Do eating habits differ according to alcohol consumption? Results of a study of the French cohort of the European Prospective Investigation into Cancer and Nutrition (E3N-EPIC)

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Abstract
Background: The potential of dietary habits to confound the association between alcohol consumption and health needs further study. Objective: We examined whether eating habits differed according to alcohol consumption in a large cohort of French women. Design: This was a cross-sectional study of the French cohort of the European Prospective Investigation into Cancer and Nutrition (E3N-EPIC). The cohort was established in 1990 and includes 100000 women born between 1925 and 1950. Dietary data were obtained between 1993 and 1995 by using self-administered food-frequency questionnaires. About 73000 questionnaires were analyzed, and women were placed into 7 categories of alcohol consumption. Results: After adjustment for energy derived from alcohol, increasing alcohol consumption was associated with a higher total energy intake, a higher percentage of energy intake as protein and lipids, and higher intakes of cholesterol, fatty acids, retinol, iron, and vitamin E. Conversely, energy provided by carbohydrates decreased with increasing alcohol consumption, as did β-carotene intake. Increasing alcohol consumption was associated with higher consumption of animal products, cheese, potatoes, oil, bread, and breakfast cereals and with lower consumption of vegetables and dairy products. Conclusion: In this population of middle-aged, highly educated French women, marked differences in dietary patterns and nutrient intakes were found according to alcohol consumption. Part of the detrimental effect of alcohol on health may be due to the less healthy dietary habits of drinkers. This points to a confounding role of eating habits and nutrient intakes in the relation between alcohol and health.