• BeulensJ W JJWUniversity Medical Center, Utrecht, The Netherlands., Y T van der Schouw, M M Bergmann, S Rohrmann, M B Schulze, B Buijsse, D E Grobbee, L Arriola, S Cauchi, M-J Tormo, N E Allen, D L van der A, B Balkau, H Boeing, F Clavel-Chapelon, B de Lauzon-Guillan, P Franks, P Froguel, C Gonzales, J Halkjaer, J M Huerta, R Kaaks, T J Key, K T Khaw, V Krogh, E Molina-Montes, P Nilsson, K Overvad, D Palli, S Panico, Ramón QuirósJJ, O Rolandsson, O Ronaldsson, I Romieu, D Romaguera, C Sacerdote, M-J Sánchez, A M W Spijkerman, B Teucher, A Tjonneland, R Tumino, S Sharp, N G Forouhi, C Langenberg, E J M Feskens, E Riboli, N J Wareham, and InterAct Consortium.
• University Medical Center, Utrecht, The Netherlands.
• J. Intern. Med. 2012 Oct 1; 272 (4): 358-70.

ObjectiveTo 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.DesignMulticentre prospective case-cohort study.SettingEight countries from the European Prospective Investigation into Cancer and Nutrition cohort.SubjectsA representative baseline sample of 16 154 participants and 12 403 incident cases of type 2 diabetes.InterventionsAlcohol consumption assessed using validated dietary questionnaires.Main Outcome MeasuresOccurrence of type 2 diabetes based on multiple sources (mainly self-reports), verified against medical information.ResultsAmongst 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 0.1-6.0 g day(-1) , adjusted for dietary and diabetes risk factors. However, the lowest risk was observed at higher intakes of 24.1-96.0 g day(-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 6.1-12.0 g day(-1) (P interaction gender <0.01). The inverse association between alcohol consumption and diabetes was more pronounced amongst overweight (BMI ≥ 25 kg m(-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 6.1-12.0 g day(-1) ). Wine consumption for men and fortified wine consumption for women were most strongly associated with a reduced risk of diabetes.ConclusionsThe 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.

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