News
Article
Alcohol Initiation, Cessation Associated With Dose-Dependent Changes in LDL, HDL Cholesterol
Author(s):
Alcohol consumption, though typically associated with adverse health outcomes, could be associated with reduced low-density lipoprotein cholesterol (LDL-C) and improved high-density lipoprotein cholesterol (HDL-C).
The initiation and cessation of alcohol consumption was associated with changes in low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) in a dose-dependent fashion, according to new study results published in the Journal of the American Medical Association. Strikingly, in this study, alcohol cessation was associated with increased LDL-C and decreased HDL-C levels compared with continued alcohol intake, contrasting with the growing warnings of alcohol and its effects on health.1
Alcohol has been known to be detrimental to myriad health outcomes. | Image Credit: © JackF - stock.adobe.com
Alcohol has been known as a contributor to disease, morbidity, and mortality globally, contributing to nearly 10% of global deaths, according to the investigators. Though often overshadowed by myriad studies highlighting the detrimental effects of alcohol consumption, one of the benefits of consumption—historically proven in clinical trials—is an association with improvements in lipid levels.1
Small randomized clinical trials and analyses have collectively indicated that alcohol intake tends to increase HDL-C and decrease LDL-C. One analysis on the effects of moderate red wine consumption on blood lipids found that LDL-C was lowered by red wine consumption. Another, which investigated the relationship between alcohol consumption and serum lipid levels in older Korean men, found that alcohol consumption was negatively associated with a risk for low HDL-C; however, the current authors note that these studies and others did not reflect lived conditions, with relatively short follow-up periods.2,3
Up to this point, it has remained unclear as to whether changes in alcohol consumption—particularly, alcohol cessation and initiation—alter long-term lipid profiles, and whether these alterations are positive or negative. The current investigators utilized a large database of longitudinal Japanese annual medical checkups to further investigate the relationship between changes in alcohol consumption and subsequent impacts to LDL-C and HDL-C.1
In total, the analysis included 328,676 visits from 57,691 individuals. Cohort 1 comprised 107,880 visits (29,042 participants) and assessed the association of alcohol initiation on cholesterol levels. At initiation visits, the median alcohol intake was about 0.40 (0.20-0.80) drinks/day. Contrastingly, cohort 2 comprised 49,898 visits (25,144 participants) and assessed alcohol cessation; participants ceased alcohol intake from the median intake of 0.40 drinks/day.1
Beginning with cohort 1, initiating an additional 1 alcoholic drink/day was associated with decreased LDL-C levels and increased HDL-C levels, with similar results observed across multiple models. Similarly, the initiation of all types of alcoholic beverages was associated with decreased LDL-C and increased HDL-C levels, according to the investigators. Moving to cohort 2, the cessation of 1 alcoholic drink was associated with increased LDL-C and decreased HDL-C levels. The cessation of all types of alcoholic beverages was associated with increased LDL-C and decreased HDL-C, the authors found. Critically, investigators observed dose-dependent changes in each cohort, with mean changes in LDL-C levels increasing with further alcohol initiation and decreasing with increased alcohol cessation.1
In their discussion, the study authors noted that this investigation uniquely focused on the association between changes in exposure and subsequent outcomes, which is an aspect missing from previous observational studies. Furthermore, the topic of associations with LDL-C and HDL-C levels had not been fully examined, despite the increasing concerns about the overall risk of alcohol consumption. These results provide important context to the conversation among possible lipid benefits associated with alcohol intake and emphasize the importance of careful monitoring of cholesterol levels following the cessation of alcohol.1,2,3
“While light alcohol consumption may have potentially favorable effects on lipid profiles, decisions regarding alcohol intake should be individualized, considering the overall health risks,” the investigators concluded. “Public health recommendations should continue to emphasize moderation in alcohol consumption, but cholesterol levels should be carefully monitored after alcohol cessation to mitigate potential CVD risks.”1
