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Alcohol Independently Reduces Diabetes Risk

Comments Off on Alcohol Independently Reduces Diabetes Risk 05 May 2010

Megan Brooks | From Medscape Medical News

May 3, 2010 — The inverse association noted in several studies between moderate alcohol consumption and type 2 diabetes is not explained by moderate drinkers’ generally healthier lifestyles, a new study suggests.

In a group of adults already at lower risk for type 2 diabetes on the basis of multiple healthy indices and behaviors and moderate alcohol drinking (up to 1 drink a day for women and up to 2 drinks daily for men) vs abstention correlated with approximately a 40% lower risk for incident type 2 diabetes.

Dr. Michel M. Joosten, of Wageningen University in Wageningen, the Netherlands, and TNO Quality of Life in Zeist, and colleagues report their findings in an article published online April 21 ahead of print in the American Journal of Clinical Nutrition.

They prospectively studied 35,625 adult participants, aged 20 to 70 years, in the Dutch European Prospective Investigation into Cancer and Nutrition. Subjects were free of diabetes, cardiovascular disease, and cancer when they entered the study between 1993 and 1997.

In addition to moderate alcohol consumption (women: 5.0 – 14.9 g/day; men: 5.0 – 29.9 g/day), the researchers defined 4 other low-risk lifestyle categories: optimal weight (body mass index, < 25 kg/m2), physically active (≥ 30 minutes/day), current nonsmoker, and a healthy diet (upper 2 quintiles of the Dietary Approaches to Stop Hypertension diet).

During median of 10.3 years of follow-up, the researchers verified 796 incident cases of type 2 diabetes: 618 in women and 178 in men.

Overall, 47.1% of study subjects had optimal weight, 62.3% were physically active, 69.3% were nonsmokers, and 38.5% had a high-quality diet.

Compared with teetotalers, and after multivariate adjustment, the hazard ratios of moderate alcohol drinkers in the low-risk lifestyle strata were 0.35 (95% confidence interval [CI], 0.17 – 0.72) when at an optimal weight; 0.65 (95% CI, 0.46 – 0.91) when being physically active; 0.54 (95% CI, 0.41 – 0.71) when being a nonsmoker; and 0.57 (95% CI, 0.39 – 0.84) when consuming a healthy diet.

When 3 or more low-risk lifestyle behaviors were present, the adjusted hazard ratio for type 2 diabetes with moderate alcohol consumption was 0.56 (95% CI, 0.32 – 1.00).

The association between moderate alcohol intake and type 2 diabetes tended to be stronger in women vs men, the investigators note. However, men made up only approximately one fourth of the cohort. Therefore, there were fewer incident cases of type 2 diabetes in men, “which may explain the weaker association between alcohol intake and type 2 diabetes in men,” Dr. Joosten and colleagues wrote.

Some of the limitations of the study noted by the authors include use of a food-frequency questionnaire for nutritional assessment including alcohol intake, inability to determine drinking pattern (regular vs episodic/binge) and drinking beverage (beer, wine, spirits), use of baseline-only measurements to characterize individuals (not changes in behaviors over the years), and the possibility of residual confounding.

These findings, they conclude, support the presence of an inverse link between moderate alcohol intake and incident type 2 diabetes and extend this association to adults already at low-risk on the basis of multiple low-risk lifestyle habits.

Note: The National Institute on Alcohol Abuse and Alcoholism defines a standard drink in the United States as 11 to 14 g of alcohol. This corresponds to approximately 1.5 ounces of 80-proof distilled spirits (approximately 14 g alcohol), one 5-ounce glass of wine (11 g), or one 12-ounce beer (12.8 g).

Megan Brooks is a freelance writer for Medscape.

The study authors have disclosed no relevant financial relationships.
Am J Clin Nutr. Published online April 21, 2010.

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