Context and objective: Protective and detrimental associations have been reported between alcohol consumption and the Metabolic Syndrome. This may be due to variations in drinking patterns and different alcohol effects on the Metabolic Syndrome components. This study is designed to examine the relationship between alcohol consumption patterns and the Metabolic Syndrome.

Design, setting, participants and measures: The 1999–2002 National Health and Nutrition Examination Survey is a population-based survey of non-institutionalized U.S. adults. Current drinkers aged 20 to 84 years without cardiovascular disease who had complete data on the Metabolic Syndrome and drinking patterns were included in the analysis (N=1529). The metabolic abnormalities comprising the Metabolic Syndrome included having 3 of the following: impaired fasting glucose/diabetes mellitus, high triglycerides, abdominal obesity, high blood pressure (HBP), and low high-density-lipoprotein cholesterol (L-HDLC). Measures of alcohol consumption included usual quantity consumed, drinking frequency, and frequency of binge drinking.

Results: In multinomial logistic regression models controlling for demographics, family history of cardiovascular disease and diabetes, and lifestyle factors, increased risk of the Metabolic Syndrome was associated with daily consumption that exceeded U.S. Dietary Guideline recommendations (>1 drink per drinking day for women and >2 drinks per drinking day for men (odds ratio (OR) = 1.60, 95% confidence interval (CI) = 1.22 2.11)) and binge drinking once /week (OR (95% CI)=1.51 (1.012.29). By individual metabolic abnormality, drinking in excess of the Dietary Guidelines was associated with an increased risk of impaired fasting glucose/diabetes mellitus, hypertriglyceridemia, abdominal obesity, and HBP.

Conclusion: Public health messages should emphasize the potential cardiometabolic risk associated with drinking in excess of national guidelines and binge drinking.