title: Moderate alcohol consumption lowers the risk of type 2 diabetes: a meta-analysis of prospective observational studies.
abstract: OBJECTIVE
  This meta-analysis was undertaken to obtain insight regarding the shape and strength of the relationship between alcohol consumption and the risk of type 2 diabetes, the effects of adjustment for confounders, and the effect of modification by type 2 diabetes definition, sex, and BMI.
  
  
  METHODS
  The 15 original prospective cohort studies that were included comprise 11,959 incident cases of type 2 diabetes in 369,862 individuals who, on average, were followed for 12 years.
  
  
  RESULTS
  After pooling the data, a U-shaped relationship was found. Compared with nonconsumers, the relative risk (RR) for type 2 diabetes in those who consumed </=6 g/day alcohol was 0.87 (95% CI 0.79-0.95). For the moderate consumption ranges of 6-12, 12-24, and 24-48 g/day, RRs of 0.70 (0.61-0.79), 0.69 (0.58-0.81), and 0.72 (0.62-0.84) were found, respectively. The risk of type 2 diabetes in heavy drinkers (>/=48 g/day) was equal to that in nonconsumers (1.04 [0.84-1.29]). In general, nonsignificant trends for larger RR reduction associated with moderate alcohol consumption were observed for women compared with men, for crude compared with multivariate-adjusted analyses, and for studies that used self-reports instead of testing for type 2 diabetes definition. No differences in RR reductions were found between individuals with low or high BMI.
  
  
  CONCLUSIONS
  The present evidence from observational studies suggests an approximately 30% reduced risk of type 2 diabetes in moderate alcohol consumers, whereas no risk reduction is observed in consumers of >/=48 g/day.
authors.affiliation: Institute for Research in Extramural Medicine, VU University Medical Center, EMGO Institute, Van der Boechorststraat 7, 1081 BT Amsterdam, Netherlands. l.koppes@vumc.nl
authors.forename: Lando L J
authors.initials: LL
authors.lastname: Koppes
authors.forename: Jacqueline M
authors.initials: JM
authors.lastname: Dekker
authors.forename: Henk F J
authors.initials: HF
authors.lastname: Hendriks
authors.forename: Lex M
authors.initials: LM
authors.lastname: Bouter
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Heine
mesh_terms: D000428:Alcohol Drinking; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000517:prevention & control*; D006801:Humans; D015995:Prevalence; D012307:Risk Factors