A Prospective Study of Drinking Patterns in Relation to Risk of Type 2 Diabetes Among Men

Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA.
Diabetes (Impact Factor: 8.47). 10/2001; 50(10):2390-5. DOI: 10.2337/diabetes.50.10.2390
Source: PubMed

ABSTRACT Using data from a 12-year prospective study, we determined the importance of the pattern of alcohol consumption as a risk factor for type 2 diabetes in a cohort of 46,892 U.S. male health professionals who completed biennial postal questionnaires. Overall, 1,571 new cases of type 2 diabetes were documented. Compared with zero alcohol consumption, consumption of 15-29 g/day of alcohol was associated with a 36% lower risk of diabetes (RR = 0.64; 95% CI 0.53-0.77). This inverse association between moderate consumption and diabetes remained if light drinkers rather than abstainers were used as the reference group (RR = 0.60, CI 0.50-0.73). There were few heavy drinkers, but the inverse association persisted to those drinking >/=50 g/day of alcohol (RR = 0.60, CI 0.43-0.84). Frequency of consumption was inversely associated with diabetes. Consumption of alcohol on at least 5 days/week provided the greatest protection, even when less than one drink per drinking day was consumed (RR = 0.48, CI 0.27-0.86). Compared with infrequent drinkers, for each additional day per week that alcohol was consumed, risk was reduced by 7% (95% CI 3-10%) after controlling for average daily consumption. There were similar and independent inverse associations for beer, liquor, and white wine. Our findings suggested that frequent alcohol consumption conveys the greatest protection against type 2 diabetes, even if the level of consumption per drinking day is low. Beverage choice did not alter risk.

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    • "While several studies showed a U-shaped relationship between alcohol and diabetes risk [1], others reported increased risks of type 2 diabetes in alcohol consumption categories of ≥25 g/day [2], >40 g/day [3], and >3 drinks per day [4]. Another study found a progressive decrease in the risk of type 2 diabetes up to a consumption of ≥50 g of alcohol per day [5]. The inconsistent results may be ascribed to differences in ascertainment of alcohol consumption and diabetes mellitus among studies and different genetic susceptibilities to alcohol exposure among study populations. "
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    ABSTRACT: This study investigated the association of ADH1B (rs1229984) and ALDH2 (rs671) polymorphisms with glucose tolerance status, as determined by a 75-g oral glucose tolerance test, and effect modification of these polymorphisms on the association between alcohol consumption and glucose intolerance in male officials of the Self-Defense Forces. The study subjects included 1520 men with normal glucose tolerance, 553 with prediabetic condition (impaired fasting glucose and impaired glucose tolerance), and 235 men with type 2 diabetes. There was an evident interaction between alcohol consumption and ADH1B polymorphism in relation to type 2 diabetes (interaction P=.03). The ALDH24∗87Lys allele was associated with a decreased prevalence odds of type 2 diabetes regardless of alcohol consumption. In conclusion, the ADH1B polymorphism modified the association between alcohol consumption and type 2 diabetes. A positive association between alcohol consumption and type 2 diabetes was confounded by ALDH2 polymorphism.
    01/2011; 2011(2090-2972). DOI:10.1155/2011/583682
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    • ">12 g vs 0 g 0.27 [0.07e1.14] Conigrave et al. [12] 12 years N Z 44,079 <5 g vs. 0 g 1.05 [0.95e1.24] Age 40e75 years 5e10 g vs. 0 g 0.88 [0.74e1.04] "
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    ABSTRACT: AIMS: To describe a) the association between alcohol consumption and the risk of type 2 diabetes (T2D) and b) the impact of alcohol on the glycemic control with and without anti-diabetic drugs. DATA SYNTHESIS: We searched MEDLINE and the Cochrane Library data base with the key words "Diabetes Mellitus, type 2" and "Alcohol Drinking" in English-language studies in adults. For the first part of the review we selected meta-analyses, review articles and observational studies more recent than year 1990 including at least 1000 participants. For the second part of the review we included all articles more recent than year 1990. Most observational studies find a J-shaped association between alcohol intake and incidence of T2D. Interestingly, drinking pattern plays a role, i.e. binge drinking increases the risk of T2D. Opposing information exists about the influence of beverage type. In T2D the acute effects on plasma glucose, insulin, fatty acids and triglyceride vary, in part depending on concomitant intake of food. Acute alcohol intake does not induce hypoglycemia in diet treated T2D, but increases the risk of hypoglycemia in sulphonylurea treated patients. In most studies, long-term alcohol use is associated with improved glycemic control in T2D. CONCLUSIONS: Alcohol consumption reduces the incidence of T2D, however, binge drinking seems to increase the incidence. Acute intake of alcohol does not increase risk of hypoglycemia in diet treated subjects with T2D, only when sulphonylurea is co-administered. Long-term alcohol use seems to be associated with improved glycemic control in T2D probably due to improved insulin sensitivity.
    Nutrition, metabolism, and cardiovascular diseases: NMCD 06/2010; 20. DOI:10.1016/j.numecd.2010.05.001 · 3.88 Impact Factor
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    • "A huge number of studies address several forms by which T2DM could be prevented. Lifestyle changes, food intake modifications – for instance, lowering the fat content (Lovejoy 1999; Van Dam et al 2002) or enhancing the fi ber and magnesium content of the diet (Lopez-Ridaura et al 2004) – and/or physical activity promoting weight loss (Eriksson and Lindgarde 1991; Pan et al 1997; Swinburn et al 2001; Tuomilehto et al 2001; Knowler et al 2002; Kosaka et al 2005), smoking status (Tuomilehto 2005), moderate coffee (Van Dam and Hu 2005) and moderate alcohol consumption (Conigrave et al 2001), and fi nally bariatric gastric surgery (Sjöström et al 2004) may be of benefi t in the prevention of T2DM in morbidly obese patients (Gruber et al 2006). These data lend powerful credence to the signifi cant weight of lifestyle changes in T2DM prevention, but regardless of the fact that these modifi cations look to be operative in the prevention, it is highly questionable if these interventions would be sustained for the long-term. "
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    ABSTRACT: There has been an increase in the concern about preventing type 2 diabetes mellitus (T2DM), a disease with great and increasing prevalence. The prevalence of obesity, physical inactivity, Western processed diet, important risk factors for the development of T2DM, are also rising. Free fatty acids are increased in obesity and reduce insulin clearance and increase hepatic glucose production. Implementation of a healthy lifestyle has been show to slow the progression of impaired glucose tolerance to T2DM. Orlistat is an inhibitor of lipase activity, with proved efficacy in body weight reduction and long-term management of obesity and more favorable effects on carbohydrate metabolism and it was prospectively shown in XENDOS study that orlistat promoted long-term weight loss and prevented T2DM onset in obese individuals with normal and impaired glucose tolerance at baseline over four years. This benefit could be associated to the weight loss itself, to the limited absorption of lipids and reduction of plasma free fatty acids, to increased production of incretins or to modulation of secretion of cytokines by adipocytes, all effects secondary to orlistat treatment. A proposed strategy is to identify subjects at highest risk to receive a drug intervention, using lifestyle interventions alone at the community level.
    Vascular Health and Risk Management 02/2008; 4(2):325-36.
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