Combined effect of alcohol consumption and lifestyle behaviors on risk of type 2 diabetes

Am J Clin Nutr. 2010 Jun;91(6):1777-83. doi: 10.3945/ajcn.2010.29170. Epub 2010 Apr 21.

Abstract

Background: It has been suggested that the inverse association between alcohol and type 2 diabetes could be explained by moderate drinkers' healthier lifestyles.

Objective: We studied whether moderate alcohol consumption is associated with a lower risk of type 2 diabetes in adults with combined low-risk lifestyle behaviors.

Design: We prospectively examined 35,625 adults of the Dutch European Prospective Investigation into Cancer and Nutrition (EPIC-NL) cohort aged 20-70 y, who were free of diabetes, cardiovascular disease, and cancer at baseline (1993-1997). In addition to moderate alcohol consumption (women: 5.0-14.9 g/d; men: 5.0-29.9 g/d), we defined low-risk categories of 4 lifestyle behaviors: optimal weight [body mass index (in kg/m(2)) <25], physically active (> or =30 min of physical activity/d), current nonsmoker, and a healthy diet [upper 2 quintiles of the Dietary Approaches to Stop Hypertension (DASH) diet].

Results: During a median of 10.3 y, we identified 796 incident cases of type 2 diabetes. Compared with teetotalers, hazard ratios of moderate alcohol consumers for risk of type 2 diabetes in low-risk lifestyle strata after multivariable adjustments were 0.35 (95% CI: 0.17, 0.72) when of a normal weight, 0.65 (95% CI: 0.46, 0.91) when physically active, 0.54 (95% CI: 0.41, 0.71) when nonsmoking, and 0.57 (95% CI: 0.39, 0.84) when consuming a healthy diet. When > or =3 low-risk lifestyle behaviors were combined, the hazard ratio for incidence of type 2 diabetes in moderate alcohol consumers after multivariable adjustments was 0.56 (95% CI: 0.32, 1.00).

Conclusion: In subjects already at lower risk of type 2 diabetes on the basis of multiple low-risk lifestyle behaviors, moderate alcohol consumption was associated with an approximately 40% lower risk compared with abstention.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Alcohol Drinking / epidemiology*
  • Body Mass Index
  • Cohort Studies
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Diabetes Mellitus, Type 2 / etiology
  • Eating
  • Female
  • Humans
  • Life Style*
  • Male
  • Middle Aged
  • Motor Activity
  • Netherlands / epidemiology
  • Proportional Hazards Models
  • Prospective Studies
  • Smoking / epidemiology
  • Young Adult