Alcohol consumption and risk of type 2 diabetes in European men and women: Influence of beverage type and body sizeThe EPIC-InterAct study
Beulens JWJ., Van der Schouw YT., Bergmann MM., Rohrmann S., Schulze MB., Buijsse B., Grobbee DE., Arriola L., Cauchi SS., Tormo SJ., Allen NE., van der A DL., Balkau B., Boeing H., Clavel-Chapelon F., de Lauzon-Guillan B., Franks P., Froguel P., Gonzales C., Halkjær J., Huerta JM., Kaaks R., Key TJ., Khaw KT., Krogh V., Molina-Montes E., Nilsson P., Overvad K., Palli D., Panico S., Ramón Quirós J., Ronaldsson O., Romieu I., Romaguera D., Sacerdote C., Sánchez MJ., Spijkerman AMW., Teucher B., Tjonneland A., Tumino R., Sharp S., Forouhi NG., Langenberg C., Feskens EJM., Riboli E., Wareham NJ.
Objective: To investigate the association between alcohol consumption and type 2 diabetes, and determine whether this is modified by sex, body mass index (BMI) and beverage type. Design: Multicentre prospective case-cohort study. Setting: Eight countries from the European Prospective Investigation into Cancer and Nutrition cohort. Subjects: A representative baseline sample of 16154 participants and 12403 incident cases of type 2 diabetes. Interventions: Alcohol consumption assessed using validated dietary questionnaires. Main outcome measures: Occurrence of type 2 diabetes based on multiple sources (mainly self-reports), verified against medical information. Results: Amongst men, moderate alcohol consumption was nonsignificantly associated with a lower incidence of diabetes with a hazard ratio (HR) of 0.90 (95% CI: 0.78-1.05) for 6.1-12.0 versus 0.1-6.0gday -1 , adjusted for dietary and diabetes risk factors. However, the lowest risk was observed at higher intakes of 24.1-96.0gday -1 with an HR of 0.86 (95% CI: 0.75-0.98). Amongst women, moderate alcohol consumption was associated with a lower incidence of diabetes with a hazard ratio of 0.82 (95% CI: 0.72-0.92) for 6.1-12.0gday -1 (P interaction gender < 0.01). The inverse association between alcohol consumption and diabetes was more pronounced amongst overweight (BMI≥25kgm -2 ) than normal-weight men and women (P interaction < 0.05). Adjusting for waist and hip circumference did not alter the results for men, but attenuated the association for women (HR=0.90, 95% CI: 0.79-1.03 for 6.1-12.0gday -1 ). Wine consumption for men and fortified wine consumption for women were most strongly associated with a reduced risk of diabetes. Conclusions: The results of this study show that moderate alcohol consumption is associated with a lower risk of type 2 diabetes amongst women only. However, this risk reduction is in part explained by fat distribution. The relation between alcohol consumption and type 2 diabetes was stronger for overweight than normal-weight women and men. © 2012 The Association for the Publication of the Journal of Internal Medicine.