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Umed A. Ajani, MBBS, MPH; Charles H. Hennekens, MD, DrPH; Angela Spelsberg, MD, SM; JoAnn E. Manson, MD, DrPH

Arch Intern Med. 2000;160:1025-1030.

Objective  To examine the association between low to moderate alcohol consumption and the incidence of type 2 diabetes mellitus (DM) in men.

Design  Prospective cohort study.

Subjects and Methods  Over an average period of 12.1 years, we evaluated 20,951 participants in the Physicians' Health Study between ages 40 and 84 years who were free of cardiovascular disease, cancer, and diabetes and provided data on alcohol consumption at baseline.

Main Outcome Measure  Type 2 DM diagnosed after randomization.

Results  Among 20,951 physicians, 766 cases of incident DM were reported over an average follow-up period of 12.1 years. After adjustment for age, randomized treatment assignment, smoking, physical activity, and body mass index, the relative risk estimates and 95% confidence intervals for those reporting alcohol use of rarely/never, 1 to 3 drinks per month, 1 drink per week, 2 to 4 drinks per week, 5 to 6 drinks per week, and 1 or more drinks per day were 1.00 (referent), 1.03 (0.80-1.33), 0.89 (0.70-1.14), 0.74 (0.59-0.93), 0.67 (0.51-0.89), and 0.57 (0.45-0.73), respectively (linear trend, P<.001). Additional adjustment for baseline history of hypertension, high cholesterol level, or parental history of myocardial infarction or family history of diabetes (data collected at 9 years) did not materially alter the results. These associations persisted in analyses stratified by age, smoking status, body mass index, physical activity, and family history of DM.

Conclusion  These data indicate that apparently healthy men who self-select for light to moderate alcohol consumption have a decreased subsequent risk of type 2 DM.

From the Division of Preventive Medicine, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital (Drs Ajani, Hennekens, and Manson), and the Department of Epidemiology, Harvard School of Public Health (Drs Spelsberg, Hennekens, and Manson), Boston, Mass. Dr Hennekens is currently with the University of Miami School of Medicine, Miami, Fla. Dr Spelsberg is currently with University Hospital Aachen, Aachen, Germany.

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