A large cross-sectional study of Japanese adults with type 2 diabetes found that alcohol consumption can affect dietary patterns and micronutrient intake differently by age and gender groups, with young men showing the most pronounced nutritional deficiencies.
Association between alcoholic beverage consumption and micronutrient intake in type 2 diabetes outpatients: A cross-sectional analysis by gender and age (JDDM#). Image credit: Halfpoint / Shutterstock
In a recent study published in the journal Clinical Nutrition ESPENresearchers investigated the association between alcohol intake and micronutrient intake in patients with type 2 diabetes (T2D).
Alcohol intake can affect diet quality. Increased alcohol consumption is associated with increased energy intake and decreased intake of fruit, dietary fiber, dairy products, and whole grains. Additionally, people who drink large amounts of alcohol reportedly consume more calories and micronutrients overall, but less vitamin C, carotenoids, and vitamin E.
Alcohol can negatively affect diet quality by altering hormones that regulate appetite, such as ghrelin, and potentially increasing hunger, thereby promoting the intake of nutrient-poor, energy-dense foods. There are significant gender and age differences in alcohol consumption, but stratified analyzes that simultaneously account for both are lacking. Also, previous studies have rarely investigated how alcohol intake is simultaneously related to both dietary patterns and micronutrient intake, which could help clarify how alcohol affects overall diet quality.
Study design and participant characteristics
In this study, researchers evaluated the association between alcohol intake and intake of micronutrients and food groups and how they were related to overall dietary patterns. Outpatients with T2D treated at Japanese clinics from December 2014 to December 2019 were included. Participants completed a lifestyle questionnaire and self-reported their weight and height. A food frequency questionnaire (FFQ) was administered to investigate dietary habits.
Meal evaluation and alcohol intake measurement
The FFQ assessed dietary intake over the past 1–2 months. Participants reported their serving size and weekly frequency of consumption. Foods consumed less than once or twice per month were excluded. Estimates of food and nutrient intake were derived using standard food composition tables. Total alcohol intake was estimated from the FFQ as the amount of alcohol consumed per day. Intake was not stratified by beverage type.
Physical activity and participant stratification
Physical activity was measured using the Japanese shortened version of the International Physical Activity Questionnaire. Participants were divided into four age-gender groups: younger men and women (65 years and younger) and older men and women (65 years and older). We further stratified based on alcohol intake for non-drinkers, individuals with alcohol intake below the median, and individuals with intake above the median.
Statistical analysis of micronutrient intake and dietary patterns
The researchers used multiple regression to examine the association between alcohol intake and micronutrient intake across groups. Spearman correlations were used to assess the association between alcohol consumption and food group intake across groups. Finally, principal component analysis (PCA) was used to derive dietary patterns and assess the relationship between alcohol intake and overall diet.
Findings: Energy intake, BMI, and lifestyle factors
The study included 1,565 participants. Specifically, the sample included 620 young men, 367 older men, 301 young women, and 277 older women. In all groups except older women, increased alcohol intake was associated with increased energy intake. Smoking rates were lowest among young men with low alcohol intake, but higher among non-drinkers and heavy drinkers.
Among young men, those who consumed more alcohol had lower body mass index (BMI). Similarly, in the older women group, drinkers’ BMI was significantly lower compared to non-drinkers, although the relationship between alcohol consumption levels was not linear.
Relationship between alcohol intake and micronutrients
Furthermore, a significant association was observed between increased alcohol intake and decreased intake of multiple micronutrients in young men, with significant decreases in potassium, calcium, vitamin A, and vitamin C, but no significant association was found for iron. The strongest association was observed for potassium. In older men, alcohol intake was only negatively associated with vitamin C. No significant association was observed for women.
Correlation between food groups and alcohol consumption
Among food groups, alcohol intake was positively correlated with seafood, soybeans and soybean products, seaweed, seeds and nuts, sugar, pickles, and spices, and negatively correlated with sweets and milk among young men. Among older men, alcohol intake was positively associated with seafood and negatively associated with sugar-sweetened beverages, bread, rice, fruit, and sweets.
Among women, positive correlations were seen with sweets, soybeans and soybean products in the younger age group, and vegetables, mushrooms, soybeans and soybean products, and seaweed in the older age group.
Dietary patterns identified by principal component analysis
The PCA revealed three dietary patterns: healthy, sweet, and savory. Alcohol consumption was associated with a flavorful food pattern characterized by high intakes of rice, meat, sugary drinks, fish, and condiments.
Conclusions: Age- and gender-specific alcohol-nutrition associations
In summary, our findings revealed a negative association between alcohol intake and several micronutrients, particularly potassium, calcium, vitamin A, and vitamin C in younger men, and only vitamin C in older men. Among women, no significant association was found between alcohol and micronutrient intake.
The authors suggest that lower intake of dairy products such as milk and associated lifestyle behaviors such as smoking may partially explain the reduced micronutrient intake observed in young men with higher alcohol intake. These results highlight age- and gender-specific associations between alcohol and micronutrient intake and highlight the need to improve nutrient intake in young men who consume alcohol.
Because this study used a cross-sectional design, the results indicate an association, rather than a causal relationship, between alcohol intake and nutrient intake.
Reference magazines:
- d’Avila Ferreira E, Hatta M, Yoshizawa-Morikawa S, et al. (2026). Association between alcoholic beverage consumption and micronutrient intake in type 2 diabetes outpatients: A cross-sectional analysis by gender and age (JDDM#). Clinical Nutrition ESPEN. DOI: 10.1016/j.clnesp.2026.103103, https://www.clinicalnutritionespen.com/article/S2405-4577(26)00199-3/
