Could drinking wine with meals reduce T2D risk?

Individuals who consume a moderate amount of wine with meals may have a reduced risk of new-onset type 2 diabetes (T2D), according to a study presented at the EPI Lifestyle Scientific Sessions 2022.

The population comprised 312,388 healthy individuals (average age 56 years, 95 percent White) without T2D who were enrolled in the UK Biobank and acknowledged current moderate alcohol consumption (≤14 g or ~150 mL/day [one glass] for women and ≤28 g or ~300 mL/day [two glasses] for men). Individuals with cardiovascular disease or cancer at baseline were excluded as were those who reduced their alcohol consumption due to physician recommendation, illness, or pregnancy.

A total of 8,598 cases of incident T2D were documented over a median 10.9 years of follow-up.

Consumption of alcohol with meals was tied to a 14 percent reduction in the risk of T2D compared with consumption of alcohol without meals (hazard ratio, 0.86, 95 percent confidence interval, 0.81–0.91). [EPI Lifestyle 2022, presentation 044]

The timing of alcohol consumption with meals modified the association between amount consumed and T2D risk (p_interaction=0.010).

“[T]he beneficial association of moderate drinking with T2D risk was only observed in participants who consumed alcohol with meals, but not in others,” said the authors.

In analysis according to type of alcohol (wine, beer, liquor), the benefits of alcohol consumption with meals were primarily attributed to consumption of wine compared with other alcohol types. Conversely, a higher intake of beer or liquor was associated with an increased risk of T2D.

“The effects of alcohol consumption on health have been described as a double-edged sword because of its apparent abilities to cut deeply in either direction – harmful or helpful, depending on how it is consumed,” said study author Hao Ma, PhD, a biostatistical analyst at the Tulane University Obesity Research Center in New Orleans, Louisiana, US.

“Clinical trials have … found that moderate drinking may have some health benefits, including on glucose metabolism,” Ma continued. “However, it remains unclear whether glucose metabolism benefits translate into a reduction of T2D.”

“In our study, we sought to determine if the association between alcohol intake and risk of T2D might differ by the timing of alcohol intake with respect to meals,” he said.

“The message from this study is that drinking moderate amounts of wine with meals may prevent T2D if you do not have another health condition that may be negatively affected by moderate alcohol consumption and in consultation with your doctor,” Ma pointed out.

Due to the particular benefit noted with wine compared with other alcoholic beverages, other ingredients in the beverages, as opposed to alcohol, may be the contributing factor, suggested Professor Robert Eckel, professor of medicine emeritus at the University of Colorado Anschutz Medical Campus, Aurora, Colorado, US, who was not affiliated with the study.

“Despite the findings of this robust analysis of healthy drinkers, the relationship between alcohol consumption and new-onset T2D remains quite controversial. These data, however, do suggest that it’s not the alcohol with meals, but other ingredients in wine, perhaps antioxidants, that may be the factor in reducing the incidence of T2D,” he said. He also suggested examining if the benefits were different with red or white wine consumption.

The authors cautioned that these findings only applied to moderate consumption of alcohol and acknowledged that the majority White population may limit generalizability of the findings to other populations. The American Heart Association recommends that adults who do not drink alcohol should not start.