People who drink more are also likely to eat less fruit and consume more calories from a combination of alcoholic beverages and foods high in unhealthy fats and added sugars.

Heavy drinking and dietary factors have independently been associated with cardiovascular disease, certain cancers, and other chronic health problems. To examine the relationship between alcoholic beverage consumption, nutrient intakes, and diet quality, researchers analysed data on 8,155 men and 7,715 women in USA, aged = 20 years who reported their past-year alcoholic beverage consumption and 24-hour dietary intake. Alcoholic beverage consumption was defined by drinking status (never, former, current drinker) and, among current drinkers, by drinking level (number of drinks per day, on average: men <1 to =5; women <1 to =3).

Among men, there was no association between drinking status and dietary intake of energy as well as most nutrients. Among women, former and current (compared to never) drinkers had significantly higher intakes of energy and several nutrients, and current drinkers had significantly lower total healthy eating index scores (current drinkers 59; never drinkers 63). Among current drinkers of both genders, as drinking level increased, intakes of energy and several nutrients significantly increased, whereas total healthy eating index scores significantly decreased (from 56 to 41 in men, and from 60 to 52 in women).

Higher alcohol consumption was associated with poor diet quality, but these findings raise questions about whether the combination of alcohol misuse and poor diet might interact to further increase health risks. This could be explained by the higher energy intake from alcohol as well as other differences in food choices.