How alcohol affects cholesterol

by Christine Humphreys

Published: February 05, 2021 Last updated: November 30, 2023

Most people know that fatty food can increase cholesterol levels but it’s not so easy to understand the association between alcohol consumption and elevated cholesterol.

Cholesterol is vital for key body functions such as absorbing vitamin D and producing five key hormones including the ‘sex’ hormones androgen and estrogen. It also produces anti-inflammation cortisols and stress-management hormones.

Your liver produces natural cholesterol and that’s all your body needs for good heart health.

What we eat and drink can add excess cholesterol into the bloodstream. If we’re not careful, it can become dangerously high and increase risks to heart health and overall wellbeing.

There are two types of cholesterol – High-Density Lipoproteins (HDL) and Low-Density Lipoproteins (LDL). HDL is often referred to as the ‘good’ cholesterol but the body needs both types to function properly.

Problems start when bad LDL cholesterol levels become too high. An excess LDL level starts to build up in the blood stream and stick to the artery walls creating plaque that hinders blood flow.

So what affect does alcohol have?

There is some evidence that red wine can actually raise HDL and provide some protection against heart disease.

However, studies suggests that it is the antioxidants of the glass of wine – these are polyphenols that come directly from the grape skin – that provide the protection. It is the alcohol in the wine that creates the problem.

According to the cholesterol education charity Heart UK, experts now also believe that excessively high HDL can be harmful.

When we drink alcohol, it’s broken down in the liver where it’s converted into triglycerides – which are a type of fat – and cholesterol.

In this way, drinking alcohol directly raises triglyceride levels and cholesterol in the blood.

If we have more of these fats than our body needs, they can build up in the organs, block arteries and lead to a higher risk for heart attack.

When levels of triglycerides go too high, they build up in the liver causing fatty liver disease. This in turn hampers the liver function so it’s less efficient at removing cholesterol from the blood, so levels rise.

The cholesterol then sticks to the artery walls causing narrowing and this raises blood pressure which increase the heart failure risk.

Is all cholesterol bad?

Heart UK says that while most health care professionals are taught that the higher the HDL cholesterol the more protective it is for your heart, some specialists are beginning to doubt this.

Current recommended levels of HDL are 1.2mmol/L or above in women and 1.1mmol/L or above in men.

However experts now believe there is a limit to the amount of HDL that benefits the body and that the beneficial effect of HDL cholesterol peaks at around 1.4mmol/L.

According to Heart UK, very high HDL has been reported to speed up the process of atherosclerosis – where the blood vessels become clogged up.

They say that the latest research shows that HDL above 2.3mmol/L behave more like LDL and increase the risk of disease.

Researchers say this is especially so for women leading up to and after the menopause as hormonal changes can affect the way HDL works and reduce its protective effects.

Conditions such as cardiomyopathy – hardening of the heart muscles – and heart arrhythmia – where the heart beats erratically – can result from heavy alcohol intake

Heart UK warn that excessive drinking can contribute to increased HDL. They recommend a break from alcohol, sticking to a healthy diet of low-fat food, and increasing exercise for at least three months to restore healthy cholesterol levels.

Watch your weight but don’t be complacent if you are thin!

Because alcohol is also high in calories, regular drinkers risk weight gain which further increases triglyceride levels in the blood, can lead to high blood pressure and increase the risk of heart damage and stroke.

Even slim people need to consider cholesterol control. In some cases high cholesterol can be hereditary and, despite maintaining a healthy weight and following a healthy diet, some people will need to take cholesterol medicines such as statins.

People prescribed statins should discuss with their doctor the risks posed by even moderate alcohol consumption.

About The Author

Christine Humphreys

Chris Humphreys is the co-founder of The Alcohol-Free Shop and AlcoholFree.com. She was a journalist for more years than she cares to remember. Ex-wife of an alcoholic, enthusiastic amateur musician and a passionate dog lover.