Is drinking bad for your cholesterol?

Alcohol can affect cholesterol levels in the body—here is what you need to know about the risks

By Kissairis Munoz | Jan. 22, 2024 Medically reviewed by Chad Shaffer, MD

Cholesterol gets a bad rap, but the truth is that your body needs cholesterol. The health issue that arises for many people is when levels get out of whack—meaning, your “bad” cholesterol is too high while the “good” kind is too low. Lots of factors can affect cholesterol levels, including drinking alcohol.

But if you’re keeping an eye on your cholesterol levels, does this mean you can never have a drink? And are there certain types of alcohol that might be better for someone with high cholesterol? Here, we discuss the relationship between alcohol consumption and cholesterol levels.

How does alcohol affect cholesterol levels?

Alcohol doesn’t contain cholesterol. However, it does affect cholesterol levels in your body. Alcohol’s effects on cholesterol vary depending on alcohol use—such as how often and what you’re drinking—and other factors, like genetics, a healthy diet, lifestyle, and any pre-existing health problems.

Your body gets cholesterol from two sources: your liver and the foods you eat. The liver creates blood cholesterol, a waxy substance necessary for your body to do things like digest certain foods or create hormones. One thing that many people don’t realize is that your body actually produces all the cholesterol it needs. Dietary cholesterol comes from the foods we eat. Because a well-functioning liver is already making all the cholesterol you need, your cholesterol levels can become too high if you’re consuming too much dietary cholesterol.

There are two types of cholesterol: low-density lipoprotein (LDL), also known as “bad” cholesterol, and high-density lipoprotein (HDL), or “good” cholesterol. A third player in this equation is triglycerides, a type of fat in your blood used for energy. Your total cholesterol level, measured through a blood test, is made up of your HDL cholesterol levels, LDL cholesterol levels, and triglyceride numbers.

If you have too much bad cholesterol or not enough good cholesterol—or high triglycerides with either of these—cholesterol can build up in your arteries (remember, it’s waxy!), making it more difficult for blood to flow freely to your brain and heart. It’s why high cholesterol can increase your risk of cardiovascular problems, like high blood pressure, coronary heart disease, or a heart attack.

While some research suggests that “there’s a small increase in good cholesterol (HDL) levels with alcohol consumption, the minuscule cholesterol benefit is not enough to overcome the negative effects on liver and brain health,” says Sanjay Bhojraj, MD, an interventional cardiologist at Providence in Orange County, California, and founder of Well12.Health.

A key factor in alcohol’s effects on cholesterol levels is how much you’re drinking.

Light to moderate alcohol use

Currently, American guidelines define drinking in moderation as limiting alcohol to two drinks or less in a day for men and one drink or less in a day for women. This is the cohort that was often told that drinking a small amount of alcohol could raise good cholesterol levels or even improve cardiovascular health.

But the tide is turning on these recommendations. Recently, researchers have been reviewing and calling into question older studies done around light-to-moderate alcohol consumption and health. While many of these studies “proved” that light drinking could be beneficial for cardiovascular health, there was something called the abstainer bias in the research.

Often, these studies didn’t account for differences between the non-alcohol drinkers, some of whom may have had underlying health issues that accounted for why they didn’t drink. It’s why, when compared to the light drinkers, who may have been healthier, it often looked like light drinking was a better option than not drinking at all.

However, after adjusting for abstainer bias, a 2015 review that encompassed nearly 4 million people found that light drinking has no mortality benefit compared with lifetime abstention or occasional drinking. Another 2022 study found a reduction in all-cause mortality but an increase in the risk of some types of cancer with modest drinking.

Additionally, if you were considering picking up alcohol for the health benefits, the World Health Organization recommends you don’t. In a 2023 statement, it advised that “no level of alcohol consumption is safe for our health.”

Dr. Bhojraj agrees that drinking alcohol for health benefits is overrated. “Though red wine does have a potent antioxidant called resveratrol, which helps heart health, to get the proper dose for heart health (which is about 500 mg), you would have to drink 40 liters of wine a day to get the same benefit as a good resveratrol supplement,” he says.

In other words, while a small amount of alcohol occasionally likely won’t impact cholesterol levels too much, drinking alcohol to improve your cholesterol levels or cardiovascular health isn’t recommended.

Heavy alcohol use

Any ambiguity about drinking levels and cholesterol disappears when looking at heavy alcohol use. In men, heavy drinking is classified as five or more drinks in a day or more than 15 over a week. For women, it’s four or more drinks in a day or more than eight a week. Problem drinking in this manner is consistently linked to high total cholesterol.

How much does alcohol raise cholesterol?

So, just how much does drinking alcohol impact your cholesterol levels? Like so much with your health, there’s not a blanket answer. Instead, it depends on a few risk factors that vary widely between individuals.

These include genetics, weight, current lifestyle, and preexisting medical conditions, explains Bradley Serwer, MD, a cardiologist and chief medical officer at VitalSolution based in Bethesda, Maryland.

However, high-intensity binge drinking (twice the amount defined as binge drinking in guidelines) is associated with increased cholesterol and triglyceride levels, as well as increased liver enzyme levels. That’s important because elevated liver enzyme levels could be a sign of liver injury, which could lead to liver disease.

It’s also worth noting that drinking alcohol often goes hand in hand with downing sugar-laden drinks and foods that can adversely affect cholesterol levels, like processed meals or extra portions.

What type of alcohol causes high cholesterol?

There’s no evidence that the type of alcohol you drink makes a difference in your cardiovascular risk. Instead, genetic and lifestyle factors control how your body will react. Someone with similar cholesterol levels to yours might respond much differently than you to alcohol.

“Depending on your current medical condition, there may be no safe option for alcohol consumption,” Dr. Serwer says. Patients with severely elevated triglyceride levels should avoid alcohol entirely.

If a provider has given you the all-clear, Dr. Serwer recommends opting for alcoholic beverages that are low in added sugars and sodium. Don’t forget to consider the sugar content of your mixers, too. High-sugar food and drinks can raise cholesterol. In moderate amounts, red wine may be the best choice for its polyphenols, particularly resveratrol, says Dr. Serwer.

Resveratrol, found in the skin of grapes, is also in red wine and has antioxidant properties that help protect the lining of blood vessels and reduce inflammation, making it a more heart-healthy option than other types of alcohol.

Does alcohol interact with cholesterol medications?

If your LDL cholesterol is 190 mg/dL or higher or your LDL is lower with certain medical conditions, your provider may prescribe cholesterol medications to decrease your levels. The most common medication prescribed for cholesterol is a type of statin. Generally, statins and alcohol are safe to mix if you aren’t exceeding the recommended daily limits (one drink a day for women and two a day for men). If you routinely drink more than this or have alcohol use disorder, it’s important to be honest with your healthcare provider and ask about what the effects of alcohol might mean for the efficacy of your medication. Anyone with an underlying liver condition is likely to have to steer clear of alcohol, too, because of an increased risk of liver damage. In fact, if you are on any type of medication, be sure to disclose this to your healthcare provider because drinking may affect it.

Is it possible to drink alcohol and maintain healthy cholesterol levels?

So once and for all: Can you drink alcohol if you’re concerned about cholesterol levels? In moderation, alcohol should have little effect on your cholesterol—as long as you are otherwise healthy and have been cleared by your healthcare provider. However, if you drink excessively, eliminating alcohol from your diet may help lower cholesterol, but be aware that the effects won’t happen overnight.

“The amount of time to see changes in cholesterol levels is determined by numerous factors, including genetics, amount of alcohol consumed on a daily basis, and triglyceride levels,” Dr. Serwer says. “We typically don’t expect to see any significant changes for six to eight weeks, but there is a dramatic variance seen from person to person.”

If you drink excessively or are having a hard time quitting alcohol, there are resources to help. Treating alcohol use disorder usually involves a combination of therapy or support groups and sometimes medication. Several organizations focus on the prevention and treatment of alcohol abuse and alcohol use disorder. These include: