The nature and strength of the relationship between expenditure on alcohol and food: an analysis of adult-only households in the UK.

INTRODUCTION AND AIMS: Unhealthy lifestyle behaviours can cluster to produce more detrimental overall health consequences than expected with a simple additive effect. This study aims to expand current knowledge of the nature and strength of the relationship between two such health behaviours, alcohol and diet, through analysis of household expenditure on food and drink from a nationally representative UK sample.

DESIGN AND METHODS: Data from the Expenditure and Food Survey for 2005-2006 was used to analyse expenditure on alcohol and diet for 3146 UK households. The classification of a food as healthy or unhealthy was determined using dietary advice provided by the Food Standards Agency. Alcohol expenditure was disaggregated into spending in pubs, bars, clubs and restaurants (on-trade expenditure) and spending in off-licenses and supermarkets (off-trade expenditure). Analyses were stratified according to household disposable income quintile and household beverage preference.

RESULTS: As household expenditure on alcohol increases, spending on both healthy and unhealthy food decreases. Higher income households spend proportionately more on on-trade alcohol and healthy food than lower income households, and less on unhealthy food. Off-trade alcohol expenditure does not differ significantly according to household income. Households that prefer to purchase wine have healthier expenditure patterns than those that prefer to buy beer or spirits, even after controlling for income.

DISCUSSION AND CONCLUSIONS: Low-income households and those that purchase more beer or spirits than wine could be targeted for health promotion interventions to reduce their risk of negative health outcomes from the clustering of alcohol consumption and unhealthy diet.