Effects of initiating moderate wine intake on abdominal adipose tissue in adults with type 2 diabetes: a 2-year randomized controlled trial

OBJECTIVE: To generate evidence-based conclusions about the effect of wine consumption on weight gain and abdominal fat accumulation and distribution in patients with type 2 diabetes.

DESIGN: In the 2-year randomized controlled CASCADEThe CASCADE study (CArdiovaSCulAr D (CArdiovaSCulAr Diabetes & Ethanol) trial, patients following a Mediterranean diet were randomly assigned to drink 150 ml of mineral water, white wine or red wine with dinner for 2 years. Visceral adiposity and abdominal fat distribution were measured in a subgroup of sixty-five participants, using abdominal MRI.

SETTING: Ben-Gurion University of the Negev, Soroka-Medical Center and the Nuclear Research Center Negev, Israel.

SUBJECTS: Alcohol-abstaining adults with well-controlled type 2 diabetes.

RESULTS: Forty-eight participants (red wine, n 27; mineral water, n 21) who completed a second MRI measurement were included in the 2-year analysis. Similar weight losses (sd) were observed: red wine 1.3 (3.9) kg; water 1.0 (4.2) kg (P=0.8 between groups). Changes (95 % CI) in abdominal adipose-tissue distribution were similar: red wine, visceral adipose tissue (VAT) -3.0 (-8.0, 2.0) %, deep subcutaneous adipose tissue (DSAT) +5.2 (-1.1, 11.6) %, superficial subcutaneous adipose tissue (SSAT) -1.9 (-5.0, 1.2) %; water, VAT -3.2 (-8.9, 2.5) %, DSAT +2.9 (-2.8, 8.6) %, SSAT -0.15 (-3.3, 2.9) %. No changes in antidiabetic medication and no substantial changes in energy intake (+126 (sd 2889) kJ/d (+30.2 (sd 690) kcal/d), P=0.8) were recorded. A 2-year decrease in glycated Hb (beta=0.28, P=0.05) was associated with a decrease in VAT.

CONCLUSIONS: Moderate wine consumption, as part of a Mediterranean diet, in persons with controlled diabetes did not promote weight gain or abdominal adiposity.