When it comes to alcohol and its effect on heart health, there's no question that the information can be confusing. According to the Mayo Clinic, moderate drinking may increase levels of good cholesterol (high-density lipoprotein, HDL). But heart health risks are associated with drinking too much.
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Alcohol Benefits vs. Risks
This conflicting information can often make people wonder how to approach alcohol like beer, whiskey and other spirits when it comes to heart health. On one hand, the American Heart Association notes that alcohol abuse has a wide range of potential complications, including obesity, stroke, high blood pressure and other heart health issues. Drinking too much alcohol can also raise your levels of a kind of fat in the blood known as triglycerides.
If you have high levels of the bad type of cholesterol (low-density lipoprotein, known as LDL) or low levels of the good type, combined with high levels of triglycerides, it can increase the chances of fatty buildup in your arteries, which raises your risk for heart attack and stroke. Beyond the heart, alcohol abuse can also increase your risk for liver disease, breast cancer, accidents, depression and suicide.
On the other hand, drinking a small amount of alcohol each day seems to offer protection for the heart and blood vessels by reducing the damaging effect of free radicals in the body. A small amount of alcohol consumption also seems to boost the production of HDL, which actually helps prevent plaque buildup in the arteries. Whether to drink alcohol can be quite a conundrum, particularly for those who may be more prone to heart problems.
Also, pregnant women should not drink alcohol, and women who are breastfeeding should avoid it, too. If you have any health conditions or if you are taking any medications, you should talk with your doctor about whether it's safe to drink even small amounts of alcohol.
How to Approach Alcohol
Though it sounds complicated, Kunal Karmali, MD, a cardiologist with Northwestern Medicine in Chicago, notes that the advice when it comes to beer, whiskey and other forms of alcohol and their effects on cholesterol can actually be fairly simple.
"If someone already drinks alcohol, then I advise they drink in moderation," he says. "But if someone is not, I certainly don't recommend they start. For those who do drink alcohol, discipline needs to play a role in that protective benefit of alcohol consumption. The person needs to already have the discipline to consume alcohol in moderation."
As for what moderation means, Jocelyn Henning, director of the Stroke Program and Patient Safety at Mercy Medical Center in Baltimore, says it's key to keep consumption low to ensure that alcohol is protecting the heart rather than harming it.
"Some studies do show a cardio-protective effect for light-to-moderate drinking," Henning says. "Women should have no more than one drink per day, and men no more than two drinks a day. Too much alcohol can lead to inflammation in the blood vessels."
Keep in mind that one drink means 12 ounces for beer, 5 ounces for wine and 1.5 ounces for spirits.
Best Alcohol for Cholesterol
When it comes to which type of alcohol — beer, wine, whiskey, rum or something else — is best for your body's cholesterol levels, Henning notes that some research has indicated the high antioxidant content in red wine might give it the edge over some other kinds of alcohol.
"Studies have shown a higher cardio-protective effect with wine over beer," she says. "Red wine also has been reported to have antioxidant effects, slowing damage to cells that make up the lining of blood vessels."
Patrick Fratellone, MD, an integrative cardiologist in practice in New York City, adds that low-sugar varieties of alcohol can also be useful as they can provide heart-healthy benefits when consumed in small amounts, without a lot of excess calories or carbohydrates. "I prefer potato-based vodka as an alcohol," he says.
Finally, Dr. Karmali notes that it's not necessarily the type of alcohol, but the amount that's really most important in avoiding harm and providing benefits to your cholesterol score. "Red wine is the one that oftentimes is mentioned, but the benefits they say come from red wine can really be found in any alcohol," he says. "Those benefits aren't exclusive to red wine."
So if you already enjoy drinking alcohol, just make sure you only drink a small or moderate amount on any given day.
Read more: Which Is Healthier: Beer or Hard Alcohol?
- Mayo Clinic: "Top 5 Lifestyle Changes to Improve Your Cholesterol"
- American Heart Association: "Is Drinking Alcohol Part of a Healthy Lifestyle?"
- Kunal Karmali, MD, cardiologist, Northwestern Medicine, Chicago
- Jocelyn Henning, director, Stroke Program and Patient Safety, Mercy Medical Center, Baltimore
- Patrick Fratellone, MD, integrative cardiologist, New York City