Although you may think of cholesterol as unhealthy, it’s essential for your health. For example, it makes up the membrane surrounding your body’s cells and is necessary to produce vitamin D and hormones such as estrogen and testosterone (1).
While your body needs cholesterol to function, having too much cholesterol may contribute to health issues, including an increased risk of heart disease. That’s why keeping your cholesterol within a healthy range is important.
Cholesterol levels are affected by many factors, including body weight and dietary intake. Alcohol intake may also affect cholesterol levels, both positively and negatively (1, 2).
This article explains how alcohol intake affects cholesterol levels and heart health.
How does alcohol affect cholesterol levels?
The relationship between alcohol and health is complicated and depends on many factors, including how much and how often you drink.
While light to moderate alcohol intake isn’t usually harmful, heavy alcohol use can cause severe effects. In fact, heavy alcohol use is one of the leading risk factors for disease burden worldwide, increasing the risk of certain cancers, liver disease, and heart disease (3).
Alcohol intake affects cholesterol levels differently depending on the level and frequency of intake.
Light to moderate alcohol intake may improve HDL (good) cholesterol
Light alcohol intake may increase levels of HDL cholesterol (2).
HDL protects heart health because it collects excess cholesterol and transports it to your liver, where it can be removed or recycled. This reduces the formation of plaque in your arteries (4, 5).
Having higher levels of HDL cholesterol may help protect against heart disease and related death.
In fact, light to moderate alcohol intake is associated with a reduced risk of coronary heart disease, stroke, and heart disease-related death in most populations (2, 6).
Heavy alcohol intake increases heart disease risk factors
Heavy drinking is consistently tied to negative health outcomes, including high LDL (bad) cholesterol, triglycerides, and blood pressure (7, 8, 9, 10).
A study in 1,519 people associated high intensity binge drinking — 8 or more drinks for women and 10 or more drinks for men per day — with a 2–8-fold increased risk of high triglyceride and total cholesterol levels (9).
Furthermore, excess alcohol intake may contribute to increases in blood pressure and waist circumference, which are also considered heart disease risk factors (11, 12).
This is why heavy drinking is linked to an increased risk of heart disease and heart disease-related death (13, 14).
While light to moderate alcohol intake may improve HDL cholesterol levels and reduce heart disease risk, heavy drinking elevates multiple heart disease risk factors, including LDL and total cholesterol.
Does how often and how much you drink matter?
The effects of alcohol on overall health, including cholesterol levels, depend on many factors.
Firstly, alcohol doesn’t affect everyone the same way.
For example, females are much more sensitive to the effects of alcohol because they have lower levels of the enzyme alcohol dehydrogenase, which breaks down alcohol (15).
Therefore, females cannot metabolize alcohol at the same rate as males and absorb more alcohol into their bloodstream. Plus, females are generally smaller than males (2).
This is why alcohol intake recommendations differ by sex.
Current recommendations for moderate alcohol intake are one drink per day or less for females and two drinks per day or less for males (16, 17).
Heavy drinking, which is associated with numerous health risks, is defined as (16):
- Males: 4 or more drinks on any given day, or more than 14 drinks per week
- Females: 3 or more drinks on any given day, or more than 7 drinks per week
According to one study, the maximum potential benefit for heart health occurs at low alcohol intake levels of 0.5–1 standard drinks per day for females and 1–2 standard drinks per day for males (13).
However, even if you fall into the heavy drinking category, cutting back on alcohol may significantly reduce your risk of heart disease.
Notably, a 10-year study found that when people with type 2 diabetes reduced their alcohol intake by 2 or more drinks per week (or abstained completely), their heart disease risk decreased by 44% compared with those who consistently drank moderate amounts (6, 18).
The frequency and amount of alcohol you drink affects heart health, including cholesterol levels. In particular, heavy drinking is associated with negative effects.
Is it possible to drink alcohol and maintain healthy cholesterol levels?
For most people, light to moderate drinking is unlikely to negatively affect cholesterol levels. In fact, it may improve HDL cholesterol levels and even reduce the risk of heart disease.
However, heavy drinking impairs heart health and may raise total cholesterol and triglyceride levels.
Keeping cholesterol levels within a certain range is recommended in order to keep your heart healthy. Current cholesterol recommendations are as follows (19):
- Total cholesterol: 200 mg/dL (5.2 mmol/L) or less
- LDL cholesterol: 130 mg/dL (3.4 mmol/L) or less
- HDL cholesterol: 40 mg/dL (1 mmol/L) or higher in males and 50 mg/dL (1.3 mmol/L) or higher in females
Although maintaining healthy cholesterol levels is essential to reducing heart disease risk, many factors contribute to this condition, including blood pressure, genetics, and sex (19).
Maintaining a healthy diet and lifestyle — which includes limiting alcohol, keeping a moderate body weight, staying active, and following a nutritious diet — promotes healthy cholesterol levels and reduces your risk of heart disease and other conditions.
When should you see a doctor?
A healthcare professional can test your cholesterol levels to determine whether they’re currently within a healthy range, as well as assess other potential heart disease risk factors.
If you’re currently consuming multiple drinks per day or feel that your alcohol intake is harming your physical and mental health, there are ways to get help.
Talk with a trusted health professional about your concerns or visit this website to find treatment options and resources near you.
Light to moderate alcohol intake is unlikely to harm cholesterol levels, but heavy drinking can. If you’re concerned that your drinking is damaging your health, consult a healthcare professional.
The bottom line
Depending on your intake, alcohol may either positively or negatively affect cholesterol levels and other measures of heart health.
While light to moderate drinking may increase HDL cholesterol, heavy alcohol use is associated with elevated levels of LDL cholesterol, total cholesterol, and triglycerides, as well as a greater risk of heart disease and death due to this condition.
If you’re concerned about your cholesterol levels or alcohol intake, talk with a healthcare professional. They can provide appropriate testing and additional resources if needed.
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