The Effect of Alcohol Intake on Insulin Sensitivity in Men

Abstract

OBJECTIVE -Population data suggest that alcohol consumption may influence the risk of diabetes in a biphasic manner, but this has not been tested by any controlled interventions. The object of this study was to determine whether reducing alcohol intake in moderate-to-heavy drinkers (40 -110 g/day) results in improvement in insulin sensitivity. RESEARCH DESIGN AND METHODS-A 4-week run-in period where subjects maintained their usual drinking pattern was followed by randomization to a two-way cross-over intervention study. In each of two 4-week treatment interventions, subjects either substituted their usual alcohol intake with a 0.9% alcohol beer or maintained their usual alcohol intake. At the end of each 4-week period, insulin sensitivity as determined by the low-dose insulin glucose infusion test and the homeostasis model assessment (HOMA) score, and biomarkers of alcohol consumption (␥-glutamyl transpeptidase [␥-GT] and HDL cholesterol) were measured.RESULTS -A total of 16 healthy men aged 51.0 Ϯ 2.7 (mean Ϯ SEM) years with a BMI of 26.4 Ϯ 0.61 kg/m 2 completed the study. There was a large reduction in alcohol intake (72.4 Ϯ 5.0 vs. 7.9 Ϯ 1.6 g/day, P Ͻ 0.001) and significant reductions in ␥-GT (geometric mean .2], P Ͻ 0.01) and HDL cholesterol (1.36 Ϯ 0.07 vs. 1.13 Ϯ 0.07 mmol/l, P Ͻ 0.001). There was no effect of alcohol on insulin sensitivity index (ISI), fasting insulin, glucose, or HOMA score.CONCLUSIONS -A substantial reduction in alcohol intake from 7.2 to 0.8 standard drinks per day in healthy men did not change insulin sensitivity as measured by ISI or HOMA score. Diabetes Care 26:608 -612, 2003P resently, it is difficult to simply define overall effects of alcohol on the insulin-glucose axis. Acutely, alcohol impairs insulin sensitivity in shortterm experiments using insulin-glucose clamp techniques (1-5). In contrast, evidence from cross-sectional populationbased studies suggests an association between chronic alcohol exposure and improvement in insulin sensitivity (6), but such studies are rendered inherently weak by the potential for confounding by other variables affecting insulin sensitivity, especially adiposity (7-10). Although there have been no prospective studies evaluating the effect of long-term alcohol use on insulin sensitivity, per se, there have been a number of studies investigating whether there is any association between alcohol use at baseline and subsequent incidence of type 2 diabetes. Many of these studies found that light (ϳ3-18 g/day) (11-13) to moderate (18 -49 g/day) (14 -16) alcohol use was associated with a reduced risk for the development of diabetes. Two of these studies (11,13) were hampered due to the very limited number of subjects with moderate to heavy intake (i.e., Ͼ20 g/day, equivalent to more than two standard drinks per day). In the prospective Rancho Bernardo Study (17), the upper tertile of drinkers consumed Ͼ25 g alcohol/day, whereas in the Atherosclerosis Risk in Communities (ARIC) Study (18), Ͼ8% of the male population consumed Ͼ36 g alcohol/day. Data from...

Alcohol consumption promotes insulin sensitivity without affecting body fat levels

“…5 Studies by other researchers show a negative association between insulin resistance and alcohol consumption. 11,20,[30][31][32][33] For example, studies by Kang et al 34 and…”

“…31,34 In their studies, however, rats consumed an ethanol-containing liquid diet, which contained high levels of fat. 32,34 Our results (Figure 3a) and those of others 19,35 show that a HFdiet can induce insulin resistance.…”

Long-term ethanol exposure inhibits glucose transporter 4 expression via an AMPK-dependent pathway in adipocytes

“…Epidemiological studies suggest that chronic light or heavy ethanol consumption leads to insulin resistance, whereas moderate ethanol consumption results in increased insulin sensitivity [37][38][39][40][41] . In the present study, we found that long-term high-dose ethanol consumption led to insulin resistance in rats, which was consistent with previous studies.…”

Effect of moderate alcohol consumption on adipokines and insulin sensitivity in lean and overweight men: a diet intervention study

“…Positive associations between alcohol consumption and insulin sensitivity are consistently reported in crosssectional studies (Kiechl et al, 1996;Bell et al, 2000), but randomized controlled studies report contradictory results (Cordain et al, 1997;Cordain et al, 2000;Davies et al, 2002;Zilkens et al, 2003;Beulens et al, 2006). Sierksma et al (2004) suggested that an increase of adiponectin could precede changes of insulin sensitivity with moderate alcohol consumption.…”