While genetic factors are major determinants of high-density lipoprotein cholesterol (HDL-C), environmental factors also play a role. The latter include 3 modifiable lifestyle factors: alcohol consumption, physical activity, and smoking. This study compared the relative effects of alcohol, physical activity, and smoking on HDL-C levels, using data from 2,309 subjects (1,226 women and 1,083 men), aged 25 to 91 years, from randomly selected families participating in the National Heart, Lung, and Blood Institute Family Heart Study.
The researchers found that alcohol consumption was associated with the largest increment in HDL-C (an increase of 9.0 for men and 13.1 mg/dL for women, from non-drinker to highest categories); physical activity with a more modest increment (an increase of 3.0-3.3 mg/dL from lowest to highest categories); and cigarette smoking with a large decrement in women (a decrease of 9.9 mg/dL) and a modest one in men (a decrease of 2.6 mg/dL) between non smoker and > or =20 cigarettes per day categories. This study suggests that, among lifestyle behaviors, alcohol consumption is the more important correlate of HDL-cholesterol.
R. Curtis Ellison, co author of the study commented ‘We were surprised to find such a small increment from physical activity, which is generally recommended by physicians when they find a low HDL-cholesterol. Even though the lowest quartile of our subjects had less than 10 minutes per day of any level of exercise (real “couch potatoes”) and the highest quartile reported at least 60 minutes per day of activity, the difference in HDL between these extreme quartiles was only about 3 mg/dl, whereas the difference between abstainers and moderate drinkers was 9 to 13 mg/dl. While drugs specifically designed to increase HDL are currently under development and should reach the market in the next couple of years (and will undoubtedly make billions for the pharmaceutical industry), none of the currently available medications has as much of an impact on HDL than a drink a day’
Source : Ellison RC, Zhang Y, Qureshi MM, Knox S, Arnett DK, Province MA. “The National Heart, Lung, and Blood Institute Family Heart Study”. Am Heart J 2004:147:529-535.