Alcohol May Keep Patients With Diabetes From Reaching Long-Term Weight Loss Goals

While light to moderate alcohol consumption is linked with a lower risk of developing type 2 diabetes (T2D), alcohol is particularly calorie-dense, and is known to be a top contributor of calories in American diets. While no clear link between alcohol consumption and bodyweight has been identified in the literature to date, alcohol consumption is linked with increased food intake and disinhibited eating. Now, a newly published study from the University of Pennsylvania School of Nursing finds that heavy alcohol consumption poses a risk for suboptimal long-term weight loss among patients with a diagnosis of T2D.

The study, published in Obesity, analyzed 4901 patients who were part of the Look AHEAD study, which enrolled patients with T2D from across the United States. The participants ranged in age from 45 to 76, had body mass indices of 25 or greater (or 27 or greater if taking insulin), and were randomized to receive either intensive lifestyle interventions (ILI) or diabetes support and education.

Patients’ alcohol intake was assessed using the National Institute on Alcohol Abuse and Alcoholism’s drinking categories, and at baseline, 38.1% of patients reported nondrinking, 53.8% reported light drinking (under 7 and 4 drinks per week for men and women, respectively), 6.3% reported moderate drinking (7 to 14 and 4 to 7 drinks per week, respectively), and 1.7% reported heavy drinking (more than 14 and 7 drinks per week, respectively). Patients in the ILI and DSE groups did not differ by baseline alcohol consumption categorization.

In the ILI group, at year 1, the trajectory of alcohol consumption did not have an effect on weight loss; relative to patients who did not drink at baseline, those with light, moderate, and heavy consumption lost a similar amount of weight.

At year 4, however, patients in the ILI group who had abstained from alcohol fully over the 4-year period lost 1.6% (±0.5%) more weight than those who drank at any time (P = .003). Furthermore, those patients who abstained from alcohol for 4 years lost 5.1% (±0.3%) of their initial body weight at year 4 compared with 2.4% (±1.3%) of body weight among patients who drank heavily (P = .04).

At year 4, the percentage of patients who achieved 10% weight loss or greater was 27.5% among those who abstained from alcohol entirely. In the group of heavy drinkers, only 2 patients achieved 10% or greater weight loss.

According to the authors, these findings suggest that alcohol may have different physiological or behavioral implications for short‐ versus long‐term weight loss among patients with T2D.

“This study indicates that while alcohol consumption is not associated with short‐term weight loss during a lifestyle intervention, it is associated with worse long‐term weight loss in participants with overweight or obesity and type 2 diabetes,” said lead investigator Ariana M. Chao, PhD, CRNP, assistant professor of nursing in Penn Nursing’s the department of biobehavioral health sciences. “Patients with type 2 diabetes who are trying to lose weight should be encouraged to limit alcohol consumption."

Reference

Chao AM, Wadden TA, Tronieri JS, Berkowitz RI. Alcohol intake and weight loss during intensive lifestyle intervention for adults with overweight or obesity and diabetes. Obesity. 2018;0:1-11. doi:10.1002/oby.22316.