Large study shows drinking alcohol is good for your cholesterol levels

There are many risks from drinking, but high cholesterol doesn't seem to be one.

Drinking alcohol is bad in many ways; raising a glass can raise your risks of various health problems, such as accidental injuries, liver diseases, high blood pressure, and several types of cancers. But, it's not all bad—in fact, it's surprisingly good for your cholesterol levels, according to a study published today in JAMA Network Open.

Researchers at Harvard University led the study, and it included nearly 58,000 adults in Japan who were followed for up to a year using a database of medical records from routine checkups. Researchers found that when people switched from being nondrinkers to drinkers during the study, they saw a drop in their "bad" cholesterol—aka low-density lipoprotein cholesterol or LDL.  Meanwhile, their "good" cholesterol—aka high-density lipoprotein cholesterol or HDL—went up when they began imbibing. HDL levels went up so much, that it actually beat out improvements typically seen with medications, the researchers noted.

On the other hand, drinkers who stopped drinking during the study saw the opposite effect: Upon giving up booze, their bad cholesterol went up and their good cholesterol went down.

The cholesterol changes scaled with the changes in drinking. That is, for people who started drinking, the more they started drinking, the lower their LDL fell and higher their HDL rose. In the newly abstaining group, those who drank the most before quitting saw the biggest changes in their lipid levels.

Specifically, people who went from drinking zero drinks to 1.5 drinks per day or less saw their bad LDL cholesterol fall 0.85 mg/dL and their good HDL cholesterol go up 0.58 mg/dL compared to nondrinkers who never started drinking. For those that went from zero to 1.5 to three drinks per day, their bad LDL dropped 4.4 mg/dL and their good HDL rose 2.49 mg/dL. For people who started drinking three or more drinks per day, their LDL fell 7.44 mg/dL and HDL rose 6.12 mg/dL.

For people who quit after drinking 1.5 drinks per day or less, their LDL rose 1.10 mg/dL and their HDL fell by 1.25 mg/dL. Quitting after drinking 1.5 to three drinks per day, led to a rise in LDL of 3.71 mg/dL and a drop in HDL of 3.35. Giving up three or more drinks per day led to an LDL increase of 6.53 mg/dL and a drop in HDL of 5.65.

The good and the bad

For reference, the optimal LDL level for adults is less than 100 mg/dL, and optimal HDL is 60 mg/dL or higher. Higher LDL levels can increase the risk of heart disease, stroke, peripheral artery disease, and other health problems, while higher HDL has a protective effect against cardiovascular disease. Though some of the changes reported in the study were small, the researchers note that they could be meaningful in some cases. For instance, an increase of 5 mg/dL in LDL is enough to raise the risk of a cardiovascular event by 2 percent to 3 percent.

The researchers ran three different models to adjust for a variety of factors, including basics like age, sex, body mass index, as well as medical conditions, such as hypertension and diabetes, and lifestyle factors, such as exercise, dietary habits, and smoking. All the models showed the same associations. They also broke out the data by what kinds of alcohol people reported drinking—wine, beer, sake, other liquors and spirits. The results were the same across the categories.

The study isn't the first to find good news for drinkers' cholesterol levels, though it's one of the larger studies with longer follow-up time. And it's long been found that alcohol drinking seems to have some benefits for cardiovascular health. A recent review and meta-analysis by the National Academies of Sciences, Engineering, and Medicine found that moderate drinkers had lower relative risks of heart attacks and strokes. The analysis also found that drinkers had a lower risk of all-cause mortality (death by any cause). The study did, however, find increased risks of breast cancer. Another recent review found increased risk of colorectal, female breast, liver, oral cavity, pharynx, larynx, and esophagus cancers.

In all, the new cholesterol findings aren't an invitation for nondrinkers to start drinking or for heavy drinkers to keep hitting the bottle hard, the researchers caution. There are a lot of other risks to consider. For drinkers who aren't interested in quitting, the researchers recommend taking it easy. And those who do want to quit should keep a careful eye on their cholesterol levels.

In their words: "Public health recommendations should continue to emphasize moderation in alcohol consumption, but cholesterol levels should be carefully monitored after alcohol cessation to mitigate potential [cardiovascular disease] risks," the researchers conclude.

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