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Researchers Say Benefits May Be Related to Effect of Moderate Drinking on HDL Levels
By Denise Mann
WebMD Health News
Reviewed by Laura J. Martin, MD
Feb. 24, 2011 -- New research shows that moderate alcohol consumption can reduce heart disease risk by up to 25%, and this is likely due, at least in part, to alcohol's positive effects on HDL "good" cholesterol levels.
The findings from two studies, which appear in the journal BMJ, dovetail with the newly released 2010 dietary guidelines that state if alcohol is drunk, it should be drunk in moderation: one alcoholic drink per day for women and up to two drinks per day for men.
A drink is defined as 1.5 ounces of spirits, 5 ounces of wine, or 12 ounces of beer. The dietary guidelines recommend that anyone younger than the legal drinking age and pregnant women should refrain from drinking alcohol.
In a review of 84 studies, people who drank one or fewer alcoholic drinks a day were 14% to 25% less likely to develop heart disease compared to their teetotaling counterparts.
Alcohol and HDL Levels
In a second report, researchers reviewed 63 studies that looked at biomarkers of heart disease and how they correlated with alcohol consumption, including cholesterol and inflammatory markers. This study showed that moderate alcohol consumption boosted levels of HDL cholesterol and had beneficial effects on apolipoprotein A1, the hormone adiponectin and fibrinogen, a protein that aids in blood clotting.
"Our studies suggest that drinking moderate amounts of alcohol may have some benefits in terms of reducing the risk for cardiac disease and death related to cardiac disease," says Susan E. Brien, a postdoctoral fellow at the University of Calgary, Canada. "This benefit may be related to the effects of alcohol on some biological markers associated with cardiac disease, such as HDL and fibrinogen." Brien is a researcher of both of the new studies.
The mechanism by which alcohol may have cardioprotective effects is not fully understood, she says in an email. "Further research should be done to determine the mechanisms by which alcohol exerts these effects."
Wine, Beer, and Spirits
While many previous studies have suggested there may be heart benefits from drinking a moderate amount of red wine, the new study shows the findings hold with a moderate intake of any type of alcohol.
The jury is in regarding the health benefits of moderate alcohol consumption, says Eric Rimm, ScD, an associate professor of medicine at Harvard Medical School in Boston.
"It's time to stop doing these studies and work on our messaging," he says. Rimm recently spoke at a luncheon on the new dietary guidelines hosted by the Distilled Spirits Council, a trade group representing producers and marketers of distilled spirits.
Public health messages need to stress moderate -- not heavy -- drinking. "Some alcohol is beneficial, but you need to stop at some," he says. "If you choose to drink, stop at moderation."
The definition of heavy drinking, according to the CDC, is having more than two drinks daily on average for men and more than one drink daily on average for women.
"Don't let it get this far," Rimm says.
The reason that the moderate drinking definition is different for women and men is not just because of the size difference between the sexes, he says.
"Women metabolize alcohol differently than men, and there are hormonal differences," Rimm says. "Women are at higher risk for breast cancer and alcohol can increase breast cancer risk."
Some may be concerned that alcohol can contribute to weight gain and obesity whether from the calories in alcohol or the effect that it has on inhibition, but this has not been borne out by the research, he says.
"Obesity is a complex condition and there are many contributors including lack of exercise and portion control, but alcohol's role in that is very small, and probably doesn't exist when alcohol is consumed in moderation," he says.
Suzanne Steinbaum, MD, director of women and heart disease at Lenox Hill Hospital in New York City, says that "moderate alcohol consumption could be part of a heart-healthy lifestyle." Research shows that it helps boost HDL levels, and this can have profound effects on heart disease risk.
"I never tell people to start drinking if it is not part of their lives," she says. "It is not a free-for-all."
Not everyone should drink alcohol, including people with liver disease, blood clotting abnormalities, or addictive personalities, she says.
Sam Zakhari, PhD, director of the division of metabolism and health effects at National Institute on Alcohol Abuse and Alcoholism in Bethesda, Md., says there have been enough studies showing the heart-healthy benefits of moderate alcohol consumption. "Now it is time to focus on why alcohol is good for the heart."
"Don't drink just for this so-called benefit because some people are not supposed to drink such as pregnant women and people on different medications," he says. "If you enjoy a drink with dinner, and have no reason not to drink, then enjoy."
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