Relationship between drinking patterns and the risk of type 2 diabetes: the Kansai Healthcare Study

The Relationship of Alcohol Consumption and Drinking Pattern to the Risk of Glomerular Hyperfiltration in Middle-aged Japanese Men: The Kansai Healthcare Study

BACKGROUND

Glomerular hyperfiltration has been reported to be associated with adverse renal outcomes in the general population. It is not known whether drinking pattern is associated with the risk of glomerular hyperfiltration in healthy individuals.

METHODS

We prospectively followed middle-aged 8,640 Japanese men with normal renal function, no proteinuria, no diabetes, and no use of antihypertensive medications at entry. Data on alcohol consumption were gathered by questionnaire. Glomerular hyperfiltration was defined as estimated glomerular filtration rate (eGFR) ≥117 mL/min/1.73 m2, which was the upper 2.5th percentile value of eGFR in the entire cohort.

RESULTS

During 46,186 person-years of follow-up, 330 men developed glomerular hyperfiltration. In a multivariate model, for men who consumed alcohol on 1-3 days per week, alcohol consumption of ≥69.1 g ethanol/drinking day was significantly associated with the risk of glomerular hyperfiltration (hazard ratio [HR] 2.37; 95% confidence interval [CI], 1.18-4.74) compared with non-drinkers. For those who consumed alcohol on 4-7 days per week, higher alcohol consumption per drinking day was associated with a higher risk of glomerular hyperfiltration: the HRs for alcohol consumption of 46.1-69.0, and ≥69.1 g ethanol/drinking day were 1.55 (95% CI, 1.01-2.38), and 1.78 (95% CI, 1.02-3.12), respectively.

CONCLUSION

For high drinking frequency per week, more alcohol intake per drinking day was associated with an increased risk of glomerular hyperfiltration, while for low drinking frequency per week, only very high alcohol intake per drinking day was associated with an increased risk of glomerular hyperfiltration in middle-aged Japanese men.

Beverage Consumption Patterns and Nutrient Intake Are Associated with Cardiovascular Risk Factors among Urban Mexican Young Adults

Regular consumption of sugar-sweetened beverages has been related to metabolic diseases. Our objective was to identify beverage consumption patterns, nutrient intake, and their possible association with the prevalence of cardiovascular risk factors among Mexican young adults. A cross-sectional survey was conducted. Beverage consumption patterns were obtained by principal components analysis. Logistic regression models were applied to assess the association between the beverage patterns and cardiovascular risk factors. Four beverage patterns were identified. Higher consumption of alcoholic beverages was associated with lower odds for high body fat percent (OR: 0.371; 95% CI: 0.173-0.798), high blood pressure (OR: 0.318; 95% CI: 0.116-0.871), and high glucose (OR: 0.232; 95% CI: 0.061-0.875). Higher consumption of yogurt was associated with lower odds for high glucose (OR: 0.110; 95% CI: 0.22-0.559). In contrast, highest consumption of juice had greater odds for high triglycerides (OR: 1.084; 95% CI: 1.011-4.656). Higher consumption of milk was associated with greater odds for high glucose (OR: 5.304; 95% CI: 1.292-21.773). Beverage consumption habits in Mexican young adults are associated with increased risk factors for cardiovascular disease. Therefore, intervening during young adulthood should be considered in order to improve current health and prevent cardiovascular mortality in later decades.

Impact of Sociodemographic Characteristics, Lifestyle, and Obesity on Coexistence of Diabetes and Hypertension: A Structural Equation Model Analysis amongst Chinese Adults

Background

In general, given the insufficient sample size, considerable literature has been found on single studies of diabetes and hypertension and few studies have been found on the coexistence of diabetes and hypertension (CDH) and its influencing factors with a large range of samples. This study aimed to establish a structural equation model for exploring the direct and indirect relationships amongst sociodemographic characteristics, lifestyle, obesity, and CDH amongst Chinese adults.

Methods

A cross-sectional study was conducted in a representative sample of 25356 adults between June 1, 2015, and September 30, 2018, in Hubei province, China. Confirmatory factor analysis was initially conducted to test the latent variables. A structural equation model was then performed to analyse the association between latent variables and CDH.

Results

The total prevalence of CDH was 2.8%. The model paths indicated that sociodemographic characteristics, lifestyle, and obesity were directly associated with CDH, and the effects were 0.187, 0.739, and 0.353, respectively. Sociodemographic characteristics and lifestyle were also indirectly associated with CDH, and the effects were 0.128 and 0.045, respectively. Lifestyle had the strongest effect on CDH (β = 0.784, P < 0.001), followed by obesity (β = 0.353, P < 0.001) and sociodemographic characteristics (β = 0.315, P < 0.001). All paths of the model were significant (P < 0.001).

Conclusion

CDH was significantly associated with sociodemographic characteristics, lifestyle, and obesity amongst Chinese adults. The dominant predictor of CDH was lifestyle. Targeting these results might develop lifestyle and weight loss intervention to prevent CDH according to the characteristics of the population.

Alcohol and Metabolic-associated Fatty Liver Disease

The diagnosis of metabolic-associated fatty liver disease is based on the detection of liver steatosis together with the presence of metabolic dysfunction. According to this new definition, the diagnosis of metabolic-associated fatty liver disease is independent of the amount of alcohol consumed. Actually, alcohol and its metabolites have various effects on metabolic-associated abnormalities during the process of alcohol metabolism. Studies have shown improved metabolic function in light to moderate alcohol drinkers. There are several studies focusing on the role of light to moderate alcohol intake on metabolic dysfunction. However, the results from studies are diverse, and the conclusions are often controversial. This review systematically discusses the effects of alcohol consumption, focusing on light to moderate alcohol consumption, obesity, lipid and glucose metabolism, and blood pressure.

Moderate Consumption of Beer and Its Effects on Cardiovascular and Metabolic Health: An Updated Review of Recent Scientific Evidence

There is growing interest in the potential health-related effects of moderate alcohol consumption and, specifically, of beer. This review provides an assessment of beer-associated effects on cardiovascular and metabolic risk factors to identify a consumption level that can be considered “moderate”. We identified all prospective clinical studies and systematic reviews that evaluated the health effects of beer published between January 2007 and April 2020. Five of six selected studies found a protective effect of moderate alcohol drinking on cardiovascular disease (beer up to 385 g/week) vs. abstainers or occasional drinkers. Four out of five papers showed an association between moderate alcohol consumption (beer intake of 84 g alcohol/week) and decreased mortality risk. We concluded that moderate beer consumption of up to 16 g alcohol/day (1 drink/day) for women and 28 g/day (1–2 drinks/day) for men is associated with decreased incidence of cardiovascular disease and overall mortality, among other metabolic health benefits.

Alcohol Consumption and Progression of Chronic Kidney Disease: Results From the Korean Cohort Study for Outcome in Patients with Chronic Kidney Disease

OBJECTIVE

To assess the association of alcohol consumption with chronic kidney disease (CKD) progression in patients with CKD.

PATIENTS AND METHODS

The KoreaN cohort study for Outcome in patients with CKD (KNOW-CKD) is a prospective observational study that included detailed questionnaires regarding alcohol consumption. The 1883 individuals with CKD were enrolled from April 1, 2011, through February 28, 2016, and followed until May 31, 2017. Using a questionnaire, alcohol consumption pattern was classified according to the amount of alcohol per occasion (none, moderate, or binge) or drinking frequency (none, occasional, or regular). The primary endpoint was a composite of 50% or greater decline in estimated glomerular filtration rate (eGFR) from the baseline level or end-stage renal disease.

RESULTS

During a follow-up of 5555 person-years (median, 2.95 years), the primary outcome occurred in 419 patients. Unadjusted cause-specific hazards model showed that the risk of the primary outcome was lower in drinkers than in non-drinkers. However, a fully adjusted model including eGFR and proteinuria yielded a reverse association. Compared with non-drinking, regular and occasional binge drinking were associated with a 2.2-fold (95% CI, 1.38-3.46) and a 2.0-fold (95% CI, 1.33-2.98) higher risk of CKD progression, respectively. This association was particularly evident in patients who had decreased kidney function and proteinuria. There was a significant interaction between alcohol consumption and eGFR for CKD progression. The slopes of eGFR decline were steeper in binge drinkers among patients with eGFR less than 60 mL/min/1.73 m².

CONCLUSIONS

Heavy alcohol consumption was associated with faster progression of CKD.

Adiposity and Diabetes Risk in Adults with Prediabetes: Heterogeneity of Findings Depending on Age and Anthropometric Measure

OBJECTIVE

The study aimed to evaluate the effect of age on diabetes incidence by general and central adiposity after 3-year follow-up in adults with prediabetes.

METHODS

Data were taken from a cohort of 1,184 subjects with prediabetes included in The Cohort Study in Primary Health Care on the Evolution of Patients with Prediabetes (PREDAPS). General adiposity was defined using body mass index (BMI), and central adiposity was defined with waist circumference and waist to height ratio. Data were analyzed by age groups 30 to 59 and 60 to 74 years. The association between adiposity and diabetes incidence was assessed using hazard ratios (HR).

RESULTS

Adjusting for sociodemographic characteristics, lifestyles, and metabolic parameters, diabetes HR for central adiposity based on the waist circumference clinical cutoff were 2.14 (1.12-4.09) and 1.48 (0.80-2.74) for people aged 30 to 59 and 60 to 74 years, respectively. In the model additionally adjusted for BMI, diabetes HR were 2.65 (1.24-5.65) and 1.33 (0.68-2.59), respectively. The use of a 1-SD increase rather than cutoff points did not alter this pattern. Similar findings were observed with central adiposity based on waist to height ratio.

CONCLUSIONS

The association of central adiposity with type 2 diabetes incidence was lower for people in the older age group than for those in the younger age group.

The bidirectional impacts of alcohol consumption and the metabolic syndrome: Cofactors for progressive fatty liver disease

Current medical practice artificially dichotomises a diagnosis of fatty liver disease into one of two common forms: alcoholic liver disease (ALD) and non-alcoholic fatty liver disease (NAFLD). Together, these account for the majority of chronic liver diseases worldwide. In recent years, there has been a dramatic increase in the prevalence of obesity and metabolic syndrome within the general population. These factors now coexist with alcohol consumption in a substantial proportion of the population. Each exposure sensitises the liver to the injurious effects of the other; an interaction that drives and potentially accelerates the genesis of liver disease. We review the epidemiological evidence and scientific literature that considers how alcohol consumption interacts with components of the metabolic syndrome to exert synergistic or supra-additive effects on the development and progression of liver disease, before discussing how these interactions may be addressed in clinical practice.

Alcohol Consumption, Diabetes Risk, and Cardiovascular Disease Within Diabetes

PURPOSE OF REVIEW

The purpose of the study is to examine and summarize studies reporting on the epidemiology, the risk of developing diabetes, and the cardiovascular effects on individuals with diabetes of different levels of alcohol consumption.

RECENT FINDINGS

Men consume more alcohol than women in populations with and without diabetes. Light-to-moderate alcohol consumption decreases the incidence of diabetes in the majority of the studies, whereas heavy drinkers and binge drinkers are at increased risk for diabetes. Among people with diabetes, light-to-moderate alcohol consumption reduces risks of cardiovascular diseases and all-cause mortality. Alcohol consumption is less common among populations with diabetes compared to the general population. Moderate alcohol consumption reduces the risk of diabetes and, as in the general population, improves cardiovascular health in patients with diabetes. Type of alcoholic beverage, gender, and body mass index are factors that affect these outcomes.

Association of Alcohol Drinking Patterns With Presence of Impaired Fasting Glucose and Diabetes Mellitus Among South Korean Adults

Background

We aimed to investigate the association between alcohol drinking patterns and the presence of impaired fasting glucose (IFG) and diabetes mellitus (DM).

Methods

We used data from the Korean National Health and Nutrition Examination Survey, 2010–2014. The participants were aged ≥30 years and had no previous diagnosis of DM. High-risk drinking was defined as alcohol consumption of ≥7 glasses at a sitting for men, and ≥5 glasses for women. After adjusting for confounding factors, a polychotomous logistic regression analysis was performed to assess the association of drinking patterns with IFG and DM.

Results

For men, high-risk drinking was associated with higher odds ratios (ORs) of IFG (2–4/month, OR 1.51; 95% confidence interval [CI], 1.13–2.04; 2–3/week, OR 1.79; 95% CI, 1.38–2.33; and ≥4/week, OR 2.24; 95% CI, 1.65–3.03) and of DM (2–4/month, OR 2.12; 95% CI, 1.20–3.77; 2–3/week, OR 1.78; 95% CI, 1.05–3.03; and ≥4/week, OR 2.98; 95% CI, 1.72–5.17). For women, high-risk drinking was associated with higher risk of IFG (2–4/month, OR 1.51; 95% CI, 1.04–2.21; 2–3/week, OR 3.19; 95% CI, 2.20–4.64; and ≥4/week, OR 2.23; 95% CI, 1.23–4.06), but not of DM, compared with non-high-risk drinkers who consumed alcohol ≤1 day/month. Non-high-risk drinkers who consumed alcohol ≥4 days/week had higher ORs of DM in men, but lower ORs of DM in women compared with non-high risk drinkers who consumed alcohol ≤1 day/month.

Conclusions

Compared with non-high-risk alcohol drinking, even occasional high-risk alcohol drinking was associated with a higher risk of IFG in men and women, and DM in men. Nearly daily non-high-risk alcohol drinking was associated with a higher risk of DM in men and lower risk of DM in women.

Diabetes prevention in the real world: Insights from the JDPP and J-DOIT1

Type 2 diabetes (T2D) is associated with increased risks of morbidity and mortality. Diabetes prevention is an urgent issue in Japan. The Finnish Diabetes Prevention Study and US Diabetes Prevention Program revealed that intensive lifestyle intervention can prevent or delay the development of T2D in high-risk populations. Translational research varies in hospitals, primary care, communities, the workplace, and other settings. Translational research is feasible but less effective. There have been no long-term follow-ups. The outcome of the studies was mainly weight changes. The Japan Diabetes Prevention Program (JDPP) is a trial to test the efficacy of a lifestyle intervention program, which carried out in a primary healthcare setting using existing resources. The Japan Diabetes Outcome Trial-1 (J-DOIT1) is a nationwide telephone-delivered lifestyle intervention in a real-world setting. This review will focus on the effectiveness of a diabetes prevention program (recruitment, target population, method of intervention, and evaluation) in the real world and insights from the JDPP and J-DOIT1.

Alcohol drinking patterns and risk of diabetes: a cohort study of 70,551 men and women from the general Danish population

AIMS/HYPOTHESIS

Alcohol consumption is inversely associated with diabetes, but little is known about the role of drinking patterns. We examined the association between alcohol drinking patterns and diabetes risk in men and women from the general Danish population.

METHODS

This cohort study was based on data from the Danish Health Examination Survey 2007-2008. Of the 76,484 survey participants, 28,704 men and 41,847 women were eligible for this study. Participants were followed for a median of 4.9 years. Self-reported questionnaires were used to obtain information on alcohol drinking patterns, i.e. frequency of alcohol drinking, frequency of binge drinking, and consumption of wine, beer and spirits, from which we calculated beverage-specific and overall average weekly alcohol intake. Information on incident cases of diabetes was obtained from the Danish National Diabetes Register. Cox proportional hazards model was applied to estimate HRs and 95% CIs.

RESULTS

During follow-up, 859 men and 887 women developed diabetes. The lowest risk of diabetes was observed at 14 drinks/week in men (HR 0.57 [95% CI 0.47, 0.70]) and at 9 drinks/week in women (HR 0.42 [95% CI 0.35, 0.51]), relative to no alcohol intake. Compared with current alcohol consumers consuming <1 day/week, consumption of alcohol on 3-4 days weekly was associated with significantly lower risk for diabetes in men (HR 0.73 [95% CI 0.59, 0.94]) and women (HR 0.68 [95% CI 0.53, 0.88]) after adjusting for confounders and average weekly alcohol amount.

CONCLUSIONS/INTERPRETATION

Our findings suggest that alcohol drinking frequency is associated with risk of diabetes and that consumption of alcohol over 3-4 days per week is associated with the lowest risk of diabetes, even after taking average weekly alcohol consumption into account.

Relationship between healthy lifestyle behaviors and cardiovascular risk factors in Chinese patients with type 2 diabetes mellitus: a subanalysis of the CCMR-3B STUDY

AIMS

This subanalysis of a cross-sectional, nationwide study was undertaken to assess the relationship between healthy lifestyle behaviors and multiple cardiovascular risk factors among people with type 2 diabetes mellitus (T2DM).

METHODS

Data collected from 25,454 participants, including demographics, lifestyle behaviors and cardiovascular risk profiles, were analyzed. Blood pressure control as well as blood glucose and blood lipid (3Bs) levels were measured as multi-risk factors for cardiovascular disease. Healthy lifestyle behaviors included regular exercise, nonsmoking status and no alcohol consumption. The relationship between the healthy lifestyle behavior(s) and control of 3B(s) was calculated.

RESULTS

Of the 25,454 eligible participants, 4171 (16.4%) were current smokers, 2011 (7.9%) currently consumed alcohol, and 11,174 (43.9%) did not exercise. In total, 654 (2.6%) reported all three unhealthy lifestyle behaviors. Most participants (71.1%) had received at least a high school education and were more likely to smoke and drink as compared to those with lower education. Unhealthy lifestyle behaviors were commonly found in participants with low atherosclerosis risk, such as non-elderly people and those with an above-college education level. Unhealthy lifestyle is associated with poor 3B control and worse medication adherence.

CONCLUSIONS

Unhealthy lifestyles are common in Chinese people with T2DM, especially in people who are non-elderly and above-college educated. Interventions aimed at changing risky lifestyle behaviors are required for improved outcomes for Chinese patients with T2DM.

The changes in biochemical parameters due to wine consumption depending on gender

The aim of this study was to investigate the effect of red wine consumption on the lipid profile and glucose in the group of male (13 men aged 34 - 64 years) and the group of female (11 women aged 28 - 57 years). Research consisted of moderate red wine consumption for 6 weeks. The dose of alcohol ranged from 200 to 300 mL per day of red wine Lemberger (Winery Masaryk, Slovakia). The blood samples were obtained after overnight fasting and were collected at baseline and after three days, three weeks and six weeks of wine consumption. Differences between male and female subjects were reflected in the results of different biochemical parameters in the dynamics of wine consumption. We found out that while in females the total cholesterol level did not change significantly and had a predominantly downward trend, for male subjects we observed at the beginning the slight increase of the levels, which, however, after 6 weeks of consumption significantly decreased from an initial value of 5.75 ±1.32 mmol.L-1 to 5.35 ±1.25 mmol.L-1 (p <0.05). The blood concentration of triglycerides in the dynamics of the experiment did not change significantly in either one gender, although small differences were observed, because while the female subjects had triglyceride development over consumption upward trend in male subjects it was vice versa. LDL-cholesterol changed significantly only in the group of female. Level of this lipid parameter decreased significantly during the six weeks of consumption of Lemberger from an initial value 3.37 ±0.68 mmol.L-1 to the lowest 2.99 ±0.61 mmol.L-1, which was recorded in the third week of consumption (p <0.0001), but statistically significant differences versus baseline we monitored after three days and six weeks of consumption (p <0.01). In the group of male, we did not observe such significant changes, but it should be noted, that the men had changes in LDL-cholesterol downward direction and all the values were in the range of benchmarks. In the group of female, HDL-cholesterol increased to 2.05 ±0.6 mmol.L-1 after six weeks of consumption from baseline of 1.7 ±0.69 mmol.L-1, and the difference was statistically significant (p <0.05), in the group of male, its level changed first significantly after three days of consumption of steep increase (1.46 ±0.61 mmol.L-1, p <0.05), and for the next six weeks, it was the significantly increase (1.59 ±0.5 mmol.L-1, p <0.01). The glucose concentration did not change significantly in the dynamics of wine consumption among men and women, and all the values were between the limits of the standard.

Relationship Between Alcohol Drinking Pattern and Risk of Proteinuria: The Kansai Healthcare Study

Background

Moderate alcohol consumption has been reported to be associated with a decreased risk of cardiometabolic diseases. Whether drinking pattern is associated with the risk of proteinuria is unknown.

Methods

Study subjects were 9154 non-diabetic Japanese men aged 40–55 years, with an estimated glomerular filtration rate ≥60 mL/min/1.73 m², no proteinuria, and no use of antihypertensive medications at entry. Data on alcohol consumption were obtained by questionnaire. We defined “consecutive proteinuria” as proteinuria detected twice consecutively as 1+ or higher on urine dipstick at annual examinations.

Results

During the 81 147 person-years follow-up period, 385 subjects developed consecutive proteinuria. For subjects who reported drinking 4–7 days per week, alcohol consumption of 0.1–23.0 g ethanol/drinking day was significantly associated with a decreased risk of consecutive proteinuria (hazard ratio [HR] 0.54; 95% confidence interval [CI], 0.36–0.80) compared with non-drinkers. However, alcohol consumption of ≥69.1 g ethanol/drinking day was significantly associated with an increased risk of consecutive proteinuria (HR 1.78; 95% CI, 1.01–3.14). For subjects who reported drinking 1–3 days per week, alcohol consumption of 0.1–23.0 g ethanol/drinking day was associated with a decreased risk of consecutive proteinuria (HR 0.76; 95% CI, 0.51–1.12), and alcohol consumption of ≥69.1 g ethanol/drinking day was associated with an increased risk of consecutive proteinuria (HR 1.58; 95% CI, 0.72–3.46), but these associations did not reach statistical significance.

Conclusions

Men with frequent alcohol consumption of 0.1–23.0 g ethanol/drinking day had the lowest risk of consecutive proteinuria, while those with frequent alcohol consumption of ≥69.1 g ethanol/drinking day had an increased risk of consecutive proteinuria.

Sociodemographic Characteristics and Health Status of Lifetime Abstainers, Ex-Drinkers, Bingers, and Nonbingers Among Baby Boomers and Older Adults

BACKGROUND

Health risks associated with abstention from alcohol drinking in previous studies may have been exaggerated because the pool of abstainers in many studies included both lifetime abstainers and ex-drinkers, including sick-quitters.

OBJECTIVES

This study compared sociodemographic and health statuses among lifetime abstainers, exdrinkers, bingers, and nonbingers in the 50-64 age group (baby boomers) and the 65+ age group.

METHODS

Data are from the 2008 to 2012 National Survey on Drug Use and Health (N = 18,443 for the 50-64 age group and N = 11,191 for the 65+ age group). Descriptive statistics and multinomial and binary logistic regression analyses were used to examine the study questions.

RESULTS

10% of the 50-64 age group and 20% of the 65+ age group reported lifetime abstention, and 21% and 28% of each group, respectively, reported being ex-drinkers (i.e., last used alcohol more than 12 months ago). In both age groups, lifetime abstainers, exdrinkers, and bingers had lower socioeconomic status than nonbingers. In the 50-64 age group, lifetime abstainers did not differ from or were less likely than nonbingers to have vascular and hepatic/gastrointestinal (HGI) disorders, but exdrinkers were more likely to have these diseases, and both lifetime abstainers and exdrinkers were more likely to have diabetes. In the 65+ age group, lifetime abstainers did not differ from nonbingers on high blood pressure, heart disease, and HGI, but both they and the exdrinkers were more likely to have stroke and diabetes.

CONCLUSIONS/IMPORTANCE

Diabetes screening/monitoring and stroke prevention/care are recommended for both age groups of abstainers and exdrinkers.

Alcohol consumption and incidence of type 2 diabetes. Results from the CoLaus study

BACKGROUND AND AIMS

Moderate alcohol consumption has been shown to decrease the risk of type 2 diabetes (T2DM), but whether this association is also valid for impaired fasting glucose (IFG) is less well known. We aimed at assessing the impact of alcohol consumption and of type of alcoholic beverage on the incidence of T2DM and T2DM + IFG.

METHODS AND RESULTS

As many as 4765 participants (2613 women, mean age 51.7 ± 10.5 years) without T2DM at baseline and followed for an average of 5.5 years. The association between alcohol consumption, type of alcoholic beverage and outcomes was assessed after adjustment for a validated T2DM risk score. During follow-up 284 participants developed T2DM and 643 developed IFG. On bivariate analysis, alcohol consumption was positively associated with the risk of developing T2DM or T2DM + IFG. Moderate (14-27 units/week) alcohol consumption tended to be associated with a lower risk of T2DM, but no protective effect was found for T2DM + IFG. Multivariable-adjusted odds ratio (OR) and (95% confidence interval) for T2DM: 0.89 (0.65-1.22), 0.66 (0.42-1.03) and 1.63 (0.93-2.84) for 1-13, 14-27 and 28 + units/week, respectively (p for quadratic trend < 0.005). For T2DM + IFG, the corresponding ORs were 1.09 (0.90-1.32), 1.33 (1.02-1.74) and 1.54 (0.99-2.39), respectively, p for trend = 0.03. No specific effect of alcoholic beverage (wine, beer or spirits) was found for T2DM or for T2DM + IFG.

CONCLUSION

Moderate alcohol consumption is associated with a reduced risk of developing T2DM, but not of developing T2DM + IFG. No specific effect of type of alcoholic beverage was found.

Drinking pattern and risk of chronic kidney disease: the kansai healthcare study

BACKGROUND/AIMS

The association between alcohol consumption and the risk of chronic kidney disease (CKD) has been reported. What is not known is whether drinking pattern combined with the weekly frequency of alcohol consumption and the quantity per drinking day is associated with the risk of CKD.

METHODS

We enrolled 9,112 Japanese nondiabetic men aged 40 to 55 years with absence of proteinuria, an estimated glomerular filtration rate (eGFR) of 60 ml/min/1.73 m(2) or higher, and not on antihypertensive medications at baseline. CKD was defined if eGFR was <60 ml/min/1.73 m(2). The weekly frequency classification was nondrinkers, 1-3 drinking days/week, or 4-7 drinking days/week. The quantity consumed per drinking day was classified as 0.1-23.0 g ethanol/drinking day, 23.1-46.0 g ethanol/drinking day, 46.1-69.0 g ethanol/drinking day, and ≥69.1 g ethanol/drinking day.

RESULTS

During the 79,099 person-years, 1,253 subjects developed CKD. Compared to nondrinkers, those who consumed 23.1-46.0 or 46.1-69.0 g ethanol/drinking day on 4-7 drinking days/week had a decreased risk of CKD (multiple-adjusted hazard ratio (HR) 0.62 (0.52-0.74) and 0.76 (0.59-0.97), respectively). The association between the quantity per drinking day and the incidence of CKD was U-shaped among each category of the weekly frequency. HRs within similar categories of quantity per drinking day were lower in the 4-7 drinking days/week group than in the 1-3 drinking days/week group.

CONCLUSION

Among middle-aged Japanese men, the people who drank middle-range quantity, specifically who drank 4-7 days/week, had lower risk of CKD than nondrinkers.

Effects of alcohol consumption and the metabolic syndrome on 10-year incidence of diabetes: the ATTICA study

AIM

The purpose of this prospective study was to investigate the effect of alcohol consumption on the 10-year diabetes incidence.

METHODS

In 2001-2002, a random sample of 1514 men (18-89 years old) and 1528 women (18-87 years old) was selected to participate in the ATTICA study (Athens metropolitan area, Greece). Among various other characteristics, average daily alcohol intakes (abstention, low, moderate, high) and type of alcoholic drink were evaluated. Diabetes was defined according to American Diabetes Association criteria. During 2011-2012, the 10-year follow-up was performed.

RESULTS

The 10-year incidence of diabetes was 13.4% in men and 12.4% in women. After making various adjustments, those who consumed up to 1 glass/day of alcohol had a 53% lower diabetes risk (RR=0.47; 95% CI: 0.26, 0.83) compared with abstainers, while trend analysis revealed a significant U-shaped relationship between quantity of alcohol drunk and diabetes incidence (P<0.001 for trend). Specific types of drinks were not associated with diabetes incidence; however, a one-unit increase in ratio of wine/beer/vodka vs. other spirits was associated with an 89% lower risk of diabetes (RR=0.11; 95% CI: 0.02, 0.67). The protective effect of low alcohol consumption on diabetes incidence was more prominent among individuals with stricter adherence to the Mediterranean diet (RR=0.08; 95% CI: 0.011, 0.70) and without the metabolic syndrome (RR=0.34; 95% CI: 0.16, 0.70).

CONCLUSION

This work revealed the protective effect of modest alcohol consumption of particularly wine and beer against the long-term incidence of diabetes, possibly due to their pleiotropic health effects.

Incidence of type 2 diabetes in Japan: a systematic review and meta-analysis

BACKGROUND

The definition of incident type 2 diabetes varies across studies; hence, the actual incidence of type 2 diabetes in Japan is unclear. Here, we reviewed the various definitions of incident type 2 diabetes used in previous epidemiologic studies and estimated the diabetes incidence rate in Japan.

METHODS

We searched for related literature in the MEDLINE, EMBASE, and Ichushi databases through September 2012. Two reviewers selected studies that evaluated incident type 2 diabetes in the Japanese population.

RESULTS

From 1824 relevant articles, we included 33 studies with 386,803 participants. The follow-up period ranged from 2.3 to 14 years and the studies were initiated between 1980 and 2003. The random-effects model indicated that the pooled incidence rate of diabetes was 8.8 (95% confidence interval, 7.4-10.4) per 1000 person-years. We observed a high degree of heterogeneity in the results (I(2) = 99.2%; p < 0.001), with incidence rates ranging from 2.3 to 52.6 per 1000 person-years. Three studies based their definition of incident type 2 diabetes on self-reports only, 10 on laboratory data only, and 20 on self-reports and laboratory data. Compared with studies defining diabetes using laboratory data (n = 30; pooled incidence rate = 9.6; 95% confidence interval = 8.3-11.1), studies based on self-reports alone tended to show a lower incidence rate (n = 3; pooled incidence rate = 4.0; 95% confidence interval = 3.2-5.0; p for interaction < 0.001). However, stratified analyses could not entirely explain the heterogeneity in the results.

CONCLUSIONS

Our systematic review and meta-analysis indicated the presence of a high degree of heterogeneity, which suggests that there is a considerable amount of uncertainty regarding the incidence of type 2 diabetes in Japan. They also suggested that laboratory data may be important for the accurate estimation of the incidence of type 2 diabetes.

Role of alcohol drinking pattern in type 2 diabetes in Japanese men: the Toranomon Hospital Health Management Center Study 11 (TOPICS 11)

BACKGROUND

Findings of past studies on the effect of drinking patterns on diabetes risk have been inconsistent.

OBJECTIVE

We aimed to investigate the role of drinking frequency and usual quantity consumed in the development of type 2 diabetes.

DESIGN

Enrolled were 1650 Japanese men without diabetes (diabetes: fasting plasma glucose ≥7.0 mmol/L, glycated hemoglobin ≥6.5%, or self-reported clinician-diagnosed diabetes). Average alcohol consumption and 12 combinations of frequency and usual quantity per drinking occasion were assessed at the baseline examination. The absolute risk and HR for the development of diabetes were calculated.

RESULTS

During a mean follow-up period of 10.2 y, 216 individuals developed diabetes. Lifetime abstainers (n = 153) had a relatively low incidence of diabetes (9.1/1000 person-years), similar to moderate consumers (99-160 g ethanol/wk; 9.0/1000 person-years). Increasingly higher quantities of alcohol usually consumed per occasion increased the risk of diabetes regardless of drinking frequency. The lowest incidence rate of diabetes (8.5/1000 person-years) was associated with the consumption of <1 drink (<23 g ethanol) per occasion over ≥6 times/wk. Binge drinking (≥3 drinks per occasion) significantly increased the risk of future diabetes regardless of frequency (HR: 1.79; 95% CI: 1.17, 2.74) compared with <1 drink per occasion.

CONCLUSIONS

Among current drinkers, a drinking pattern of <1 drink per occasion regularly over 6 times within a week was associated with the lowest risk of developing diabetes. Usual quantity per drinking occasion was a more important determinant than was weekly drinking frequency in the association between alcohol consumption and risk of diabetes in Japanese men.

Dietary patterns and odds of Type 2 diabetes in Beirut, Lebanon: a case-control study

Background

In Lebanon, Type 2 diabetes (T2D) has a major public health impact through high disease prevalence, significant downstream pathophysiologic effects, and enormous financial liabilities. Diet is an important environmental factor in the development and prevention of T2D. Dietary patterns may exert greater effects on health than individual foods, nutrients, or food groups. The objective of this study is to examine the association between dietary patterns and the odds of T2D among Lebanese adults.

Methods

Fifty-eight recently diagnosed cases of T2D and 116 population-based age, sex, and place of residence matched control participants were interviewed. Data collection included a standard socio-demographic and lifestyle questionnaire. Dietary intake was evaluated by a semi-quantitative 97-item food frequency questionnaire. Anthropometric measurements including weight, height, waist circumference, and percent body fat were also obtained. Dietary patterns were identified by factor analysis. Multivariate logistic regression analysis was used to evaluate the associations of extracted patterns with T2D. Pearson correlations between these patterns and obesity markers, energy, and nutrient intakes were also examined.

Results

Four dietary patterns were identified: Refined Grains & Desserts, Traditional Lebanese, Fast Food and Meat & Alcohol. While scores of the “Refined Grains & Desserts” had the highest correlations with energy (r = 0.74) and carbohydrates (r = 0.22), those of the “Fast Food” had the highest correlation with fat intake (r = 0.34). After adjustment for socio-demographic and lifestyle characteristics, scores of the Refined Grains & Desserts and Fast Food patterns were associated with higher odds of T2D (OR: 3.85, CI: 1.13-11.23 and OR: 2.80, CI: 1.14-5.59; respectively) and scores of the Traditional Lebanese pattern were inversely associated with the odds of T2D (OR: 0.46, CI: 0.22-0.97).

Conclusions

The findings of this study demonstrate direct associations of the Refined Grains & Desserts and Fast Food patterns with T2D and an inverse association between the Traditional Lebanese pattern and the disease among Lebanese adults. These results may guide the development of nutrition interventions for the prevention and management of T2D among Lebanese adults.

Dietary patterns are associated with insulin resistance in Chinese adults without known diabetes

The aim of the present study was to examine the association between dietary patterns and insulin resistance in Chinese adults without known diabetes. Study subjects were 1070 Chinese adults aged 18 years and above in Jiangsu Province who participated in the 2006 wave of the China Health and Nutrition Survey. Usual dietary intake was assessed by using a validated FFQ. Dietary patterns were identified by factor analysis using a principal component analysis method. Insulin resistance was defined as the highest quartile of the homeostasis model assessment of insulin resistance (HOMA-IR) scores. We derived four dietary patterns in our population by factor analysis: the Western, High-wheat, Traditional and Hedonic pattern. After adjusted for potential confounders, the Western pattern was significantly associated with greater odds for insulin resistance (P for trend = 0·009), while a significant negative association was found between the Hedonic pattern and insulin resistance (P for trend = 0·035). Compared with the lowest quartile of the Western pattern, the highest quartile had higher odds of insulin resistance (adjusted OR 1·89, 95 % CI 1·12, 3·19). There was a 42 % decrease in the odds after adjustment for all covariates in the highest quartile of the Hedonic pattern, compared with the lowest quartile (adjusted OR 0·58, 95 % CI 0·34, 0·99). HOMA-IR levels as a continuous variable also increased across the quartiles of the Western pattern and decreased across the quartiles of the Hedonic pattern. In conclusion, dietary patterns were significantly associated with insulin resistance in Chinese adults without known diabetes.