…according to an article in the American Journal of Clinical Nutrition. A review of the scientific literature looked at various populations at baseline, noting alcohol consumption, then determined who developed type 2 diabetes over subsequent years. Folks with light to moderate alcohol consumption were 20% less likely to develop diabetes.
Wine is one of the potentially healthy components of the Mediterranean diet
This doesn’t prove that alcohol prevents diabetes. Alcohol intake may instead just be a marker for other factors that do prevent diabetes. For instance, maybe drinkers are genetically less susceptible to diabetes, or they exercise more.
Steve Parker, M.D.
Banting eschewed salmon (too fatty?)
I’ve been reading about Banting’s diet for at least five years. Thanks to Tim Noakes in South Africa, it’s seeing a mini-surge in popularity. William Banting published his Letter on Corpulence in 1863. Eating like him to lose weight is sometimes referred to as “Banting.” It’s one form of a low-carb diet and considered a precursor to the Atkins diet.
Form your own opinion of what William Banting may have eaten by reading these:
In terms of macronutrient calories, here’s my rough back-of-the-envelope synthesis of Banting’s diet:
- 20–25% carbohydrate
- 25% protein
- 20–25% fat
- 25% alcohol
- 1800–2000 total calories
For the 200 lb (91 kg) man that Banting was, 2000 calories would almost certainly have been a calorie-restricted diet. Leigh estimated he was eating at least 2800 cals/day at baseline before losing weight. I don’t doubt that.
In summary, Banting drank a lot of alcohol (even more than on the Ketogenic Mediterranean Diet), and ate fairly low-fat, moderately carb-restricted, and relatively high protein. In other words: low cal, low carb, low fat, high protein, high alcohol.
His weight loss, assuming it wasn’t a hoax, came from calorie restriction. Something about that combination of macronutrients apparently allowed him to stick with the program and maintain a 50-lb weight loss. Protein is particularly satiating. Your mileage may vary.
I’m concerned that 25% of calories from alcohol would displace more healthful micronutrients.
Steve Parker, M.D.
PS: William Banting was a distant relative of Frederick Banting, the co-discoverer of insulin in 1921.
I’ll drink to that!
It’s an old study from 2000 that I should have known about. It’s an observational study, not interventional. So it’s suggestive but not proof of hearing protection by alcohol.
h/t Glenn Reynolds (Instapundit)
Researchers studied 24,444 Swedish women over the course of 6.2 years, analyzing dietary patterns, healthy lifestyle choices, and body weight. Information on the women was obtained mostly by surveys at the start and end of the study. The women were aged 48 to 83 at the start of the study and were free of diabetes mellitus, cardiovascular disease, cancer, and coronary artery disease.
Heart attacks in the study cohort were identified in the Swedish Hospital Discharge Registry and the Cause of Death Registry. Over the course of six years there were 308 heart attacks.
The study authors noted a greatly reduced incidence of heart attacks in women with the following characteristics:
- high consumption of fruits, vegetables, whole grains, legumes, and fish
- moderate consumption of alcohol
- avoidance of overweight, especially abdominal fat (waist-hip ratio < 0.85)
- physically active (at least 40 minutes daily of walking or bicycling and 1 hour weekly of leisure-time exercise
Women meeting these criteria had a 92% lower risk of having a heart attack! Such women were only 5% of the cohort, however. I suspect the physical activity criterion knocked a lot of women out of the super heart-healthy subset.
The authors conclude that “most [heart attacks] in women may be preventable by consuming a healthy diet and moderate amounts of alcohol, being physically active, not smoking, and maintaining a healthy weight.”
I see little reason to doubt that these findings apply to the typical woman in the U.S. or Europe, and not just to Swedes. The traditional Mediterranean diet of the mid-20th century fulfills the dietary prescription for a healthy heart. The Advanced Mediterranean Diet incorporates these healthy diet and lifestyle choices while simultaneously working to control weight.
Steve Parker, M.D.
Reference: Akesson, Agneta, et al. Combined Effect of Low-Risk Dietary and Lifestyle Behaviors in Primary Prevention of Myocardial Infarction in Women. Archives of Internal Medicine, 167 (2007): 2,122-2,127.
For centuries, the healthier populations in the Mediterranean region have enjoyed wine in light to moderate amounts, usually with meals. Epidemiologic studies there and in other parts of the world have associated reasonable alcohol consumption with prolonged lifespan, reduced coronary artery disease, diminished Alzheimer’s and other dementias, and possibly fewer strokes.
Alcohol tends to increase HDL cholesterol (the good stuff), have an antiplatelet effect, and may reduce C-reactive protein, a marker of arterial inflammation. These effects would tend to reduce cardiovascular disease. Wine taken with meals provides antioxidant phytochemicals (polyphenols, procyanidins) which may protect against atherosclerosis and some cancers.
What’s a “reasonable” amount of alcohol? An old medical school joke is that a “heavy drinker” is anyone who drinks more than the doctor does. Light to moderate alcohol consumption is generally considered to be one or fewer drinks per day for a woman, two or fewer drinks per day for a man. One drink is 5 ounces of wine, 12 ounces of beer, or 1.5 ounces of 80 proof distilled spirits (e.g., vodka, whiskey, gin). The optimal health-promoting type of alcohol is unclear. I tend to favor wine, a time-honored component of the Mediterranean diet. Red wine in particular is a rich source of resveratrol, which is thought to be a major contributor to the cardioprotective benefits associated with light to moderate alcohol consumption. Grape juice may be just as good—it’s too soon to tell.
Steve Parker, M.D.
Standridge, John B., et al. Alcohol consumption: An overview of benefits and risks. Southern Medical Journal, 97 (2004): 664-672.
Luchsinger, Jose A., et al. Alcohol intake and risk of dementia. Journal of the American Geriatrics Society, 52 (2004): 540-546.
The Million Women Study (2009) looked at the association between alcohol consumption and the incidence of various cancers in middle-aged women in the United Kingdom.
Here’s the conclusion from the abstract in the Journal of the National Cancer Institute:
Low to moderate alcohol consumption in women increases the risk of certain cancers. For every additional drink regularly consumed per day, the increase in incidence up to age 75 years per 1000 for women in developed countries is estimated to be about 11 for breast cancer, 1 for cancers of the oral cavity and pharynx, 1 for cancer of the rectum, and 0.7 each for cancers of the esophagus, larynx and liver, giving a total excess of about15 cancers per 1000 women up to age 75.
Other cancers seemed to be reduced by increasing levels of alcohol consumption: thyroid, non-Hodgkin lymphoma, renal cell carcinoma.
Comparing wine with other alcohol types, no differences in cancer risks were found.
Low to moderate alcohol consumption is associated with prolonged life, lesser risk of dementia, and lower rates of cardiovascular disease. The article abstract doesn’t mention these issues, nor the possibility that the benefits of judicious alcohol consumption may outweigh the cancer risks.
Steve Parker, M.D.
Szwarc, Sandy. In Vino Veritas – Part Two. Junkfood Science blog, March 1, 2009. Accessed March 10, 2009. A quote from Ms. Szwarc regarding the Million Women Study:
The bottom line is that scary claims that “there is no level of alcohol consumption that can be considered safe,” simply was not supported by the data. This study actually found no credible link between alcohol consumption and cancers at all. Or, if you want to split hairs and believe the small computed numbers, it found that the lowest risk for cancers was associated with women drinking up to 1-2 drinks a day.
Judicious alcohol consumption is linked to lower risk of developing type 2 diabetes: 40% lower risk in women, 13% lower in men.
Why does this matter?
In 2009, 24 million in the U.S. had diabetes. Another 57 million had pre-diabetes, a condition that increases your risk for diabetes.
At least 23% of U.S. adults over 60 have diabetes.
In 2009, Diabetes Care reported the comparison of lifetime abstainers with alcohol drinkers. The protective “dose” of alcohol is 22–24 grams a day. I’ll leave it to you to figure out how much alcohol that is. Prior studies looking at overall health benefits of alcohol indicate that judicious consumption is ≤ one drink daily, on average, for women, and ≤ 2 drinks a day for men.
Of course, many people shouldn’t drink any alcohol.
Steve Parker, M.D.
Reference: Baliunas, D., et al. Alcohol as a risk factor for type 2 diabetes: A systematic review and meta-analysis. Diabetes Care, 32 (2009): 2,123-2,132.