AIMS/INTRODUCTION: Previous meta-analyses identified an inverse association of total alcohol consumption with the risk of type 2 diabetes. The current study further explored the relationship between specific types of alcoholic beverage and the incidence of type 2 diabetes.
MATERIALS AND METHODS: A search of PubMed, Embase and Cochrane Library databases from January 1966 to February 2016 was carried out for prospective cohort studies that assessed the effects of specific types of alcoholic beverage on the risk of type 2 diabetes. The pooled relative risks with 95% confidence interval were calculated using random- or fixed-effect models when appropriate.
RESULTS: A total of 13 prospective studies were included in this meta-analysis, with 397,296 study participants and 20,641 cases of type 2 diabetes. Relative to no or rare alcohol consumption, wine consumption was associated with a significant reduction of the risk of type 2 diabetes, with the pooled relative risks of 0.85, whereas beer or spirits consumption led to a slight trend of decreasing risk of type 2 diabetes (relative risk 0.96, 0.95, respectively). Further dose-response analysis showed a U-shaped relationship between all three alcohol types and type 2 diabetes. Additionally, the peak risk reduction emerged at 20-30 g/day for wine and beer, and at 7-15 g/day for spirits, with a decrease of 20, 9 and 5%, respectively.
CONCLUSIONS: Compared with beer or spirits, wine was associated with a more significant decreased risk of type 2 diabetes. The present study showed that wine might be more helpful for protection against type 2 diabetes than beer or spirits.
The prevalence of the metabolic syndrome is rising worldwide. Its association with alcohol intake, a major lifestyle factor, is unclear, particularly with respect to the influence of drinking with as opposed to outside of meals. We investigated the associations of different aspects of alcohol consumption with the metabolic syndrome and its components. In cross-sectional analyses of 14,375 active or retired civil servants (aged 35-74 years) participating in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), we fitted logistic regression models to investigate interactions between the quantity of alcohol, the timing of its consumption with respect to meals, and the predominant beverage type in the association of alcohol consumption with the metabolic syndrome. In analyses adjusted for age, sex, educational level, income, socioeconomic status, ethnicity, smoking, body mass index, and physical activity, light consumption of alcoholic beverages with meals was inversely associated with the metabolic syndrome (/=14 drinks/week: OR = 1.60, 95%CI 1.29-1.98). Drinking predominantly wine, which occurred mostly with meals, was significantly related to a lower syndrome prevalence; drinking predominantly beer, most notably when outside of meals and in larger quantity, was frequently associated with a greater prevalence. In conclusion, the alcohol-metabolic syndrome association differs markedly depending on the relationship of intake to meals. Beverage preference-wine or beer-appears to underlie at least part of this difference. Notably, most alcohol was consumed in metabolically unfavorable type and timing. If further investigations extend these findings to clinically relevant endpoints, public policies should recommend that alcohol, when taken, should be preferably consumed with meals.
OBJECTIVE: To generate evidence-based conclusions about the effect of wine consumption on weight gain and abdominal fat accumulation and distribution in patients with type 2 diabetes.
DESIGN: In the 2-year randomized controlled CASCADE (CArdiovaSCulAr Diabetes & Ethanol) trial, patients following a Mediterranean diet were randomly assigned to drink 150 ml of mineral water, white wine or red wine with dinner for 2 years. Visceral adiposity and abdominal fat distribution were measured in a subgroup of sixty-five participants, using abdominal MRI.
SETTING: Ben-Gurion University of the Negev, Soroka-Medical Center and the Nuclear Research Center Negev, Israel.
SUBJECTS: Alcohol-abstaining adults with well-controlled type 2 diabetes.
RESULTS: Forty-eight participants (red wine, n 27; mineral water, n 21) who completed a second MRI measurement were included in the 2-year analysis. Similar weight losses (sd) were observed: red wine 1.3 (3.9) kg; water 1.0 (4.2) kg (P=0.8 between groups). Changes (95 % CI) in abdominal adipose-tissue distribution were similar: red wine, visceral adipose tissue (VAT) -3.0 (-8.0, 2.0) %, deep subcutaneous adipose tissue (DSAT) +5.2 (-1.1, 11.6) %, superficial subcutaneous adipose tissue (SSAT) -1.9 (-5.0, 1.2) %; water, VAT -3.2 (-8.9, 2.5) %, DSAT +2.9 (-2.8, 8.6) %, SSAT -0.15 (-3.3, 2.9) %. No changes in antidiabetic medication and no substantial changes in energy intake (+126 (sd 2889) kJ/d (+30.2 (sd 690) kcal/d), P=0.8) were recorded. A 2-year decrease in glycated Hb (beta=0.28, P=0.05) was associated with a decrease in VAT.
CONCLUSIONS: Moderate wine consumption, as part of a Mediterranean diet, in persons with controlled diabetes did not promote weight gain or abdominal adiposity.