Can Brief Periods of Alcohol Abstinence Really Improve Insulin Resistance?

With commentary by Joel Zonszein, MD, professor of clinical medicine and director of the Clinical Diabetes Center at Montefiore Medical Center, the Bronx.

Abstaining from alcohol on a short-term basis improved insulin resistance, according to new research by scientists in the U.K. However, a U.S. expert says the findings are counter to other research and to traditional advice that moderate alcohol intake may benefit those with diabetes.

alchohol abstinence The U.K. researchers, who presented their data at the Liver Meeting 2015 in December in San Francisco, evaluated 102 men and women who were enrolled in the UK's "Dry January" campaign. Those who participated were moderate drinkers who agreed to abstain for a month.

The researchers measured changes in insulin resistance (when the body's cells are resistant to the effects of insulin), and also looked at markers of a condition called non-alcoholic fatty liver disease (NAFLD) after a month of the men and women being ''on the wagon."

They found reduced insulin resistance, reduced liver stiffness and better blood pressure. The improvements held even after they adjusted for such factors as age, gender, exercise, smoking and  diet changes. The researchers can't say how durable the benefits might be, as they only looked at the one-month window. The researchers concluded that the risk of NAFLD increases with more alcohol intake.

NAFLD is an extra buildup of fat cells in the liver, but not believed to be caused by alcohol, according to the Liver Foundation. Those who are overweight or have diabetes are more at risk, experts know.

Alcohol & diabetes: another view

The findings run counter to what would be expected, says Joel Zonszein, MD, professor of clinical medicine and director of the Clinical Diabetes Center at Montefiore Medical Center, the Bronx.

"We recommend in this country moderate alcohol consumption, including [for] patients with diabetes," says Dr. Zonszein. The American Diabetes Association concurs. A drink is 12 ounces of beer, five ounces of wine or 1.5 ounces of distilled spirits such as vodka or whiskey.

Moderate is considered one drink a day for a woman, two for a man, Dr. Zonszein and others agree.

"I always tell my patients to have some drinks, but to do it in moderation," he says. "Moderate drinking does not cause insulin resistance."

The test used to measure insulin resistance in the study is not ideal, he says. And he says it is difficult to understand how a change in liver fat could occur in such a short time period.

"If someone drinks moderately and has no reason to stop, they can continue," he says. "When people stop drinking, they become more insulin resistance, need more medications and blood pressure tends to go up," he says, especially in those with diabetes.

Bottom line, says Dr. Zonszein: "We will need more studies" to verify the U.K. findings.

 

 

 

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