Moderate alcohol intake boosts cardiovascular health, meta-analysis finds

A new meta-analysis of human intervention studies has reinforced the argument that moderate alcohol consumption plays a beneficial role in cardiovascular health. The post Moderate alcohol intake boosts cardiovascular health, meta-analysis finds appeared first on The Drinks Business.

Mar 20, 2025 - 11:14

Moderate alcohol intake boosts cardiovascular health, meta-analysis finds

A new meta-analysis of human intervention studies has reinforced the argument that moderate alcohol consumption plays a beneficial role in cardiovascular health. Digital generated heart shape with pulse trace. (3d render) evocative of cardiovascular health.

The study, published by the International Scientific Forum on Alcohol Research, reveals that drinking up to 40 grams of alcohol per day significantly increases apolipoprotein A-I (ApoA-I) and apolipoprotein A-II (ApoA-II) levels — key components of high-density lipoprotein (HDL) cholesterol, widely known for its heart-protective effects.

Alcohol’s impact on blood lipids

The research, which systematically reviewed 25 human intervention studies, demonstrates a clear link between moderate alcohol intake and increased ApoA-I levels. The meta-analysis found that ApoA-I concentrations rose by an average of 7.77 mg/dL compared to abstainers, with men showing a more pronounced effect than women (9.70 mg/dL vs. 7.31 mg/dL). ApoA-II levels also increased modestly by 1.61 mg/dL. However, the study found no significant impact on apolipoprotein B (ApoB), a marker more closely associated with low-density lipoprotein (LDL) cholesterol and cardiovascular risk. The findings add weight to decades of epidemiological research suggesting that moderate drinking is linked to reduced cardiovascular disease (CVD) risk, particularly through its influence on lipid metabolism. Given that HDL cholesterol plays a crucial role in clearing cholesterol from arteries and reducing inflammation, these results may offer further mechanistic insights into why moderate drinkers tend to have lower rates of heart disease.

A robust dataset, but questions remain

Unlike observational studies, which can be hampered by misreporting of alcohol intake, this meta-analysis focused exclusively on controlled trials, eliminating concerns about ‘sick quitter’ bias or misclassification. However, the authors caution that while the consistency of results is notable, the overall quality of evidence is graded as low to very low due to methodological limitations in the original studies. Issues such as inadequate randomisation reporting and inconsistent wash-out periods in cross-over trials meant that some findings had a higher risk of bias. Forum members reviewing the study remain confident in the central conclusion: moderate alcohol consumption has a tangible impact on lipid metabolism that supports cardiovascular health. “It is reassuring that clinical trials confirm the strong association between alcohol and lipid markers related to heart disease,” noted professor Curtis Ellison from Boston University. “Since these effects are seen across all alcoholic beverage types, it is likely the alcohol itself that is driving the changes.”

Gender differences and unanswered questions

One of the more intriguing aspects of the study is the gender disparity in response to alcohol. While men consistently showed significant increases in ApoA-I, the effect in women did not reach statistical significance. Some experts argue that the widely accepted threshold for significance (p<0.05) may be misleading in this context, as the observed increase in women closely mirrors that in men. Dr Erik Skovenborg, a Scandinavian Medical Alcohol Board member, suggests that “to the naked eye, there is no real difference between male and female responses.” Furthermore, the study provides little insight into how menopausal status might affect the lipid response to alcohol. Previous research has suggested that premenopausal women may experience a greater reduction in ApoB with moderate drinking than their postmenopausal counterparts, but this remains an area for future investigation.

A welcome challenge to the anti-alcohol lobby?

The findings arrive at a time when public health authorities are becoming increasingly vocal in their calls to reduce alcohol consumption. Recent policy shifts, such as Canada’s new guidelines advocating for near-zero alcohol intake, starkly contrast with studies such as this one, which suggest that moderate drinking confers measurable cardiovascular benefits. Forum reviewer Dr James McIntosh argues that “many recent studies understate alcohol’s protective role due to the way they handle confounding variables. This meta-analysis offers a clearer picture by focusing on clinical trials.” Of course, this does not mean that drinking beyond moderate levels is advisable. Excessive alcohol intake remains a well-established risk factor for a host of diseases, including hypertension, liver disease and certain cancers. Yet for those who enjoy a glass of wine with dinner or a pint of beer at the pub, this study offers reassuring evidence that their drinking habits may contribute to better heart health.