Relationships between consumption of alcoholic beverages and healthy foods: the French supermarket cohort of 196,000 subjects.
OBJECTIVE
Moderate alcohol consumption is associated with reduced risk of cardiovascular disease. Related dietary habits and lifestyle may bias assessment of the relationship between alcohol intake and health status. We examined the relationship between key features relating to the consumption of alcoholic beverages and individual profiles of objective food purchases.


RESULTS
Data were collected on regular clients of a large supermarket chain implanted across France (n = 196,604). Food items purchased were classified into three categories: (1) healthy foods; (2) unhealthy foods; and (3) others. Wine consumers favoured purchase of healthy foods more often than others, whereas the lowest level of healthy food purchasers was associated with consumption of beer and aniseed-based beverages. Bordeaux wine purchasers spent less in their average budget than the whole population for nine out of the 11 unhealthy food categories. Conversely, the budget was markedly higher in non-alcohol purchasers as compared to the whole population for seven out of the 11 unhealthy foods. The ratio of the budget for healthy to that for unhealthy foods was also distinct between the groups, being highest for wine and lowest for beer. In the subgroup of non-alcohol consumers, this ratio was intermediate but significantly lower relative to values in the five subcategories of wine purchasers.


CONCLUSIONS
Marked differences in the profile of the purchase of healthy versus unhealthy food products as a function of the subcategory of alcoholic beverage consumed were documented, revealing a critical unidentified confounding feature in analyses of the potential relationship between alcohol consumption and protection against cardiovascular disease.
Hôpital Bichat, Paris, France INSERM, Paris, France Institute of Cardiometabolism and Nutrition, Paris, France Université Paris-Diderot, Paris, France boris.hansel@bch.aphp.fr.
Boris
B
Hansel
Hôpital Bichat, Paris, France INSERM, Paris, France Université Paris-Diderot, Paris, France.
Ronan
R
Roussel
Dunnhumby, Bordeaux, France.
Vincent
V
Diguet
Dunnhumby, Bordeaux, France.
Amandine
A
Deplaude
INSERM, Paris, France Institute of Cardiometabolism and Nutrition, Paris, France.
M John
MJ
Chapman
Institute of Cardiometabolism and Nutrition, Paris, France Hôpital de la Pitié, Paris, France.
Eric
E
Bruckert
D000428:Alcohol Drinking / Q000453:epidemiology*; D015331:Cohort Studies; D003258:Consumer Behavior / Q000706:statistics & numerical data*; D003327:Coronary Disease / Q000453:epidemiology; D005247:Feeding Behavior; D005518:Food Preferences; D058870:Food, Organic / Q000706:statistics & numerical data*; D005602:France / Q000453:epidemiology; D015438:Health Behavior; D006801:Humans; D009747:Nutritional Physiological Phenomena
Alcohol; French paradox; cardiovascular disease; cardiovascular risk; healthy foods; nutrition; supermarket; wine