, Volume 62, Issue 5, pp 770–778 | Cite as

Alcohol consumption and incident diabetes: The Atherosclerosis Risk in Communities (ARIC) study

  • Xintong He
  • Casey M. Rebholz
  • Natalie Daya
  • Mariana Lazo
  • Elizabeth SelvinEmail author



The aim of this study was to evaluate the prospective association between baseline and 9 year change in alcohol consumption and long-term risk of diabetes and whether these associations might be modified by sex and/or BMI.


We conducted a prospective analysis of 12,042 Atherosclerosis Risk in Communities (ARIC) study participants without prevalent diabetes (55% women, 78% white, mean age 54 years). Alcohol consumption was assessed at visit 1 (1987–1989) and visit 4 (1996–1998). We used Cox models to estimate hazard ratios for diabetes risk by baseline drinking categories and change in alcohol consumption, stratified by sex and obesity status.


During a median follow-up of 21 years, there were 3795 incident cases of diabetes. Among women, consuming 8–14 drinks/week was associated with a significantly lower risk of diabetes (HR 0.75, 95% CI 0.58, 0.96) compared with current drinkers consuming ≤1 drink/week. Among men, consuming 8–14 drinks/week was associated with a borderline significant lower risk of diabetes (HR 0.84, 95% CI 0.70, 1.00) and consuming >14 drinks/week was associated with a significantly lower risk of diabetes (HR 0.81, 95% CI 0.67, 0.97) (pinteraction < 0.01 for sex). For both sexes, among current drinkers, there was a significant decreasing trend in diabetes risk as the alcohol consumption increased. The association was modified by BMI (pinteraction = 0.042 for women, pinteraction < 0.001 for men). In women, the inverse association was only seen among overweight and obese participants. In men, the inverse association was more pronounced among obese participants. On average, drinking status did not change substantially over the 9 year period. For men with alcohol intake ≥7 drinks/week at baseline, decreasing alcohol intake was associated with higher risk of diabetes (HR per daily drink decrease 1.12, 95% CI 1.02, 1.23).


In this community-based population, there was an inverse association between alcohol consumption and diabetes risk. The amount of the alcohol consumption associated with lower risk was different in women and men, and the association was more pronounced among participants with higher BMI.


Alcohol Diabetes 



Atherosclerosis Risk in Communities



The authors thank the staff and participants of the ARIC study for their important contributions. The manuscript has undergone internal review and approval by the ARIC Publications Committee and ARIC Steering Committee.

Contribution statement

All the authors have made substantial contributions to conception and design, acquisition of data or analysis and interpretation of data. All the authors have contributed to drafting the article or revising it critically for important intellectual content, and have given final approval for the version to be published. XH is the guarantor of this work.


The ARIC study has been funded in whole or in part with Federal funds from the National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services, under Contract nos (HHSN268201700001I, HHSN268201700003I, HHSN268201700005I, HHSN268201700004I, HHSN268201700002I). ES was supported by NIH/NIDDK grants K24DK106414 and R01DK089174. CMR is supported by a Mentored Research Scientist Development Award from the National Institute of Diabetes and Digestive and Kidney Diseases (K01 DK107782). ML was supported by NIH/NIDDK grant R01DK089174.

Duality of interest

ML was formerly a clinical site principal investigator of the Moderate Alcohol and Cardiovascular Health Trial (U10AA025286 from the National Institutes of Health) which received partial support from industry contributions to the Foundation for NIH. All other authors declare that they have no duality of interest associated with this manuscript.

Supplementary material

125_2019_4833_MOESM1_ESM.pdf (246 kb)
ESM (PDF 245 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Xintong He
    • 1
  • Casey M. Rebholz
    • 1
  • Natalie Daya
    • 1
  • Mariana Lazo
    • 1
    • 2
  • Elizabeth Selvin
    • 1
    • 2
    Email author
  1. 1.Department of EpidemiologyJohns Hopkins Bloomberg School of Public Health, Welch Center for Prevention, Epidemiology, and Clinical ResearchBaltimoreUSA
  2. 2.Division of General Internal MedicineSchool of Medicine, Johns Hopkins UniversityBaltimoreUSA

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