OBJECTIVEObservational studies indicate that moderate levels of alcohol consumption may reduce the risk of type 2 diabetes. In addition to providing an updated summary of the existing literature, this meta-analysis explored whether reductions in risk may be the product of misclassification bias. RESEARCH DESIGN AND METHODSA systematic search was undertaken, identifying studies that reported a temporal association between alcohol consumption and the risk of type 2 diabetes. No restrictions were placed upon the language or date of publication. Non-English publications were, where necessary, translated using online translation tools. Models were constructed using fractional polynomial regression to determine the best-fitting dose-response relationship between alcohol intake and type 2 diabetes, with a priori testing of sex and referent group interactions. RESULTSThirty-eight studies met the selection criteria, representing 1,902,605 participants and 125,926 cases of type 2 diabetes. A conventional noncurrent drinking category was reported by 33 studies, while five reported a never-drinking category. Relative to combined abstainers, reductions in the risk of type 2 diabetes were present at all levels of alcohol intake <63 g/day, with risks increasing above this threshold. Peak risk reduction was present between 10-14 g/day at an 18% decrease in hazards. Stratification of available data revealed that reductions in risk may be specific to women only and absent in studies that adopted a never-drinking abstention category or sampled an Asian population region. CONCLUSIONSReductions in risk among moderate alcohol drinkers may be confined to women and non-Asian populations. Although based on a minority of studies, there is also the possibility that reductions in risk may have been overestimated by studies using a referent group contaminated by less healthy former drinkers.

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ObjeCtives To examine the suitability of age specific limits for alcohol consumption and to explore the association between alcohol consumption and mortality in different age groups.

Objetivo Avaliar associação entre excesso de peso e consumo de feijão em adultos. Métodos O estudo constou de indivíduos adultos (≥18 anos), moradores em Belém (PA), em 2005. A amostragem foi realizada por sorteio de residências com telefone fixo e de um morador adulto de cada casa sorteada. A variável desfecho foi excesso de peso, a variável explanatória consumo de feijão e as variáveis de controle foram idade, escolaridade e situação conjugal, além de atividade física no lazer e hábitos alimentares de risco. A análise dos dados foi feita pelo teste do qui-quadrado e por regressão logística. Resultados Foram avaliados 2.352 indivíduos (39,8% do sexo masculino). O excesso de peso atingiu mais os homens, 49,3%, do que as mulheres, 34,0% (p<0,001). A prevalência de excesso de peso apresentou associação direta com idade em ambos os sexos e com escolaridade para homens, para as mulheres a associação com a escolaridade foi inversa. A variável referente ao consumo alimentar que melhor se associou com excesso de peso foi o consumo de feijão. Após ajuste para as demais variáveis, o risco de excesso de peso foi cerca de 1,4 vez maior para os homens que consomem feijão menos do que cinco vezes na semana, porém o inverso para as mulheres. Conclusão Os resultados indicam a necessidade de estudos mais controlados para melhor entendimento da associação entre consumo de feijão e excesso de peso. Termos de indexação: Adultos. Consumo de feijão. Excesso de peso. Hábitos alimentares.

SummaryBackground and objectives Vitamin D deficiency is an important contributor to the development of hyperparathyroidism and is independently associated with cardiovascular and bone disease. The hypothesis was that nutritional vitamin D (ergocalciferol) supplementation in children with CKD stages 2-4 delays the onset of secondary hyperparathyroidism.Design, setting, participants, & measurements A randomized, double-blinded, placebo-controlled study in children with CKD2-4 who had 25-hydroxyvitamin D [25(OH)D] deficiency was conducted. Ergocalciferol (or a matched placebo) was given daily as per Kidney Disease Outcomes Quality Initiative guidelines. The primary endpoint was the time to development of hyperparathyroidism.Results Seventy-two children were screened. Forty-seven children were 25(OH)D-deficient and randomly assigned to receive ergocalciferol or placebo. Twenty children in each arm completed the study; median followup was 12 months. Groups were well matched for age, race, estimated GFR, and season when recruited. Nine of 20 children on placebo and 3 of 20 children on ergocalciferol developed hyperparathyroidism (odds ratio, 4.64; 95% confidence interval, 1.02-21.00). The time to development of hyperparathyroidism was significantly longer with ergocalciferol treatment compared with placebo (hazard ratio, 0.30; 95% confidence interval, 0.09-0.93, P=0.05). With ergocalciferol treatment, normal 25(OH)D levels were achieved in all 8 children with CKD2, 8 of 11 children with CKD3, but not in the single patient with CKD4. There were no ergocalciferol-related adverse events. 25(OH)D levels .100 nmol/L were required to achieve normal levels of 1,25-dihydroxyvitamin D.Conclusions Ergocalciferol is an effective treatment that delays the development of secondary hyperparathyroidism in children with CKD2-3.