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Nutrition and Disease

Moderate Alcohol Consumption Is More Cardioprotective in Men with the Metabolic Syndrome¹

Iris Gigleux², Josée Gagnon², Annie St-Pierre², Bernard Cantin³, Gilles R. Dagenais³, Franois Meyer⁴, Jean-Pierre Després³ and Benoît Lamarche^2,*

² Institute on Nutraceuticals and Functional Foods Quebec City, QC, Canada; ³ Quebec Heart Institute, Laval Hospital Quebec City, QC, Canada; and ⁴ Cancer Research Center, Quebec City, QC, Canada

^* To whom correspondence should be addressed. E-mail: benoit.lamarche{at}inaf.ulaval.ca.

The aim of the present study was to evaluate the relation among alcohol consumption, the metabolic syndrome, and the risk of ischemic heart disease (IHD). The study was conducted in a cohort of 1966 men from the Quebec Cardiovascular Study. All men were initially free of IHD and, during the follow-up period of 13 y, 219 first cases of IHD were diagnosed. Alcohol consumption was determined by calculating the g/d intake based on standard portions of beer, wine, and spirits. Metabolic syndrome was diagnosed according to a modification of the National Cholesterol Education Program Adult Treatment Panel III definition. Men who consumed 15.2 g of alcohol/d (4th quartile of the distribution) were younger (P < 0.001), had elevated plasma HDL-C concentrations (P < 0.001), and lower plasma concentrations of insulin (P = 0.01), CRP (P = 0.01), and fibrinogen (P < 0.001) than men in the 1st quartile (<1.3 g of alcohol/d). After adjustment for a series of coronary risk factors, alcohol consumption 15.2 g/d was associated with a 39% reduction in the 13-y risk of IHD [relative risk (RR) of IHD = 0.61, P = 0.02]. Finally, an alcohol consumption <15.2 g/d was associated with an increase of the risk of IHD in men with the metabolic syndrome (RR = 2.24, P < 0.001) but not in men without the metabolic syndrome (RR = 1.31, P = 0.22). These results confirm that moderate daily alcohol consumption has cardioprotective properties and suggest that the effects may be more important in subjects with a deteriorated risk profile, such as those with the metabolic syndrome.

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