Abstract
Alcohol intake is known to influence serum high-density lipoprotein cholesterol (HDL-C), yet how drinking patterns shape this association is less researched. We examined whether frequency of drinking versus amount per occasion was differently related to HDL-C in a large population sample. Data were taken from a cross-sectional study of 18,614 respondents aged 40–79 years in the Tromsø general population health study. Alcohol use was assessed by self-report. Fasting HDL-C was measured using standardized laboratory protocols. Mean alcohol intake was 6.7 g/day and mean HDL-C 1.57 mmol/L. Total alcohol consumption correlated positively with HDL-C (r = 0.075; p < 0.001). In regression models, each additional gram/day was associated with an increase of 0.005 mmol/L HDL-C (95% CI 0.004–0.005; p < 0.001). Drinking frequency showed a positive correlation to HDL-C (r = 0.183; p < 0.001), whereas amount per occasion was inversely related to HDL-C (r = −0.128; p < 0.001). A significant frequency × amount interaction indicated that higher amounts per occasion were linked to lower HDL-C primarily among the infrequent drinkers (p < 0.001). The results indicate that the alcohol–HDL-C association was driven by how often alcohol was consumed rather than how much was consumed per occasion. Frequent, lower-dose drinking related to higher HDL-C, whereas infrequent, higher-dose occasions related to lower HDL-C. These findings underscore the need to consider drinking patterns, beyond average intake, when interpreting HDL-C and appraising alcohol-related cardiovascular risk.
Citation
Jørgen G. Bramness, Jørg Mørland, Torgeir Gilje Lid, Anne Høye, Gudrun Høiseth, The impact of drinking patterns on the relationship between alcohol use and levels of serum high-density lipoprotein cholesterol (HDL-C), Alcohol, Volume 135, 2026, Pages 70-76, https://doi.org/10.1016/j.alcohol.2026.07.003