A Drink or Two Is Probably OK

Summarized by Robert W. Griffith, MD
March 24, 2005

Introduction

"Light to moderate alcohol consumption" is known to be linked to decreased deaths from heart disease and a lessened frequency of type 2 diabetes. The metabolic syndrome is a cluster of test results that describe a group of people at an increased risk of these two conditions. So it's not surprising that investigators have tackled the question of whether alcohol intake influences the occurrence of the metabolic syndrome. A study of this question is reported in the journal Diabetes Care, and is summarized here.

What was done

Data from the Third National Health and Nutrition Examination Survey (NHANES III) were analyzed to detect participants with the metabolic syndrome. The syndrome was defined as the presence of at least 3 of the following:

• Abdominal obesity - waist circumference greater than 102 cm (40 inches) in men, or 88 cm (35 inches) in women
• Blood triglyceride level 150 mg/dL or above (1.69 mmol/L or above)
• HDL-cholesterol 40 mg/dL (1.03 mmol/L) or below in men, or 50 mg/dL (1.29 mmol/L) or below in women.
• High blood pressure - 130/85 mm Hg or higher, or taking blood pressure medication
• High fasting glucose level - 110 mg/dL (6.1 mmol/L) or above, or taking anti-diabetic medication

(If you want to see if you may have the metabolic syndrome, go to the first link below.) In addition, fasting insulin was measured; it was considered abnormal if it was over 166 pmol/L.

The number of drinks consumed, and the type (beer, wine, or hard liquor), were also analyzed. Consumption was classified as less than 1 drink a month, 1-19 drinks a month, or 20 or more drinks a month.

Further data collected included age, gender, ethnicity, educational level, income, smoking habit, physical activity, and diet.

What the analyses showed

There were 8,125 subjects in the analysis; their average age was 44, and 51% of them were women. Over half (58%) were current drinkers, with more men (66%) than women (50%). Over one in 5 of them had the metabolic syndrome - 22% in men and 23% in women.

Adjustments were made for age, gender, ethnicity, and the other factors listed above, to avoid any possible bias being introduced. After this step, analyses showed that those who consumed low amounts of alcohol (1-19 drinks/month) had a 35% reduction in the chance of having the metabolic syndrome. Those who drank a moderate amount (20 or more drinks/month) had a 66% reduction in the chance of having the syndrome.

These findings were similar in different ethnic groups, except for being more pronounced in white men and women - reductions of 65% and 78%, respectively. The effect was clear cut with both beer and wine, but was not seen with liquor consumption.

In addition to the association with the metabolic syndrome, low and moderate alcohol intake was linked to a higher HDL ('good') cholesterol, lower triglycerides, a lesser waist circumference, and lessened occurrence of elevated fasting insulin.

What this means

The findings are not really surprising, but they do help confirm the health benefits of a low or moderate alcohol intake. By low or moderate we mean 1 drink a day for women, and 2 drinks a day for men. (The different amount for men and women is related to different average size and body weights, which affect the metabolism of alcohol; it's not just plain 'sexism'.) We haven't reached the point where we want to recommend alcohol for everyone. If you don't drink, don't start just because you've read this or other studies. The risks of alcohol are still considerable!

Source

• Alcohol consumption and the prevalence of the metabolic syndrome in the U.S. MS. Freiberg, HJ. Cabral, TC. Heeren,  et al., Diabetes Care, 2004, vol. 27, pp. 2954--2959

Related Links
Tool: Do You Have the Metabolic Syndrome?
Regular Alcohol Intake Cuts the Heart Attack Risk
Your Waistline Can Tell You a Lot About Your Health Risk

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