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This version published online on November 2, 2004
Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2004-1511
A more recent version of this article appeared on February 1, 2005
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Submitted on July 30, 2004
Accepted on October 25, 2004

BENEFICIAL POSTPRANDIAL EFFECT OF A SMALL AMOUNT OF ALCOHOL ON DIABETES AND CARDIOVASCULAR RISK FACTORS Modification by Insulin Resistance

Jerry R. Greenfield FRACP, Katherine Samaras FRACP, Chris S. Hayward FRACP, Donald J. Chisholm FRACP, and Lesley V. Campbell FRACP*

Diabetes and Obesity Program, Garvan Institute of Medical Research, St. Vincent's Hospital, Sydney, Australia; Diabetes Centre and Department of Cardiology, St. Vincent's Hospital, Sydney, Australia

* To whom correspondence should be addressed.
Lesley V. Campbell, E-mail: l.campbell{at}garvan.org.au

Moderate alcohol consumption protects against type 2 diabetes and cardiovascular disease. Because humans spend most of their time in the postprandial state, we examined the effect of 15 g of alcohol on postprandial metabolic factors in 20 postmenopausal women over 6-hrs. We measured (i) glucose, insulin, lipids, C-reactive protein (CRP) and adiponectin levels; (ii) augmentation index [AIx] by applanation tonometry; (iii) energy expenditure and substrate oxidation by indirect calorimetry. Subjects received low-carbohydrate (LC: visits 1, 2) and high-carbohydrate (HC: visits 3, 4) high-fat meals with and without alcohol. Alcohol augmented the postprandial increment in insulin (P = 0.07) and reduced the postprandial increment in glucose (P = 0.04) following the LC-meal only. Triglycerides were increased by alcohol following the LC- (P = 0.002) and HC- (P = 0.008) meals. Total and HDL-cholesterol, fatty acids and total adiponectin responses were unaffected. CRP levels decreased postprandially; reductions were enhanced by alcohol following the HC-meal but attenuated following the LC-meal. Postprandial reductions in AIx were increased by alcohol following the LC-meal only (P = 0.007). Alcohol enhanced the postprandial increase in energy expenditure 30-60mins after the LC-meal ({Delta}373 ± 49 vs. 236 ± 32kcal/d, P = 0.02) and HC-meal ({Delta}362 ± 36 vs. {Delta}205 ± 34kcal/d, P = 0.0009), but suppressed fat and carbohydrate oxidation. Our findings may be mechanisms for lower diabetes and cardiovascular risks in moderate drinkers.


Key words: alcohol • postprandial lipids • arterial stiffness • augmentation index • energy expenditure • fat oxidation • carbohydrate oxidation • insulin resistance




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