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

Michel M. Joosten, Diederick E. Grobbee, Daphne L. Van Der A, W. M.Monique Verschuren, Henk F.J. Hendriks, Joline W.J. Beulens

Research output: Contribution to journalArticleAcademicpeer-review

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/m2) <25], physically active (≥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 ≥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 ≈40% lower risk compared with abstention.

Original languageEnglish
Pages (from-to)1777-1783
Number of pages7
JournalAmerican Journal of Clinical Nutrition
Volume91
Issue number6
DOIs
Publication statusPublished - 1 Jun 2010

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