Does Alcohol Cause High Cholesterol?

Cholesterol¹ makes up cell membranes and aids in hormones and vitamin D production. While it’s an integral part of your body, you can still have too much of it.

Your liver produces most of the cholesterol your body needs, but cholesterol can also come from the food you eat. 

Keep reading to discover the relationship between cholesterol and alcohol. 

What is cholesterol?

Cholesterol is a waxy substance that moves throughout your body through your blood vessels in packages called lipoproteins. 

The two types of cholesterol are: 

• High-density lipoprotein (HDL)—“good” cholesterol

• Low-density lipoprotein (LDL)—“bad” cholesterol 

Your body needs cholesterol to function adequately. However, elevated cholesterol can increase the risk of heart disease, stroke, and heart attack. It is vital to keep your cholesterol at a healthy level, so it should not exceed 200 mg/dL. You can find your cholesterol levels with a routine blood test—just ask your doctor.  

Several factors influence your cholesterol levels, including:

Age

Cholesterol levels generally increase with age. According to the CDC, you should check your cholesterol levels every five years if you are over 20. 

Weight

Obesity is a risk factor for high cholesterol as it can increase the amount of LDL cholesterol your body produces. You can manage this by increasing your activity levels and implementing a healthy diet rich in fruits and vegetables. 

Dietary intake

Your diet influences your cholesterol levels. A diet high in saturated and trans fats can increase your LDL cholesterol. Added sugars can also increase your triglyceride levels in the long term, contributing to your total cholesterol levels and increasing your risk of cardiovascular disease. 

Genetics

Conditions that cause high cholesterol can be genetic. Learn about your family health history to determine if you are predisposed to high LDL cholesterol. 

Keeping your cholesterol levels within a healthy range is essential for preventing and treating cardiovascular disease. If your LDL cholesterol gets too high, cholesterol deposits called plaque can build up on the walls of your blood vessels. 

The buildup of plaque within your blood vessels can increase your risk for cardiovascular disease and stroke. The plaques can increase in size and break off, blocking blood flow to the rest of your body and causing blood clots. 

Plaques can also cause your arteries to become narrow and hard, making it more difficult for the heart to pump blood around your body. 

HDL cholesterol can keep your LDL cholesterol levels within a healthy range. HDL cholesterol packages up LDL cholesterol from the blood, transporting it to the liver to be eliminated from the body or recycled.  

Alcohol intake recommendations: How much is safe and how often?

Alcohol affects everyone differently. Women are more sensitive to the effects of alcohol due to decreased levels of the enzyme alcohol dehydrogenase, which breaks down alcohol. 

Women have a lower rate of alcohol metabolism² than men and absorb higher amounts of alcohol into the bloodstream.  

The US Dietary Guidelines for Americans³ suggest that adults of the legal drinking age can drink in moderation. Women should limit their daily intake to one drink or less, and men should stick to two drinks or less. 

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines heavy drinking as:

• Men: 4+ standard drinks a day, 14+ drinks per week

• Women: 3+ standard drinks a day, 7+ drinks per week 

One standard drink contains around 14g of pure alcohol. One standard drink is typically 12oz of beer, 1.5oz of spirit, or 5oz of wine. However, drink sizes can vary greatly depending on their alcohol content.

Types of alcoholic drinks and how they affect cholesterol

A high alcohol intake can cause severe health problems. However, light-to-moderate alcohol intake isn’t usually a concern. 

Drinking too much alcohol is a significant risk factor for disease burden (impact of health issues), increasing your risk of developing heart disease, liver disease, and some cancers.⁴

Alcohol can also affect your cholesterol levels, depending on how much alcohol you consume and how often you drink it.

Your liver processes alcohol in the bloodstream, and it can turn it into other substances, such as cholesterol and triacylglycerols (TAG). So, too much alcohol can raise your total cholesterol levels. However, in addition to the effect of alcohol, each type of alcoholic drink impacts your body differently.  

Wine

Drinking low to moderate quantities of red wine⁵ is thought to be heart-healthy due to the antioxidants it contains. Antioxidants called polyphenols may protect the blood vessel lining within the heart.

Resveratrol⁶ is a specific polyphenol in red wine and red grape juice, which may reduce LDL cholesterol levels. As it’s resveratrol, not alcohol, that promotes this reduction, drinking red grape juice is preferable to red wine.

Beer

Beer contains alcohol and carbohydrates, which can raise your triglyceride levels. Triglycerides are part of your total cholesterol, so raising these levels increases your total cholesterol.

Liquor and cocktails

Liquor and cocktails often contain a high level of added sugar, which means they are high in carbohydrates. As with beer, this can raise your total cholesterol. 

Can I drink alcohol and maintain healthy cholesterol levels?

Drinking alcoholic beverages should not be seen as a strategy to maintain health. However, light to moderate alcohol consumption may increase your body's healthy cholesterol (HDL).⁷ 

HDL packages up and collects excess LDL cholesterol around the body. It transports the LDL cholesterol to the liver to be recycled or eliminated from the body. High HDL is good as it can protect your body against cardiovascular disease and stroke. 

Keeping your cholesterol levels within a normal range is essential for a healthy heart. The Centers for Disease Control and Prevention⁸ define healthy levels as: 

• A range of 100 mg/dL or lower is the LDL cholesterol recommendation.

• The healthy range for HDL cholesterol levels is 60 mg/dL or more.

• The healthy range for total cholesterol levels is less than 200 mg/dL. 

Many other things besides cholesterol levels can contribute to your risk of heart disease. Other factors include genetics, blood pressure, and sex.⁹

Some people should abstain from drinking alcohol completely

Research has determined you should not drink alcohol during pregnancy and breastfeeding.

Alcohol use during pregnancy and breastfeeding increases the risk of behavioral and cognitive problems in children, miscarriage, and congenital disabilities.¹⁰ Alcohol levels are highest in breast milk approximately 30-60 minutes after consuming alcohol. 

The time that alcohol remains in breast milk increases with the number of alcoholic beverages you consume. Breastfeeding mothers should wait at least two hours per drink before nursing.¹¹ 

Underage drinking is not recommended, as alcohol can impact the developing brain. Using alcohol as a teen can increase the risk of developmental problems.  

Alcohol can also interact with some medications, including antibiotics, opioids, and antidepressants. 

Managing cholesterol levels 

Lifestyle choices influence your cholesterol levels. To keep your cholesterol within a healthy range, your doctor will advise you to: 

• Avoid smoking

• Eat heart-healthy foods:¹² Eat fruits, vegetables, whole grains, and lean meats instead of heavily processed foods.

• Increase your activity levels:¹³ Make sure you are active for 30 minutes daily.

• Reduce stress:¹⁴ High levels of cortisol can increase LDL cholesterol. 

Several medication types treat high cholesterol levels: 

• Statins decrease the amount of cholesterol produced by the liver. 

• Bile acid-binding drugs bind to bile acid, so your body can’t use it for digestion. The liver increases its production of bile which uses up cholesterol.

• Fibrates decrease triglycerides instead of reducing LDL cholesterol levels.

It is crucial to check your cholesterol levels frequently as you age. The only way to know your cholesterol levels is through a routine blood test that your doctor can request for you.

Overall, cutting down on alcohol can decrease your cholesterol and improve your heart health.

The lowdown  

Depending on the amount and type of alcohol you consume, alcohol may increase or decrease your cholesterol levels and heart disease risk. Light-to-moderate levels of alcohol intake may increase HDL levels.

However, research has associated heavy alcohol use with increased LDL or “bad” cholesterol levels, increasing your risk of stroke, heart disease, and death.

Talk to your doctor or a healthcare professional if you have concerns about your alcohol intake or cholesterol levels. They can test your cholesterol levels and provide other helpful resources.