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Alcohol volume, not drinking frequency, increases plasma high-density lipoprotein sub-class particle concentration
Summary: The authors assessed the hypothesis that usual daily alcohol intake (volume), beverage type and drinking frequency influence plasma HDL sub-class concentrations as determined by NMR. Six hundred and ninety volunteers (389 women) aged 40-69 years at baseline (1990-1994) participated in a cross-sectional study using the Melbourne Collaborative Cohort Study, Australia. Measures included self-reported alcohol intake using beverage-specific quantity-frequency questions (volume) and a drinking diary for previous week (frequency).

The median alcohol intake was 15.2 g/d (2.7, 32.0) for men and 1.0 g/d (0, 9.6) for women. Alcohol volume was positively associated with total HDL particle concentration in men and women. For men, a 10 g/d increment in alcohol intake increased total HDL particle concentration by 0.62 µmol/L (95% CI: 0.27, 0.98) and small HDL particle concentration by 0.34 µmol/L (0.01, 0.68). For women, total HDL particle concentration increased 1.06 µmol/L (0.60, 1.53) for every 10 g/d increment in alcohol intake. Results varied by menopausal status, as alcohol volume was positively associated with large HDL particle concentration in premenopausal women [0.67 µmol/L (0.19, 1.15)] and small HDL particle concentration in postmenopausal women [0.82 µmol/L (0.14, 1.51)]. Drinking frequency was not associated with total HDL particle concentration or any of its sub-classes. The authors conclude that alcohol volume (and not drinking frequency) was positively associated with NMR-determined plasma total HDL particle concentration for men and women. These associations appeared to be regardless of beverage type, although comparison of beverage types was not possible for women. These results suggest that for any given weekly volume of alcohol, the number of drinking days does not influence HDL particle concentration.

Comments: In our previous analysis of middle-aged subjects in the Family Heart Study, we found that in comparison with non-drinkers, men who consumed 2 drinks/day had about 9 mg/dl higher total HDL, while for women the increase was almost 13 mg/dl. In the present study, the estimated increase that would be associated with 2 drinks/day was the equivalent of an increase in total HDL of about 6 mg/dl for men and 10 mg/dl for women, only slightly lower than our earlier population estimates.

As has been shown in most studies, it is the alcohol in a beverage that is the main determinant of HDL, rather than the type of beverage. In this study after taking the amount of alcohol consumed into consideration, the frequency of drinking had no effect on HDL; however, these investigators did not evaluate effects of alcohol on coagulation and fibrinolysis, which may well have varied by frequency of drinking. The impact on heart disease risk associated with differences between large and small HDL particles, the main object of this study, remains unclear.

Alcohol volume, not drinking frequency, increases plasma high-density lipoprotein sub-class particle concentration. Harriss LR, English DR, Wolfe R, Tonkin AM . . . Jenkins AJ. Abstracts related to alcohol consumption from the scientific sessions of the American Heart Association, October 4-7, 2007 reviewed by R Curtis Ellison Abst 3645

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