ORIGINAL ARTICLE Alcoholic beverage preference and diet in a representative Dutch population: the Dutch national food consumption survey 2007–2010 D Sluik, L van Lee, A Geelen and EJ Feskens BACKGROUND/OBJECTIVES: The habitual consumption of a specific type of alcoholic beverage may be related to the overall dietary pattern. The objective of this cross-sectional study was to investigate associations between alcoholic beverage preference and dietary intake in The Netherlands. SUBJECTS/METHODS: A total of 2100 men and women from the Dutch National Food Consumption Survey 2007–2010 were studied. A general questionnaire assessed alcoholic beverage preference and two non-consecutive 24-h dietary recalls assessed overall diet. Mean nutrient and food group intakes, and adherence to the 2006 Dutch dietary guidelines across categories of alcoholic beverage preference were compared and adjusted for age, sex, body mass index (BMI), education, smoking, physical activity, energy intake and frequency and absolute alcohol consumption. RESULTS: Largest differences in dietary habits were detected between persons who preferred wine and those who preferred beer. Persons with a beer preference had a higher absolute intake of meat, soft drinks, margarine and snacks. In contrast, persons with a wine preference had a higher absolute consumption of healthy foods. However, after multiple adjustments, wine consumers still consumed less energy and more vegetables and fruit juices compared with beer consumers. Adherence to the Dutch dietary guidelines did not differ between preference categories after multiple adjustments. CONCLUSIONS: In this cross-sectional analysis in a representative sample of the Dutch population, a beer preference was associated with less healthy dietary behaviour, especially compared with wine preference. However, these differences were largely explained by other socio-demographic and lifestyle factors. These results suggest that alcoholic beverage preference may not be independently related to diet. European Journal of Clinical Nutrition advance online publication, 8 January 2014; doi:10.1038/ejcn.2013.279 Keywords: alcohol consumption; alcoholic beverage preference; wine; beer; diet quality; Netherlands INTRODUCTION The association between alcohol consumption and overall mortality has been of continuing scientific interest during the last decades. It has been shown that heavy drinkers have a substantially increased risk of mortality and moderate drinkers a slightly reduced risk, resulting in the well-known J-shaped alcohol- mortality curve. 1,2 Some studies show that people in wine-drinking countries had a lower risk of mortality due to coronary heart disease compared with countries where beer or liquor were the most frequently consumed beverages. This has raised the hypothesis for possible differences between different types of alcoholic beverages and their association with mortality risk. 3 Indeed, wine consumption, but not beer or liquor consumption, was found to be prospectively related to lower mortality in 128 934 Northern Californian subjects. 4 However, a more recent meta-analysis found a similar J-shaped association for both wine and beer and cardiovascular risk. 1 The habitual consumption of a specific type of alcoholic beverage may be related to the overall dietary pattern, which may partly explain the difference in mortality risk. Several studies have shown that wine drinking is associated with a healthy diet. 5–8 Additionally, a Danish study showed that wine buyers made more purchases of healthy food items than people who routinely bought beer. 9 However, studies in Southern European populations have found no strong evidence for a healthier dietary pattern in wine drinkers as compared with consumption of other alcoholic beverages. 10,11 A recent systematic review and meta-analysis found limited scientific evidence that beer consumption is associated with the so-called ‘beer belly’. The authors suggested that the overall diet of the beer consumer may explain the common belief that beer intake is a major determinant of waist circumference. 12 In the Netherlands, the only report on national data on alcohol consumption dates from 1988, and found a strong positive relationship between alcohol consumption and smoking, but no indications that moderate alcohol users had a healthier lifestyle. 13 However, the type of alcoholic beverage was not specified. Therefore, the objective of this study was to investigate the associations between alcoholic beverage preference and diet in the most recent representative sample of the Dutch population, from 2007 to 2010. Based on previous studies, 5,8,14 we hypothesized that people with a beer preference had an overall less healthy diet compared with people with a preference for wine. Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands. Correspondence: Dr D Sluik, Division of Human Nutrition, Wageningen University, PO Box 8129, Wageningen 6700EV, The Netherlands. E-mail: Diewertje.Sluik@wur.nl Received 28 April 2013; revised 29 October 2013; accepted 25 November 2013 European Journal of Clinical Nutrition (2014), 1–8 & 2014 Macmillan Publishers Limited All rights reserved 0954-3007/14 www.nature.com/ejcn