This article delves into the complex relationship between alcohol consumption and cholesterol levels, drawing on a series of scientific studies. It reveals that moderate alcohol intake may have a positive impact on lipid profiles, whiles stop drinking can lead to unfavorable changes in cholesterol levels. However, it also emphasizes that the key lies in moderation, as excessive drinking poses significant health risks.
In the stillness of the night, with dim lights casting a warm glow, holding a glass of wine in hand seems to create an intimate sense of ritual for those enjoying some alone time. Some people advocate the idea that "a little drink can lift the spirits, and one should enjoy until slightly intoxicated," suggesting that a life of mild inebriation might be ideal. On the contrary, others express concerns, saying, "Alcohol is a poison that passes through the intestines; excessive drinking can damage the liver and kidneys," dousing the romantic allure of alcohol.
Recently, the question of whether that late - night drink is a blessing or a curse has become intertwined with an unexpected factor: cholesterol. A large - scale study by a research team from Harvard University, published in JAMA Network Open, followed more than 50,000 Japanese individuals over a decade. The results were rather astonishing: those who consumed alcohol in moderation experienced a decrease in "bad cholesterol" (low - density lipoprotein cholesterol, LDL - C) and an increase in "good cholesterol" (high - density lipoprotein cholesterol, HDL - C). Conversely, those who quit drinking saw a deterioration in their cholesterol levels.
D0l:10.1001/jamanetworkopen
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2831319
The Decade - Long Exploration: How Alcohol Influences Lipid Profiles
Imagine blood vessels as the roads in a city, and the two main components of blood lipids, LDL - C and HDL - C, as different types of "vehicles" shuttling along these roads, responsible for transporting substances like cholesterol. Just as a city's traffic requires order to function smoothly, our blood vessels need the "operation" of blood lipids to remain in balance.
LDL - C carry cholesterol from the liver to various parts of the body. But when there are too many of them, they tend to "drop off cargo" along the way. Cholesterol deposits on the walls of blood vessels, forming plaques that can gradually clog the vessels, which is why it's known as "bad cholesterol."
In contrast, HDL - C acts like sanitation trucks in the city. It cleans up excess cholesterol from the blood vessel walls and transports it back to the liver for processing, rightfully earning the title of "good cholesterol."
The question remains: does alcohol bring more order to these "vehicles," or does it completely disrupt the traffic? To explore how alcohol consumption or abstinence affects blood lipids from the perspective of cholesterol, the research team analyzed data from residents who underwent at least two health check - ups at St. Luke’s International Hospital in Tokyo between October 2012 and October 2022. Eventually, 57,691 eligible participants (53% of whom were female) were included in the study, with a total of 328,676 medical records.
Based on this selected group, the research team established two cohorts to analyze the long - term effects of changes in drinking behavior on LDL - C and HDL - C levels. Cohort 1 focused on the initiation of drinking behavior, while Cohort 2 concentrated on the act of quitting alcohol.
Varying Responses of Cholesterol to Different Alcohol Intakes
The researchers first turned their attention to those who started drinking (Cohort 1) to see if consuming an additional glass of alcohol (containing about 10g of pure alcohol) per day would have any impact on blood lipids.
The results were surprising. These new drinkers experienced a decrease in "bad cholesterol" (LDL - C) and an increase in "good cholesterol" (HDL - C). This effect was observed regardless of whether the alcohol consumed was beer, wine, or spirits. In other words, it's not about the type of alcohol, but rather the act of drinking itself.
Association between alcohol initiation and changes in LDL-C and HDL-C levels
However, the research team wasn't satisfied with just knowing the difference between drinking and not drinking. They further analyzed the effects of different drinking amounts and discovered a dose - response curve between alcohol intake and blood lipid levels.
Specifically, compared to non - drinkers, those who consumed less than 1.5 glasses of alcohol per day had an average decrease of 0.85mg/dL in "bad cholesterol" (LDL - C) and an increase of 0.58mg/dL in "good cholesterol" (HDL - C). For those drinking 1.5 - 3 glasses per day, the decrease in "bad cholesterol" (LDL - C) reached 4.40mg/dL, and the increase in "good cholesterol" (HDL - C) was 2.49mg/dL. When the daily alcohol consumption was 3 glasses or more, the changes were even more significant: "bad cholesterol" (LDL - C) decreased by 7.44mg/dL, and "good cholesterol" (HDL - C) increased by 6.12mg/dL.
Adjusted association between alcohol initiation and changes in lipid levels
To put it more vividly, it's like a "cholesterol traffic renovation project." With each additional glass of alcohol consumed per day, there are fewer "jammed delivery trucks" (LDL - C) on the road, and more "city sanitation trucks" (HDL - C) appear.
The Unanticipated Outcome of Quitting Alcohol on Blood Lipids
So, if drinking can increase "good cholesterol," does quitting alcohol have the opposite effect on blood lipids? In our traditional understanding, quitting alcohol is often associated with a fresh start: the liver becomes healthier, the skin improves, and blood lipids should also return to normal. But the results of this study were astonishing.
When people stopped their daily habit of having one glass of alcohol, LDL - C (bad cholesterol) increased instead of decreasing, and HDL - C (good cholesterol) decreased. This trend was not dependent on the type of alcohol. Once people quit drinking, their blood lipid levels were likely to deviate from the normal range.
The researchers further divided the amount of alcohol consumed before quitting into three levels and found that the degree of change in blood lipids after quitting was related to the previous drinking amount. Compared with those who maintained the same daily alcohol consumption, for those who previously drank less than 1.5 glasses per day, LDL - C increased by 1.10mg/dL and HDL - C decreased by 1.25mg/dL after quitting. If they used to drink 1.5 - 3 glasses per day, LDL - C decreased slightly by 3.71mg/dL, but HDL - C decreased more significantly, by 3.35mg/dL. For those who previously drank more than 3 glasses per day, LDL - C soared by 6.53mg/dL and HDL - C plummeted by 5.65mg/dL after quitting.
In short, quitting alcohol is associated with an increase in LDL - C levels and a decrease in HDL - C levels. The more one drank before and the more abruptly one quit, the greater the fluctuations in blood lipids. The researchers pointed out that in people with alcohol dependence, quitting alcohol reduces IGFBP - 1 (a protein related to lipid metabolism), thereby affecting the level of HDL - C.
At this point, you might be wondering: should we still quit drinking? Don't misunderstand. Quitting alcohol is still beneficial for the body in the long run, especially in terms of liver health, pancreatic function, and reducing the risk of cancer.
Overall, this study presents an interesting phenomenon: those who start drinking experience a decrease in LDL - C and an increase in HDL - C, while those who quit drinking see these two indicators change in the opposite direction, and this change also shows a "dose - response relationship."
Alcohol: A Double - Edged Sword for Health
This may seem surprising, but it's not an isolated finding. There have been numerous discussions in the scientific community about the potential health benefits of moderate alcohol consumption.
For example, a research team from Qilu Medical College of Shandong University conducted a 12 - year follow - up study on more than 910,000 adults to explore the relationship between alcohol consumption and health risks. The study showed that current light to moderate drinkers (women consuming ≤7 glasses per week and men ≤14 glasses per week) had a 13% - 23% lower all - cause mortality risk compared to lifelong non - drinkers. The risk reductions for cardiovascular diseases, Alzheimer's disease, and influenza - related deaths were particularly significant. As can be seen from the following figure, when the daily alcohol consumption is around one glass, the all - cause mortality risk reaches its lowest point, decreasing by approximately 20%.
Dose-response relationship between alcohol consumption and risk of all-cause mortality
Another study by Harvard University, published in the Journal of the American College of Cardiology, found that compared to non - drinkers or those who rarely drank (less than one glass per week), light to moderate drinkers (1 to 14 glasses per week) had a 22% lower risk of major adverse cardiovascular events. The researchers further pointed out that moderate alcohol consumption may reduce the level of stress signals in the brain over the long term, thereby reducing the burden on the cardiovascular system.
Notably, a national retrospective cohort study published in JAMA Network Open, covering more than 3.93 million people, revealed another benefit of moderate alcohol consumption. Compared with non - drinkers, continuous light and moderate drinkers had a lower risk of all - cause dementia. Additionally, those who transitioned from non - drinking to light to moderate drinking also showed a decreased risk of all - cause dementia and Alzheimer's disease (AD).
D01:10.1001/iamanetworkopen.2022.54771
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2800994
The research team retrieved data from a national database for 3,933,382 people and divided them into four groups based on their drinking frequency and alcohol intake in the past year: non - drinkers (0g per day), light drinkers (<15g per day), moderate drinkers (15 - 29.9g per day), and heavy drinkers (>30g per day).
During an average follow - up period of 6.3 years, the researchers found an interesting result: compared with non - drinkers, light and moderate drinkers had a 21% and 17% lower risk of all - cause dementia, respectively.
In other words, drinking a small amount each day may actually protect the brain. What's more interesting is that if someone who previously never drank started to have an occasional drink, there was also a downward trend in risk. Data showed that compared with those who never drank, individuals who transitioned from "non - drinking" to "light drinking" had a 7% lower risk of all - cause dementia and an 8% lower risk of Alzheimer's disease.
Association between changes in alcohol intake and dementia (partial chart)
The research team further explained that light to moderate drinking may protect cognitive function by activating certain "pro - survival" pathways and reducing neuroinflammation. It's like providing an umbrella for the brain, shielding it from the ravages of time and disease.
However, before "drinkers" who can't live without alcohol raise their glasses in celebration, it's important to note that the study clearly shows that once alcohol consumption becomes excessive, the risks start to reverse. Heavy drinkers have an increased risk of dementia. Moreover, defining "moderation" is easier said than done. Each person's "safe dose" varies, as factors such as gender, body weight, and genetic metabolic capacity (such as the activity of aldehyde dehydrogenase) can affect how quickly the body metabolizes alcohol. Even "moderate" drinking can potentially cause other harm to the body, such as increasing the risk of cancer.
The study also makes it clear that while "a little drink" can be pleasant, "excessive drinking" is truly harmful to health. Specifically, compared with lifelong non - drinkers, heavy drinkers (women drinking more than 7 glasses per week and men drinking more than 14 glasses per week) have a 24% higher risk of cancer - related death, which is significantly higher than that of light drinkers.
In conclusion, this article is not intended to encourage people to start drinking for the sake of health. Especially during holiday gatherings, it's crucial to remember to drink in moderation, avoid pressuring others to drink, and never force oneself to overindulge. Don't let "moderation" turn into "excess."