Public Health Nutrition Editorial Highlight: Effects of Initiating Moderate Wine Intake on Abdominal Adipose Tissue in Adults with Type 2 Diabetes: A Two-Year Randomized Controlled Trial’

In a new study published in Public Health Nutrition, Dr. Rachel Golan and colleagues, from the Ben-Gurion University of the Negev, found that moderate wine consumption, in persons with controlled diabetes did not promote weight gain or abdominal adiposity. Their findings contribute to the discourse on whether alcohol consumption bears risks or benefits to those with type 2 diabetes.

Alcohol consumption has been linked to lower cardiovascular and total mortality rates in both healthy persons and persons with type 2 diabetes, yet, whether to recommend initiation of moderate wine consumption, particularly in type 2 diabetes, remains questionable.

In the two year randomized controlled CASCADE (CArdiovaSCulAr Diabetes & Ethanol) trial, 224 alcohol-abstaining adults with type 2 diabetes, were assigned to drink 15oml of mineral water, white wine, or red wine with dinner for two years. In addition, we provided all participants with guidelines to follow a Mediterranean diet, based on quality rather than quantity of foods. We hypothesised that initiating moderate wine consumption would decrease cardiometabolic risk.

The study was made possible thanks to funding by the European Foundation for the Study of Diabetes.

Moderate wine intake and abdominal fat

In the study published in PHN we aimed to address the effect of initiating moderate wine consumption on the accumulation and distribution of central adiposity as evaluated by abdominal magnetic resonance imaging (MRI). We looked at forty eight adults (40-73 years) from the CASCADE study who completed a second MRI measurement (red wine n = 27, mineral water n = 21).

After two years, participants exhibited modest reductions in weight and an increase in HDL-cholesterol. “These changes were similar between those who consumed wine and those who consumed water” said Dr. Golan. “No substantial changes in energy intake or exercise habits were recorded. However, all groups improved their dietary consumption similarly, as expected when adopting a Mediterranean diet”.  A re-distribution of abdominal adipose tissues was observed similarly in both groups. Visceral adipose tissue and superficial subcutaneous adipose tissue both decreased whereas deep subcutaneous adipose tissue increased. Furthermore, two year increases in the intake of both polyunsaturated and monounsaturated fatty acids and two year decrease in HbA1c were associated with a two year decrease in visceral adipose tissue.

Future implications

In this two year randomized controlled intervention trial, researchers suggest that the initiation of moderate wine intake, among alcohol-abstaining patients older than 40 years, with type 2 diabetes is apparently safe with regard to central adiposity and abdominal fat distribution, if the wine is consumed as part of a comprehensive healthy diet. These benefits should be weighed against potential risks when translated into clinical practice.

The paper, Effects of Initiating Moderate Wine Intake on Abdominal Adipose Tissue in Adults with Type 2 Diabetes: A Two-Year Randomized Controlled Trial’ is published in the journal Public Health Nutrition and is freely available until 17th October 2016.
Authors: Rachel Golan, Ilan Shelef, Elad Shemesh, Yaakov Henkin, Dan Schwarzfuchs, Yftach Gepner, Ilana Harman-Boehm, Shula Witkow, Michael Friger, Yoash Chassidim, Idit F Liberty, Benjamin Sarusi, Dana Serfaty, Nitzan Bril, Michal Rein, Noa Cohen, Sivan Ben-Avraham, Uta Ceglarek, Michael Stumvoll, Matthias Blüher, Joachim Thiery, Meir J Stampfer, Assaf Rudich and Iris Shai.