Wine, Women, and ... Improved Glucose Tolerance?
June 30, 2002 3 minutes read
Wine, Women, and ... Improved Glucose Tolerance?
Abstract & Commentary
Synopsis: Two drinks per day (30 g) of alcohol improved insulin and triglyceride concentrations and insulin sensitivity in healthy postmenopausal women.
Source: Davies MJ, et al. JAMA. 2002;287:2559-2562.
This was a well-controlled, prospective study of 63 healthy postmenopausal women. Participants consumed 0, 15, or 30 g/dL of alcohol (ethanol dissolved in orange juice) for 8 weeks in a randomized, blinded, crossover design. Diet and fluid intake were rather rigorously controlled. Measurements included glucose, insulin concentrations, triglyceride concentrations, and corrected insulin sensitivity. Davies and colleagues controlled for body mass index (BMI), caloric intake, and overall nutritional intake. The diet prescribed was 54% carbohydrates (and alcohol, if applicable), 32% fat, and 14% protein. Weight remained stable throughout the testing period.
Data were reported for 51 women. The "high-dose" alcohol condition (30 g/dL or 2 drinks/d) resulted in significant improvement in fasting insulin (reduced by 19.2%; P = 0.004), insulin sensitivity (increased by 7.2%; P = 0.002), and triglyceride levels (reduced by 10.3%; P = 0.001) compared with 8 weeks of no alcohol consumption. The changes in these measures with "low-dose" alcohol (15 g/dL) were not significant except for triglyceride levels, which were reduced by 7.8% (P = 0.03). Serum glucose did not change significantly compared with no alcohol intake for either alcohol consumption condition. Findings were consistent for all BMI strata (eg, were independent of BMI).
Comment by Barbara A. Phillips, MD, MSPH
Previous studies have documented that moderate alcohol intake is associated with reduced risk of type 2 diabetes, reduced serum insulin concentration, and improved insulin sensitivity,1-3 but this is the first study to demonstrate reduced fasting insulin concentrations in postmenopausal women.
So, what do you say to your menopausal or post-menopausal patient about alcohol consumption, diabetes, and diet? This study suggests that her lipid profile and insulin sensitivity may fare better if she drinks at least 30 g/dL alcohol a day. Further, moderate alcohol intake has a cardioprotective effect.4,5
In their discussion, however, Davies et al point out that data from this same cohort have previously demonstrated that 1-2 drinks a day result in increased serum levels of dehydroepiandrosterone sulfate and estrone sulfate compared with placebo.6 These steroid hormones may increase the risk of breast cancer.7 Many women have an unreasoning fear of breast cancer, which is misguided, since heart disease (and lung cancer, for that matter) kill far greater percentages of women. A discussion about the risks and benefits of moderate alcohol intake might include some reality testing about relative likelihood (and modifiability of risk factors) for heart disease, lung cancer, and breast cancer.
Dr. Phillips, Professor of Medicine, University of Kentucky; Director, Sleep Disorders Center, Samaritan Hospital, Lexington, KY, is Associate Editor of Internal Medicine Alert.
References
1. Stampfer MJ, et al. Am J Epidemiol. 1988;128:549-558.
2. Lazarus R, et al. Am J Epidemiol. 1997;145:909-916.
3. Flanagan DE, et al. Eur J Clin Invest. 2000;30:297-301.
4. Wollin SD, Jones PJH. J Nutr. 2001;131:1401-1404.
5. Stern MP. Ann Intern Med. 1996;124(1 Pt 2):110-116.
6. Hankinson SE, et al. J Natl Cancer Inst. 1998;90: 1292-1299.
7. Dorgan JF, et al. J Natl Cancer Inst. 2001;93:710-715.
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content