From the Guidelines
Moderate alcohol consumption, defined as up to one drink daily for women or up to two drinks daily for men, may have a beneficial effect on HDL cholesterol levels, increasing them by approximately 12% on average, as noted in the 2001 American Heart Association science advisory 1. When considering the impact of alcohol on cholesterol levels, it's essential to weigh the potential benefits against the risks.
- Alcohol can increase plasma triglyceride levels, particularly in individuals with underlying hypertriglyceridemia, which may lead to marked elevations and exacerbate conditions like pancreatitis.
- The primary effect of alcohol on lipoproteins is to increase circulating levels of high-density lipoprotein (HDL) cholesterol, with one to two drinks per day resulting in an average increase of 12% in HDL levels, similar to the effects seen with exercise programs and fibric acid medications 1.
- However, it's crucial to note that no clinical trials have verified the use of alcohol as a means to increase HDL cholesterol levels, and other interventions like statins and fibric acids have demonstrated benefits in primary and secondary prevention, respectively.
- Light to moderate alcohol intake, up to 60 mL of alcohol per day, may also have antithrombotic actions, with decreases in platelet aggregation observed in numerous studies, although the controversy surrounding the specific effects of different types of alcoholic beverages, such as red wine, remains 1. Given the complex relationship between alcohol and cholesterol, it is recommended to prioritize proven cholesterol management strategies, including a heart-healthy diet, regular exercise, maintaining a healthy weight, and taking prescribed medications like statins, over alcohol consumption.
From the Research
Alcohol Consumption and Cholesterol Levels
- Alcohol consumption has been associated with both positive and negative effects on cholesterol levels, depending on the amount and frequency of consumption 2, 3.
- Moderate alcohol consumption, defined as up to 14 g per day for women and up to 28 g per day for men, may be associated with reduced mortality risk, mainly due to reduced risks for cardiovascular disease and type-2 diabetes 2.
- A study found that low-to-moderate alcohol consumption significantly increased HDL2-c and reduced TG, total cholesterol, LDL-c, sdLDL-c, and apoB levels, suggesting a causal role of regular low-to-moderate alcohol consumption in improving lipid profiles 4.
Effects of Alcohol on Lipid Profiles
- Alcohol consumption has been shown to have a hormetic physiological behavior, resulting in either increased or decreased cardiovascular risk depending on the amount consumed, drinking frequency, pattern of consumption, and the outcomes under study 3.
- A Mendelian randomization study found that alcohol consumption causally affects lipid levels, with low-to-moderate consumption associated with improved lipid profiles, including increased HDL2-c and reduced TG, total cholesterol, and LDL-c 4.
- However, the relationship between alcohol consumption and lipid profiles is complex, and the effects of alcohol on cholesterol levels may vary depending on individual factors, such as age, sex, and genetic background 3, 4.
Comparison of Lipid-Lowering Treatments
- Studies have compared the efficacy and safety of different lipid-lowering treatments, including atorvastatin and simvastatin, in patients with dyslipidemia with and without coronary heart disease 5, 6.
- These studies found that atorvastatin had significantly greater reductions in LDL cholesterol and other lipid parameters compared to simvastatin, and was well tolerated by patients 5, 6.
- The choice of lipid-lowering treatment depends on individual patient factors, including the presence of coronary heart disease, lipid profiles, and other cardiovascular risk factors 5, 6.