Drinking and Diabetes

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Moderate drinking has long been associated with a number of health benefits, including a lower risk of cardiovascular problems, dementia, and Type 2 diabetes. But due to the design of most studies on drinking, there has been doubt about whether alcohol is actually the cause of these outcomes — no large randomized, controlled study of drinking has ever been conducted, so preexisting differences might account for both the decision to drink and the better health outcomes seen in moderate drinkers.

However, a new study on alcohol and Type 2 diabetes prevention seems to show not only that alcohol is associated with a lower diabetes risk, but that this link cannot be explained by the healthier lifestyles of moderate drinkers. The study, published on the Web site of the American Journal of Clinical Nutrition, examined both the drinking habits and four other characteristics of over 35,000 Dutch adults between the ages of 20 and 70: body weight, physical activity, smoking status, and diet. A low-risk category was defined for each of these traits. After an average follow-up period of just over 10 years, it was found that moderate drinkers in each of the four low-risk categories had a lower risk of developing Type 2 diabetes than did nondrinkers (moderate drinking was defined as between 5 and 15 grams of alcohol daily for women and between 5 and 30 for men, estimated based on self-reporting). After controlling for baseline factors such as age and sex, this risk was 65% lower for those with normal body weight, 35% lower for the physically active (at least 30 minutes of exercise a day, on average), 46% lower for nonsmokers, and 43% lower for those with a healthy diet (based on the DASH diet). Among study subjects who fit in at least three of the low-risk groups, the risk of developing Type 2 diabetes was 44% lower for moderate drinkers.

While this study appears to dispel the claim that moderate drinkers only have better health outcomes because of their all-around healthy behavior, it still cannot rule out the possibility that study subjects who chose not to drink might have a common, unknown trait that increased their risk of developing diabetes. Only the traits controlled for in the study can be ruled out as causes of differences in diabetes risk, which means that alcohol might not actually be the reason — or not the only reason — for the lower risk seen in moderate drinkers. When deciding whether or not to drink, it is also important to remember that alcohol has known risks. In addition to its potential for addiction and abuse, in some people alcohol has a significant effect on the blood triglyceride level.

What are the most important factors in your decision to drink or not to drink? Although most experts currently do not recommend starting to drink alcohol for its potential health benefits, if this advice changed, would you start drinking if you do not? If medical opinion turned against alcohol, would you stop drinking if you do? Should the US government support a randomized, controlled study of moderate alcohol consumption to learn more conclusively about its effects? Leave a comment below!

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