Alcohol Consumption and the Prevalence of the Metabolic Syndrome in the U.S.

A cross-sectional analysis of data from the Third National Health and Nutrition Examination Survey

  1. Matthew S. Freiberg, MD1,
  2. Howard J. Cabral, PHD, MPH2,
  3. Tim C. Heeren, PHD2,
  4. Ramachandran S. Vasan, MD34 and
  5. R. Curtis Ellison, MD3
  1. 1Section of General Internal Medicine, Boston University School of Medicine, Boston, Massachusetts
  2. 2Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
  3. 3Section of Preventive Medicine and Epidemiology, Boston University School of Medicine, Boston, Massachusetts
  4. 4National Heart, Lung & Blood Institute’s Framingham Heart Study, Framingham, Massachusetts
  1. Address correspondence and reprint requests to Matthew S. Freiberg, MD, Boston Medical Center, 91 E. Concord St., MAT 2 Suite 200, Boston, MA 02118. E-mail: matthew.freiberg{at}


OBJECTIVE—The aim of this study was to examine the relations of alcohol consumption to the prevalence of the metabolic syndrome and its components in the U.S. population.

RESEARCH DESIGN AND METHODS—We performed a cross-sectional analysis on data from 8,125 participants from the Third National Health and Nutrition Examination Survey who were evaluated for each component of the metabolic syndrome, using the National Cholesterol Education Program criteria, fasting insulin, and alcohol consumption. Current alcohol consumption was defined as ≥1 alcoholic drink per month.

RESULTS—After adjustment for age, sex, race/ethnicity, education, income, tobacco use, physical activity, and diet, subjects who consumed 1–19 and ≥20 drinks of alcohol per month had odds ratios (ORs) for the prevalence of the metabolic syndrome of 0.65 and 0.34, respectively (P < 0.05 for all), compared with current nondrinkers. These findings were particularly noteworthy for beer and wine drinkers. The association of ≥20 alcoholic drinks per month with the prevalence of the metabolic syndrome was consistent across ethnicities but was most striking in white men and women (ORs 0.35 and 0.22, respectively; P < 0.05). Alcohol consumption was significantly and inversely associated with the prevalence of the following three components of the metabolic syndrome: low serum HDL cholesterol, elevated serum triglycerides, high waist circumference, as well as hyperinsulinemia (P < 0.05 for all).

CONCLUSIONS—Mild to moderate alcohol consumption is associated with a lower prevalence of the metabolic syndrome, with a favorable influence on lipids, waist circumference, and fasting insulin. This association was strongest among whites and among beer and wine drinkers.


  • R.C.E. serves on an advisory panel that oversees a major study funded by the National Institute on Alcohol Abuse and Alcoholism and has received grant/financial support for research from companies/organizations that have some relation to the wine or beverage alcohol industry.

    A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.

    • Accepted August 26, 2004.
    • Received July 26, 2004.
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