et al. Influence of alcohol consumption and various beverages on waist girth and waist-to-hip ratio in a sample of French men and women. Int J Obes. 1998;22:1178–1183.

10) Ronksley PE, et al. Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis. BMJ. 2011 Feb 22;342:d671

11) Baliunas DO, et al. Alcohol as a risk factor for type 2 diabetes: A systematic review and meta-analysis. Diabetes Care. 2009 Nov;32(11):2123-32

12) Chiva-Blanch G, et al. Effects of red wine polyphenols and alcohol on glucose metabolism and the lipid profile: A randomized clinical trial. Clin Nutr. 2013 Apr;32(2):200-6

13) Jenkinson C, et al. Red wine and component flavonoids inhibit UGT2B17 in vitro. Nutr J 2012 Sep 7;11:67

14) Shufelt C, et al. Red versus white wine as a nutritional aromatase inhibitor in premenopausal women: a pilot study. J Womens Health (Larchmt). 2012 Mar;21(3):281-4

#beerbelly #alcohol #wine #polyphenols

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