Alcohol and Heart Disease

The Harvard School of Public Health in Boston recently collected evidence that supports alcohol as a dietary factor linked with elevated levels of HDL cholesterol and reduced coronary disease risk.

Men who had at least one alcoholic drink per day and were slow alcohol metabolizers (mean serum HDL level of 51 mg/dL) had an 86% reduced risk of a myocardial infarction compared with men who had less than one drink per day and were rapid metabolizers (mean HDL of 44 mg/dL).

The rate-limiting step in alcohol metabolism is controlled by the enzyme alcohol dehydrogenase. Two variants of the gene for this enzyme exist: fast-metabolizing and slow-metabolizing. This creates three types of metabolizers: fast (with two fast-metabolizer genes), slow (with two slow-metabolizer genes), and intermediate (those with one of each gene).

Confirmatory data from the Nurses' Health Study, also focusing on HDL levels, showed that women who were slow metabolizers and averaged 0.5 or more drinks per day had a mean serum HDL level of 72 mg/dL. Those who were fast metabolizers and averaged less than 0.5 drinks per day had a mean serum HDL level of 57 mg/dL.

Internal Medicine News. December 1, 2000 . Mitchel Zoler, Philadelphia Bureau