Alcohol Consumption in the Severely Obese: Relationship with the Metabolic Syndrome

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Abstract
DIXON, JOHN B., MAUREEN E. DIXON, AND PAUL E. O'BRIEN. Alcohol consumption in the severely obese: relationship with the metabolic syndrome. Obes Res. 2002; 10:245-252. Objective: The aim of this study was to examine the asso- ciation between the clinical and biochemical features of the metabolic syndrome and quantity and type of alcohol intake in the severely obese. Research Methods and Procedures: A cross-sectional study was performed in 486 consecutive severely obese subjects. Data on alcohol consumption was collected by serial clinical interviews and a questionnaire. The relation- ship between alcohol intake and the clinical and serum chemistry features of the metabolic syndrome was analyzed by multiple statistical techniques. Laboratory measures in- cluded lipid profile, fasting blood glucose, hemoglobin A1c, and fasting serum insulin. An indirect index of insulin resistance was calculated using the log-transformed fasting insulin and glucose product. Results: There were 486 subjects, 84% women, with a mean age of 40.6 10 years (range, 16 to 71 years) and a body mass index of 45.3 7 kg/m2 (range, 34 to 77 kg/m2). Alcohol consumers (N 276) showed a marked reduction in the adjusted odds ratio of type 2 diabetes (odds ratio 0.29; 95% confidence interval, 0.16 to 0.55) compared with rare or nonconsumers (N 210). There was a U-shaped relationship between the amount and frequency of alcohol consumption and fasting triglyceride, fasting glucose, he- moglobin A1c, and index of insulin resistance measure- ments. Consumers of 100 g/wk had more favorable mea- sures. The effect was attenuated when diabetics were excluded from the analysis. Timing of alcohol consumption did not influence outcome measures. Discussion: Light-to-moderate alcohol consumption is as- sociated with a lower prevalence of type 2 diabetes, reduced insulin resistance, and more favorable vascular risk profile in the severely obese. We would propose that light to moderate alcohol consumption should not be discouraged in the severely obese.