Studies have suggested that moderate alcohol consumption is associated with a reduced risk of CVD and premature mortality in individuals with diabetes mellitus. However, history of alcohol consumption has hardly been taken into account. We investigated the association between current alcohol consumption and mortality in men and women with diabetes mellitus accounting for past alcohol consumption. Within the European Prospective Investigation into Cancer and Nutrition (EPIC), a cohort was defined of 4797 participants with a confirmed diagnosis of diabetes mellitus. Men and women were assigned to categories of baseline and past alcohol consumption. Hazard ratios (HR) and 95 % CI for total mortality were estimated with multivariable Cox regression models, using light alcohol consumption (>0–6 g/d) as the reference category. Compared with light alcohol consumption, no relationship was observed between consumption of 6 g/d or more and total mortality. HR for >6–12 g/d was 0·89 (95 % CI 0·61, 1·30) in men and 0·86 (95 % CI 0·46, 1·60) in women. Adjustment for past alcohol consumption did not change the estimates substantially. In individuals who at baseline reported abstaining from alcohol, mortality rates were increased relative to light consumers: HR was 1·52 (95 % CI 0·99, 2·35) in men and 1·81 (95 % CI 1·04, 3·17) in women. The present study in diabetic individuals showed no association between current alcohol consumption >6 g/d and mortality risk compared with light consumption. The increased mortality risk among non-consumers appeared to be affected by their past alcohol consumption rather than their current abstinence.

Given the limitations associated with the measurement of food intake, we aimed to determine the reliability of a food menu to measure energy intake (EI) and macronutrient intake within the laboratory and under free-living conditions. A total of eight men and eight women (age 25·74 (sd 5·9) years, BMI 23·7 (sd 2·7) kg/m2) completed three identical in-laboratory sessions (ILS) and three out-of-laboratory sessions (OLS). During the ILS, participants had ad libitum access to a variety of foods, which they chose from a menu every hour, for 5 h. For the OLS, the foods were chosen from the menu at the start of the day and packed into containers to bring home. There were no significant differences in total EI (6118·6 (sd 2691·2), 6678·8 (sd 2371·3), 6489·5 (sd 2742·9) kJ; NS) between the three ILS and three OLS (6816·0 (sd 2713·2), 6553·5 (sd 2364·5), 6456·4 (sd 3066·8) kJ; NS). Significant intraclass correlations (ICC) for total energy (r 0·77, P < 0·0001), carbohydrate (r 0·81, P < 0·0001), dietary fat (r 0·54, P < 0·0001) and protein (r 0·81, P < 0·0001) intakes for the ILS and significant ICC for total energy (r 0·85, P < 0·0001), carbohydrate (0·85, P < 0·0001), dietary fat (0·72 P < 0·0001) and protein (0·80, P < 0·0001) intakes for the OLS were noted. The average within-subject CV for total EI was 18·3 (sd 10·0) and 16·1 (sd 10·3) % for the ILS and OLS, respectively, with a pleasantness rating for foods consumed of 124 (sd 14) mm out of 150 mm (83 %). Overall, the food menu produces a relatively reliable measure of EI inside and outside the laboratory. The results also underscore the difficulties in capturing a representative image of food intake given the relatively high day-to-day variation in the amount and composition of foods consumed.

The present report summarises the symposium ‘Nutrition Transition and the Global Burden of Type 2 Diabetes’ and a workshop on strategies for dietary interventions to prevent type 2 diabetes held by the Global Nutrition and Epidemiologic Transition Initiative, Boston, MA, USA in November 2011. The objectives of this event were to bring attention to the global epidemic of type 2 diabetes in light of the ongoing nutrition transition worldwide, especially in low- and middle-income countries, and to highlight the present evidence on key dietary risk factors contributing to the global diabetes burden. The meeting put forward ideas for further research on this topic and discussed practical recommendations to design and implement culturally appropriate dietary interventions with a focus on improving carbohydrate quality to help alleviate this growing health problem.