The objective of this study was to examine the association between moderate alcohol consumption and risk of type 2 diabetes in adults stratified according to lifestyle behaviours. Analyses were performed on the cohort of the Dutch European Prospective Investigation into Cancer and Nutrition (EPIC-NL) which included 35,625 adults aged 20-70 years who were free of diabetes, cardiovascular disease and cancer at baseline. During a median follow-up of 10.3 years, 796 incident cases of type 2 diabetes were recorded. Results showed that moderate alcohol consumption (~0.5-1 drink/day for women and 0.5-2 drinks/day for men) was associated with a reduced risk of developing type 2 diabetes, independently of other favourable behavioural lifestyles such as a normal weight, physically active, nonsmoking and consuming a healthy diet. Moreover, moderate alcohol consumption was still associated with a lower risk of type 2 diabetes among individuals with multiple low-risk lifestyle behaviours combined. These results suggest that the inverse association between moderate alcohol consumption and incidence of type 2 diabetes is only partly explained by a healthier lifestyle.
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