01 July 2021

Wine and weight management – is it possible?


Adult overweight and obesity prevalence are increasing worldwide. Understanding the associations and mechanism between types of alcoholic drinks and adiposity has public health relevance.

Wine is a fermented drink that contains calories, coming mainly from ethanol and partly from the residual sugar, unless it is a sweet wine. One glass of wine of 100 mL has approximately 80 calories, called empty calories, which means that they do not supply other nutrients, besides energy. These ethanol calories are the main reason why in a hypocaloric diet to lose weight, wine is eliminated from the diet.

Considering alcoholic beverages in general, there are some discrepancies with the results. It is currently unclear, whether the consumption of alcoholic beverages is a risk factor for weight gain because studies performed to date have found positive, negative, or no associations. At the same time, the scientific evidence shows that light-to-moderate wine intake may be more likely to protect against weight gain, or abdominal adiposity (waist circumference). Because wine does not only contain ethanol, but it is also rich in polyphenols. Wine is one of the main sources of polyphenols in Mediterranean diet. 100 ml of wine may supply 200 mg pf polyphenols. Polyphenol intake has been correlated with a decrease in body weight and waist circumference. A higher intake of foods rich in flavanols, flavan-3-ols, anthocyanins, and flavonoid polymers that are present in red wine seems to contribute to weight maintenance in adulthood.

1. Introduction

Overweight and obesity are major health problems in developed countries and are strongly related to risk factors of many chronic diseases such diabetes, cardiovascular diseases, some cancers and other health problems [1]. The World Health Organization (WHO) states that worldwide, obesity has nearly tripled since 1975. In 2016, more than 1.9 billion adults, 18 years and older were overweight and of these, over 650 million were obese. This translates into 39% of adults being overweight and 13% obese [1].
Obesity is a complex disorder and results from the interaction of various factors, including genetic and environmental factors. Dietary habits play a crucial role in its development [2]. Obesity develops when energy intake continuously exceeds energy expenditure causing a fundamental chronic energy imbalance. When energy intake exceeds expenditure, the excess energy is deposited as fat tissue [3].
Based on the fact that 1 gram of alcohol provides 7.1 kcal (29kJ) and studies showing that the energy consumed as alcohol is additive to that from other foods [4], increased energy intake with drinking alcoholic beverages can certainly promote a positive energy balance and ultimately weight gain.
Epidemiological investigations of the association between the intake of alcoholic beverages and body weight have produced inconsistent and conflicting evidence [5].

Alcohol is a complex and unique component of the human diet and there are various reasons why the consumption of alcoholic beverages may potentially contribute to obesity:

  • It provides 7.1 kcal per gram and comes just after fat as a potential source of energy; It is an energy-dense, yet nutritionally poor food source.
  • The total energy content can vary considerably depending on the type of alcoholic beverage [6].
  • It does not have a satiating effect.
  • It cannot be stored by the body, so it has priority for oxidation
  • Alcohol seems to have short-term stimulatory effects on appetite and food intake, which can result in progressive weight gain [4].

These arguments seem to be plausible because alcohol cannot be stored by the body, which means it has priority for oxidation compared to fat and carbohydrates, allowing a greater storage of triglycerides from dietary fat and carbohydrates, and is often consumed in addition to normal meals resulting in excess calorie intake [7].

However, epidemiological data suggest that there is not a clear cause-and-effect association between the intake of alcoholic beverages and weight gain based on the mixed and conflicting evidence on this topic [6].

2. What does the scientific evidence say? Alcoholic beverages and risk of overweight/obesity

The available epidemiological studies assessing the intake of alcoholic beverages and weight gain have provided conflicting and contradictory results, showing

  • positive associations [7-9], where alcoholic beverages were related to weight gain/obesity,
  • negative associations [10, 11] with a lower risk of obesity/weight gain among moderate drinkers or
  • no association [12].

Only a few of prospective studies have assessed the role of specific alcoholic beverages on weight gain [5, 13].

However, since the positive associations between alcoholic beverages and weight gain were mainly found in studies with data on higher levels of drinking, it is possible that an effect on weight gain or abdominal adiposity may only be experienced by heavy drinkers or binge drinkers [8, 9]. While some studies found different results depending on sex, others found that both male and female heavy drinkers showed the biggest weight gain [9, 14], the highest waist circumference [15] or had the highest rates of obesity.
In contrast, moderate consumption was either negatively associated [7, 10] or not associated with body weight and adiposity [5, 16].
Thus, looking at the recent evidence, it appears that a light-to-moderate intake of alcoholic beverages is less likely to be a risk factor for obesity than heavy drinking. Heavy drinking and binge drinking have been more consistently linked with adiposity [6].

Factors that may explain the conflicting findings

The conflicting evidence regarding the role of alcoholic beverages in promoting obesity is a product of many factors: gender, type, frequency, and amount of alcoholic beverage consumed, drinking pattern (i.e. binge drinking), diet, physical activity level, chronic illnesses, predisposition to gain weight, etc. [6]. Not considering these potential confounding factors can lead to wrong conclusions.

  • Gender: the association between the intake of alcoholic beverages and body weight is stronger in men than in women because of the amount and type of alcohol consumed. Men usually consume more than women and are more likely to drink beer which provides more energy than wine per standard drink [4].
  • Physical activity: many studies do not consider lifestyle factors such as physical activity and sedentary behaviour –> Exercise may counter increased energy intake through consumption of alcoholic beverages [9, 17]
  • Dietary pattern: beer and spirit drinkers appear to have poorer diets and lifestyle habits in general than wine drinkers [6, 18, 19]. For example, there seems to be a higher physical activity level and a smaller percentage of smokers among wine drinkers.
  • Definition of adiposity: The different definitions/measures of adiposity may be another explanation for the different study results. Some used body weight, others the Body Mass Index (BMI) and others waist circumference [7, 9].
  • Drinking pattern: It also may be related to the drinking pattern and drinking frequency [20, 21].
  • Type of alcoholic beverage: Another possible explanation for the observed conflicting results may be that the different types of alcoholic drinks can have different effects on body weight [4, 6, 22] .

Considering these multiple confounding factors, it seems difficult to truly assess the independent influence of alcoholic beverages intake on obesity risk.

Obesity is a multi-factorial condition, which is defined by an excess of fat tissue, that occurs through an increase in the number and size of fat cells (adipocytes) [23]. The fat tissue is an endocrine organ, which secretes a variety of inflammatory adipocytokines leading to chronic inflammation, insulin resistance and several obesity-related disorders.

The intake of foods rich in bioactive compounds such as polyphenols has been described to decrease low-degree inflammation [23]. Wine is one of the main sources of polyphenols in Mediterranean diet. One glass of wine (100 ml) can supply 200 mg of polyphenols.

Moderate wine consumption and weight management – a paradox?

Thus, is wine different? When some studies analysed each type of alcoholic beverage separately, specifically for wine drinkers, only negative associations with weight gain or abdominal adiposity were found.
Based on the current scientific evidence, it seems that light-to-moderate intake of alcoholic beverages, in particular wine, may be more likely to protect against, rather than promote weight gain [22]. The precise effect of wine/alcohol on body weight remains to be determined and several mechanisms have been suggested.

The type of alcoholic beverage might play an important role in modifying the effect of alcohol consumption on weight gain. It is known for example, that obesity is associated with a high-grade inflammation. In this context, the polyphenolic components of (red) wine may attenuate the effect of alcohol on obesity when the alcoholic beverage is wine [22].

When evaluating whether the type of alcoholic beverage had an influence on weight gain and overweight/obesity risk, a Mediterranean population was followed up for 6 years. No association between wine consumption and the risk of developing overweight/obesity was observed. In contrast, drinkers of beer and spirits (≥ 7 drinks/week) had a higher risk to develop overweight/obesity compared to non-drinkers [24].

Similar results were observed in other long-term prospective studies outside the Mediterranean region, where light to moderate wine drinkers appeared to have a lower obesity risk [5, 25]:

A large study in the UK examined the relationship between the overall intake of alcoholic beverages and the types of alcoholic drinks with obesity/adiposity. The results showed that drinkers of red wine, champagne/white wine and fortified wine had a lower BMI compared to never drinkers, whereas beer and spirits drinkers had a higher BMI compared to never drinkers.
It was also observed that moderate drinkers of all alcoholic beverages within the guidelines had a lower BMI than never drinkers or previous drinkers [5].

A Danish study investigated for the first time the long-term consequences of adolescent consumption of alcoholic beverages and subsequent adult weight gain into midlife. During a follow-up of up to 22 years, among non-smoking adolescents, particularly wine consumption seemed to be related to less weight gain until midlife. They concluded: whether these observations may be associated with a specific lifestyle, including a healthy dietary pattern and activity habits associated with wine drinking during adolescence or with functional properties in wine cannot be concluded from the present study.

Is wine different – How can it be explained? Possible mechanisms

A healthier eating pattern and a more active lifestyle may be an explanation of the positive results observed among wine consumers. However, is there a plausible biological explanation for wine drinkers to have a lower risk of overweight/obesity than consumers of other alcoholic beverages? Several hypotheses have been proposed to explain the possible inverse association between wine consumption and body weight.


Wine is different from other alcoholic beverages because it contains – besides ethanol – bioactive compounds: polyphenols.

The health effects of such polyphenols depend on the amount consumed and their bioavailability and here, the gut microbiota might be the most crucial factor for the absorption and metabolism of such dietary polyphenols.
The individual gut microbiota is very much affected by the dietary pattern. Diets richer in plant-based rather than animal-based foods represent healthier choices to prevent disease, most likely also due to the different intestinal microbes of the host [26]. A Mediterranean dietary pattern, including moderate wine consumption, contains a large portion of plant-based foods and these foods are rich in polyphenols, which are implicated in preventing chronic diseases such as obesity [27, 28]. PolyphenolsPolyphenols are mainly phytochemicals found abundantly in natural plant food sources. The most impor... may act as prebiotic substrate for microbiota, they are broken down by the microbiota to stimulate a healthy bacterial growth.

The red wine polyphenols – among them flavonoids (anthocyanins proanthocyanins, catechins or flavan-3-ols), nonflavonoids such as resveratrol, gallic acid, – promote the beneficial gut bacteria [29, 30].

Once ingested, relatively small amounts of the wine polyphenols are absorbed in the small intestine (5%–10%), with the rest reaching the colon, where they are metabolized by the host’s microbiota in such a way that they can be used/absorbed by the body [31] (Figure 1).

Figure 1 [32]
Figure 1 [32]

However, inter-individual differences in the gut microbiota play an important role in bioavailability of polyphenols and their gut microbiota metabolites [33] and can be affected by antibiotic medication and changes in food intake [29, 31].

Many studies have indicated that an imbalance of unhealthy and healthy microbes in the intestine is closely linked to overweight/obesity and related metabolic disorders [34, 35].
Red wine polyphenols seem to increase beneficial bacteria [36, 37] while inhibiting potentially pathogenic bacterial populations [37].

Thus, the gut microbiota appears to be involved in the protective effects of dietary polyphenols against overweight/obesity and obesity-related inflammation processes in the body. It plays an important role in the host’s metabolism, energy extraction, fat deposition, inflammatory status and satiety. Specific polyphenols such as flavonoids present in wine, have been reported to decrease fat absorption and to play a role as anti-obesity agents [38].

Wine polyphenols as magic bullets?

Wine is one of the main sources of polyphenols in Mediterranean diet. A glass of wine (100 ml) may supply 200 mg of polyphenols. Polyphenol intake has been correlated with a decrease in body weight and waist circumference [39].

A large intake of foods rich in flavan-3-ols, anthocyanins, flavanols and flavonoid polymers that are present in red wine seems to contribute to weight maintenance in adulthood. Studies conducted in the Mediterranean area demonstrated that a higher dietary intake of flavonoids is inversely associated with an excess of weight and obesity [40].

Evidence from in-vitro and experimental studies suggested the potential effects of polyphenols on obesity, obesity-related inflammation, and other metabolic disorders.
These studies showed a significant reduction of body weight based on a number of mechanisms that

  • reduce food intake/absorption and induce satiety [41],
  • promote energy expenditure by increasing the body’s metabolic rate and increasing ß-oxidation of fats,
  • prevent energy storage [38] by lowering the fat synthesis and improving insulin sensitivity [42].
  • Also in recent years, the concept of obesity as an “epigenetic disease” is being discussed. This means that nutrition/foods can affect the expression of a number of genes by turning them “off” or “on”. Thus, more information on these “epigenetically active compounds” – nutrients that can cause adverse as well as positive health effects – is needed, among them phytochemicals/polyphenols present in plant foods and beverages such as wine [38].

FlavonoidsFlavonoids represent a structurally diverse group of polyphenolic bioactive compounds found in many ...

Particularly flavonoids are implicated in being able to alter epigenetic cellular mechanisms [43], for example inducing/”turning on” an enzyme activity (aromatase) in the body’s fat tissues, which in turn leads to a decreased size of fat cells (adipocyte size) and thus, body weight [44].


There is no doubt that wine has calories, mainly due to ethanol, one glass of wine of 100 mL has approximately 80 kcal and this is the main reason why in a hypocaloric diet to lose weight, wine is eliminated from the diet. However, epidemiological data and randomized clinical trials do not observe an association between drinking wine in moderation and weight gain, this effect seems to be due to the polyphenols.

Thus, a higher intake of foods rich in polyphenols such the ones that are present in a Mediterranean type of dietary pattern and in red wine, seems to contribute to weight maintenance. 


Overweight and obesity share the characteristics of abnormal or excessive fat accumulation in the body due to long-term intake of high-energy foods and low energy expenditure. The number of overweight people in 2016 exceeded >1.9 billion, accounting for 38.9% of the global adult population, among overweight adults, the obese proportion was 13.1% which translates into approximately 650 million obese individuals. This number has tripled since 1975 [1].

For adults, WHO defines overweight, and obesity as follows:

  • overweight is a BMI greater than or equal to 25
  • obesity is a BMI greater than or equal to 30.

Most common measurements of

General obesity:
Body weight
Body fat percentage


Central obesity:
Body Mass Index (BMI)
Waist circumference (WC)
Waist to height
Waist to hip ratio



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