Alcohol consumption and dietary quality among adults with clinical and preclinical obesity attending a specialized obesity clinic in Portugal: a cross-sectional study

The Lancet Commission recently proposed diagnostic criteria distinguishing clinical from preclinical obesity according to the presence of obesity-related organ dysfunction and/or limitations in activities of daily living. Evidence on alcohol consumption and dietary quality across these newly proposed obesity phenotypes remains limited. We aimed to compare alcohol consumption and dietary quality between adults with clinical and preclinical obesity and to explore associations between alcohol intake and body composition. Dietary intake was assessed using a validated food frequency questionnaire, and dietary quality was evaluated using the Healthy Eating Index (HEI). Alcohol consumption was additionally assessed with the Alcohol Use Disorders Identification Test (AUDIT). Among 135 adults attending an obesity clinic, 64.4% had clinical obesity and almost half reported alcohol consumption; among consumers, 18.5% exceeded recommended intake levels. Alcohol intake was higher in individuals with clinical than preclinical obesity in unadjusted analyses (median 11.1 vs. 1.9 g/day; p = 0.004), but the association was not significant after adjustment for age, sex, and BMI (adjusted OR = 0.990; 95% CI: 0.969–1.011; p = 0.345). Similarly, alcohol intake was positively correlated with waist-to-hip ratio (Spearman’s ρ = 0.450; p < 0.001) and body fat percentage (ρ = 0.410; p < 0.001) in unadjusted analyses. However, these associations were not significant after adjustment for age, sex, and BMI (waist-to-hip ratio: standardized β = 0.116, p = 0.154; body fat percentage: standardized β = −0.013, p = 0.833). Dietary quality did not differ significantly between obesity phenotypes. Overall, differences in alcohol consumption and dietary quality between clinical and preclinical obesity were not evident after accounting for demographic and anthropometric characteristics, underscoring the importance of these factors when examining lifestyle characteristics across the newly proposed obesity phenotypes.