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Moderate alcohol consumption, types of beverages and drinking pattern with cardiometabolic biomarkers in three cohorts of US men and women

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Abstract

Underlying mechanisms of the inverse relationship between moderate alcohol consumption and cardiometabolic disorders are unclear. Modification by types of alcoholic beverages consumed and drinking pattern remains understudied. We aimed to provide insight into the mechanisms by examining 14 insulinemic/glycemic, inflammatory and lipid markers. We used cross-sectional data from 15,436 women in the Nurses’ Health Study, 19,318 women in the Nurses’ Health Study II, and 6872 men in the Health Professionals Follow-up Study. Multivariable linear regression was used to estimate the percentage differences in biomarker concentrations according to alcohol intakes. The average alcohol intake in the combined cohort was 3.3 servings/week. We found a 1 serving/d increment in alcohol intake (14 g ethanol, 44 ml liquor or 355 ml beer or 118 ml wine per day) was associated with a 0.6% lower level of HbA1c, 1.7–3.6% lower proinflammatory markers and 4.2% higher adiponectin, as well as 7.1% higher HDL-cholesterol and 2.1% lower triglyceride with a significant linear trend. Wine, especially red wine, was associated with lower inflammation in particular. Beer had weaker favorable to null associations with blood lipids and adiponectin. Liquor was associated with higher C-peptide and interleukin-6, yet equally associated with lower HbA1c and higher HDL-cholesterol as other beverages. Drinking 3 days or more per week was related to a better biomarker profile than nonregular drinking independent of intake levels. Drinking appeared to have similar associations irrespective whether done with meals or not. Our data indicated moderate alcohol intake, especially if consumed from wine and done regularly, was associated with favorable profiles of insulinemic/glycemic and inflammatory markers and blood lipids.

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References

  1. U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020–2025. 9th Edition. December 2020. Available at DietaryGuidelines.gov.

  2. Hoek AG, van Oort S, Mukamal KJ, Beulens JWJ. Alcohol Consumption and Cardiovascular Disease Risk: placing New Data in Context. Curr Atheroscler Rep. 2022;24(1):51–9. https://doi.org/10.1007/s11883-022-00992-1.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Brien SE, Ronksley PE, Turner BJ, Mukamal KJ, Ghali WA. Effect of alcohol consumption on biological markers associated with risk of coronary heart disease: systematic review and meta-analysis of interventional studies. BMJ. 2011;342:d636. https://doi.org/10.1136/bmj.d636.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Schrieks IC, Heil AL, Hendriks HF, Mukamal KJ, Beulens JW. The effect of alcohol consumption on insulin sensitivity and glycemic status: a systematic review and meta-analysis of intervention studies. Diabetes Care. 2015;38(4):723–32. https://doi.org/10.2337/dc14-1556.

    Article  CAS  PubMed  Google Scholar 

  5. Costanzo S, Di Castelnuovo A, Donati MB, Iacoviello L, de Gaetano G. Wine, beer or spirit drinking in relation to fatal and non-fatal cardiovascular events: a meta-analysis. Eur J Epidemiol. 2011;26(11):833–50. https://doi.org/10.1007/s10654-011-9631-0.

    Article  PubMed  Google Scholar 

  6. Estruch R, Sacanella E, Badia E, et al. Different effects of red wine and gin consumption on inflammatory biomarkers of atherosclerosis: a prospective randomized crossover trial. Effects of wine on inflammatory markers. Atherosclerosis. 2004;175(1):117–23. https://doi.org/10.1016/j.atherosclerosis.2004.03.006.

    Article  CAS  PubMed  Google Scholar 

  7. Ma H, Li X, Zhou T et al. Alcohol Consumption Levels as Compared With Drinking Habits in Predicting All-Cause Mortality and Cause-Specific Mortality in Current Drinkers. Mayo Clin Proc. 2021;96(7):1758-69. https://doi.org/10.1016/j.mayocp.2021.02.011.

  8. Rimm EB, Klatsky A, Grobbee D, Stampfer MJ. Review of moderate alcohol consumption and reduced risk of coronary heart disease: is the effect due to beer, wine, or spirits. BMJ. 1996;312(7033):731–6. https://doi.org/10.1136/bmj.312.7033.731.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Pai JK, Hankinson SE, Thadhani R, Rifai N, Pischon T, Rimm EB. Moderate alcohol consumption and lower levels of inflammatory markers in US men and women. Atherosclerosis. 2006;186(1):113–20. https://doi.org/10.1016/j.atherosclerosis.2005.06.037.

    Article  CAS  PubMed  Google Scholar 

  10. Shai I, Rimm EB, Schulze MB, Rifai N, Stampfer MJ, Hu FB. Moderate alcohol intake and markers of inflammation and endothelial dysfunction among diabetic men. Diabetologia. 2004;47(10):1760–7. https://doi.org/10.1007/s00125-004-1526-0.

    Article  CAS  PubMed  Google Scholar 

  11. Bao Y, Bertoia ML, Lenart EB, et al. Origin, methods, and evolution of the three Nurses’ Health Studies. Am J Public Health. 2016;106(9):1573–81. https://doi.org/10.2105/ajph.2016.303338.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Rimm EB, Giovannucci EL, Willett WC, et al. Prospective study of alcohol consumption and risk of coronary disease in men. Lancet (London England). 1991;338(8765):464–8. https://doi.org/10.1016/0140-6736(91)90542-w.

    Article  CAS  PubMed  Google Scholar 

  13. Hunter DJ, Hankinson SE, Hough H, et al. A prospective study of NAT2 acetylation genotype, cigarette smoking, and risk of breast cancer. Carcinogenesis. 1997;18(11):2127–32. https://doi.org/10.1093/carcin/18.11.2127.

    Article  CAS  PubMed  Google Scholar 

  14. Willett WC, Sampson L, Stampfer MJ, et al. Reproducibility and validity of a semiquantitative food frequency questionnaire. Am J Epidemiol. 1985;122(1):51–65. https://doi.org/10.1093/oxfordjournals.aje.a114086.

    Article  CAS  PubMed  Google Scholar 

  15. Mukamal KJ, Jensen MK, Grønbaek M, et al. Drinking frequency, mediating biomarkers, and risk of myocardial infarction in women and men. Circulation. 2005;112(10):1406–13. https://doi.org/10.1161/circulationaha.105.537704.

    Article  PubMed  Google Scholar 

  16. Giovannucci E, Colditz G, Stampfer MJ, et al. The assessment of alcohol consumption by a simple self-administered questionnaire. Am J Epidemiol. 1991;133(8):810–7. https://doi.org/10.1093/oxfordjournals.aje.a115960.

    Article  CAS  PubMed  Google Scholar 

  17. Nimptsch K, Brand-Miller JC, Franz M, Sampson L, Willett WC, Giovannucci E. Dietary insulin index and insulin load in relation to biomarkers of glycemic control, plasma lipids, and inflammation markers. Am J Clin Nutr. 2011;94(1):182–90. https://doi.org/10.3945/ajcn.110.009555.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Rosner B, Cook N, Portman R, Daniels S, Falkner B. Determination of blood pressure percentiles in normal-weight children: some methodological issues. Am J Epidemiol. 2008;167(6):653–66. https://doi.org/10.1093/aje/kwm348.

    Article  CAS  PubMed  Google Scholar 

  19. Chiuve SE, Fung TT, Rimm EB, et al. Alternative dietary indices both strongly predict risk of chronic disease. J Nutr. 2012;142(6):1009–18. https://doi.org/10.3945/jn.111.157222.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Chasan-Taber S, Rimm EB, Stampfer MJ, et al. Reproducibility and validity of a self-administered physical activity questionnaire for male health professionals. Epidemiol (Cambridge Mass). 1996;7(1):81–6. https://doi.org/10.1097/00001648-199601000-00014.

    Article  CAS  Google Scholar 

  21. Rimm EB, Stampfer MJ, Colditz GA, Chute CG, Litin LB, Willett WC. Validity of self-reported waist and hip circumferences in men and women. Epidemiol (Cambridge Mass). 1990;1(6):466–73. https://doi.org/10.1097/00001648-199011000-00009.

    Article  CAS  Google Scholar 

  22. Kim D, Masyn KE, Kawachi I, Laden F, Colditz GA. Neighborhood socioeconomic status and behavioral pathways to risks of colon and rectal cancer in women. Cancer. 2010;116(17):4187–96. https://doi.org/10.1002/cncr.25195.

    Article  PubMed  Google Scholar 

  23. Song M, Giovannucci E. Substitution analysis in nutritional epidemiology: proceed with caution. Eur J Epidemiol. 2018;33(2):137–40. https://doi.org/10.1007/s10654-018-0371-2.

    Article  PubMed  Google Scholar 

  24. Kalinowski A, Humphreys K. Governmental standard drink definitions and low-risk alcohol consumption guidelines in 37 countries. Addiction. 2016;111(7):1293–8. https://doi.org/10.1111/add.13341.

    Article  PubMed  Google Scholar 

  25. Rimm EB, Williams P, Fosher K, Criqui M, Stampfer MJ. Moderate alcohol intake and lower risk of coronary heart disease: meta-analysis of effects on lipids and haemostatic factors. BMJ. 1999;319(7224):1523–8. https://doi.org/10.1136/bmj.319.7224.1523.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Oneta CM, Pedrosa M, Rüttimann S, Russell RM, Seitz HK. Age and bioavailability of alcohol. Z Gastroenterol. 2001;39(9):783–8. https://doi.org/10.1055/s-2001-17196.

    Article  CAS  PubMed  Google Scholar 

  27. Vatsalya V, Byrd ND, Stangl BL, Momenan R, Ramchandani VA. Influence of age and sex on alcohol pharmacokinetics and subjective pharmacodynamic responses following intravenous alcohol exposure in humans. Alcohol. 2023;107:144–52. https://doi.org/10.1016/j.alcohol.2022.08.010.

    Article  CAS  PubMed  Google Scholar 

  28. Di Castelnuovo A, Costanzo S, Bonaccio M, et al. Alcohol intake and total mortality in 142 960 individuals from the MORGAM Project: a population-based study. Addiction. 2022;117(2):312–25. https://doi.org/10.1111/add.15593.

    Article  PubMed  Google Scholar 

  29. Briel M, Ferreira-Gonzalez I, You JJ, et al. Association between change in high density lipoprotein cholesterol and cardiovascular disease morbidity and mortality: systematic review and meta-regression analysis. BMJ. 2009;338:b92. https://doi.org/10.1136/bmj.b92.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. De Oliveira ESER, Foster D, McGee Harper M, et al. Alcohol consumption raises HDL cholesterol levels by increasing the transport rate of apolipoproteins A-I and A-II. Circulation. 2000;102(19):2347–52. https://doi.org/10.1161/01.cir.102.19.2347.

    Article  Google Scholar 

  31. McMonagle J, Felig P. Effects of ethanol ingestion on glucose tolerance and insulin secretion in normal and diabetic subjects. Metabolism. 1975;24(5):625–32. https://doi.org/10.1016/0026-0495(75)90142-0.

    Article  CAS  PubMed  Google Scholar 

  32. Joosten MM, Beulens JW, Kersten S, Hendriks HF. Moderate alcohol consumption increases insulin sensitivity and ADIPOQ expression in postmenopausal women: a randomised, crossover trial. Diabetologia. 2008;51(8):1375–81. https://doi.org/10.1007/s00125-008-1031-y.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Imhof A, Koenig W. Alcohol inflammation and coronary heart disease. Addict Biol. 2003;8(3):271–7. https://doi.org/10.1080/13556210310001602176.

    Article  CAS  PubMed  Google Scholar 

  34. González R, Ballester I, López-Posadas R, et al. Effects of flavonoids and other polyphenols on inflammation. Crit Rev Food Sci Nutr. 2011;51(4):331–62. https://doi.org/10.1080/10408390903584094.

    Article  CAS  PubMed  Google Scholar 

  35. Pérez-Jiménez J, Neveu V, Vos F, Scalbert A. Identification of the 100 richest dietary sources of polyphenols: an application of the phenol-explorer database. Eur J Clin Nutr. 2010;64(Suppl 3):112–20. https://doi.org/10.1038/ejcn.2010.221.

    Article  CAS  Google Scholar 

  36. Chiva-Blanch G, Urpi-Sarda M, Llorach R, et al. Differential effects of polyphenols and alcohol of red wine on the expression of adhesion molecules and inflammatory cytokines related to atherosclerosis: a randomized clinical trial. Am J Clin Nutr. 2012;95(2):326–34. https://doi.org/10.3945/ajcn.111.022889.

    Article  CAS  PubMed  Google Scholar 

  37. Vázquez-Agell M, Sacanella E, Tobias E, et al. Inflammatory markers of atherosclerosis are decreased after moderate consumption of cava (sparkling wine) in men with low cardiovascular risk. J Nutr. 2007;137(10):2279–84. https://doi.org/10.1093/jn/137.10.2279.

    Article  PubMed  Google Scholar 

  38. Chiva-Blanch G, Magraner E, Condines X, et al. Effects of alcohol and polyphenols from beer on atherosclerotic biomarkers in high cardiovascular risk men: a randomized feeding trial. Nutr Metab Cardiovasc Dis. 2015;25(1):36–45. https://doi.org/10.1016/j.numecd.2014.07.008.

    Article  CAS  PubMed  Google Scholar 

  39. McCann SE, Sempos C, Freudenheim JL, et al. Alcoholic beverage preference and characteristics of drinkers and nondrinkers in western New York (United States). Nutr Metab Cardiovasc Dis. 2003;13(1):2–11. https://doi.org/10.1016/s0939-4753(03)80162-x.

    Article  CAS  PubMed  Google Scholar 

  40. Sedman AJ, Wilkinson PK, Sakmar E, Weidler DJ, Wagner JG. Food effects on absorption and metabolism of alcohol. J Stud Alcohol. 1976;37(9):1197–214. https://doi.org/10.15288/jsa.1976.37.1197.

    Article  CAS  PubMed  Google Scholar 

  41. Conigrave KM, Hu BF, Camargo CA Jr., Stampfer MJ, Willett WC, Rimm EB. A prospective study of drinking patterns in relation to risk of type 2 diabetes among men. Diabetes. 2001;50(10):2390–5. https://doi.org/10.2337/diabetes.50.10.2390.

    Article  CAS  PubMed  Google Scholar 

  42. Mukamal KJ, Conigrave KM, Mittleman MA, et al. Roles of drinking pattern and type of alcohol consumed in coronary heart disease in men. N Engl J Med. 2003;348(2):109–18. https://doi.org/10.1056/NEJMoa022095.

    Article  PubMed  Google Scholar 

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Acknowledgements

We would like to thank the participants and staff of the NHS, NHSII, and HPFS for their valuable contributions.

Funding

The Nurses’ Health Study is supported by NIH grants UM1 CA186107 and R01 CA49449. The Nurses’ Health Study II is supported by NIH grants U01 CA176726 and R01 CA67262. The Health Professionals Follow-Up Study is supported by NIH grant U01 CA167552. This work was in addition supported by NIH grant R00 CA215314 (to MS), American Cancer Society Mentored Research Scholar grant MRSG-17-220-01—NEC (to MS), NIH grant R37 CA246175 (to YC), and a research grant from the Ottogi Ham Taiho Foundation (to JH). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors assume full responsibility for the analyses and interpretation of these data. The funding sources played no role in the study design, data collection, data analysis, and interpretation of results, or the decisions made in preparation and submission of the article.

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Authors and Affiliations

  1. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Xinyi Li, Mingyang Song, Stephanie A. Smith-Warner, Liming Liang, Eric B. Rimm & Edward L. Giovannucci

  2. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Jinhee Hur, Mingyang Song, Stephanie A. Smith-Warner, Eric B. Rimm & Edward L. Giovannucci

  3. Department of Food Science and Biotechnology, Sungkyunkwan University, Suwon, Gyeonggi, South Korea

    Jinhee Hur

  4. Food Clinical Research Center, Institute of Biotechnology and Bioengineering, Sungkyunkwan University, Suwon, Gyeonggi, South Korea

    Jinhee Hur

  5. Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA

    Yin Cao

  6. Alvin J Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA

    Yin Cao

  7. Division of Gastroenterology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA

    Yin Cao

  8. Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA

    Mingyang Song

  9. Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA

    Mingyang Song

  10. Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Liming Liang

  11. Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Kenneth J. Mukamal

  12. Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA

    Eric B. Rimm & Edward L. Giovannucci

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  1. Xinyi Li
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Contributions

X.L. and E.L.G. conceived and designed the study. X.L. performed the statistical analysis, interpreted data and drafted the manuscript. J.H. verified the data. All authors helped to interpret the data and critically revised the manuscript for important intellectual content. J.H., M.S. and Y.C. obtained funding. E.L.G. provided supervision. X.L., J.H. and E.L.G. had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. All authors have read and approved the final manuscript and the authorship list.

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Correspondence to Xinyi Li or Jinhee Hur.

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Li, X., Hur, J., Cao, Y. et al. Moderate alcohol consumption, types of beverages and drinking pattern with cardiometabolic biomarkers in three cohorts of US men and women. Eur J Epidemiol 38, 1185–1196 (2023). https://doi.org/10.1007/s10654-023-01053-w

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