Effect of drinking pattern on plasma lipoproteins and body weight

doi:10.1016/0021-9150(91)90256-3

Atherosclerosis

Volume 88, Issue 1, May 1991, Pages 49-59

https://doi.org/10.1016/0021-9150(91)90256-3 Get rights and content

Abstract

The effect of drinking pattern on plasma lipoproteins and body weight was examined in three groups of squirrel monkeys: (1) controls fed isocaloric liquid diet; (2) regular drinkers given liquid diet containing ethanol (EtOH) substituted isocalorically for carbohydrate at 12% of calories daily; and (3) binge drinkers fed 6% EtOH calories daily for a four-day period followed by three days of 20% EtOH to mimic a weekend bout drinking cycle. The number of calories offered per day was the same for all groups, and the average weekly EtOH consumption (12% calories) was identical for the two alcohol treatments. The entire study lasted six months. There were no significant differences in plasma cholesterol, triglyceride or liver function tests. Regular drinkers had the highest high density lipoprotein₂/high density lipoprotein₃ ( $HDL_{2} HDL_{3}$ ) protein and apolipoprotein $A-I B$ ratios of any group and exhibited a significant elevation in the molar plasma lecithin: cholesterol acyltransferase (LCAT) rate (nmol/min/ml). Binge drinking produced a selective increase in low density lipoprotein (LDL) cholesterol and apolipoprotein B, and a depression in the fractional LCAT rate (% esterified/min). During the course of the study, controls ate 92% of their diet while the alcohol groups each consumed 95% of the liquid diet. Despite this difference, body weight and Quetelet index (weight/height²)decreased progressively in the order controls > regular drinkers > binge drinkers. Results from our study indicate that moderate, regular daily consumption of EtOH at 12% of calories causes a modest reduction in body weight and produces a coronary protective lipoprotein profile (↑ $HDL_{2} HDL_{3}$ , T apolipoprotein $A-I B$ , low LDL cholesterol). By contrast, when this same average weekly dose is concentrated in a binge cycle, unfavorable alterations in lipoprotein composition (↑ LDL cholesterol, ↑ apolipoprotein B) and metabolism (↑ LCAT activity) occur along with weight loss and depletion of body fat. These studies point to the value of the squirrel monkey model in evaluating both favorable and pathophysiological effects of chronic EtOH intake.

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Citation Excerpt :
A recent meta-analysis study revealed a 45% increase in the risk of ischemic heart disease as an effect of episodic heavy drinking, while controlling for volume of alcohol consumed (Roerecke & Rehm, 2010). However, there is limited knowledge regarding the relationships between pattern of drinking and blood lipid levels, and results of previous studies on the effects of binge drinking on HDL cholesterol and LDL cholesterol levels are inconsistent (Gruchow, Hoffmann, Anderson, & Barboriak, 1982; Hojnacki et al., 1991; Peasey et al., 2005; Rakic, Puddey, Dimmitt, Burke, & Beilin, 1998; Taskinen, Välimäki, Nikkilä, Kuusi, & Ylikahri, 1985). The ratio of LDL cholesterol to HDL cholesterol (LDL-C/HDL-C), a classic atherogenic index (Kannel, 1985), has been reported to decrease as alcohol intake increases (Wakabayashi, 2012a).
The ratio of triglycerides to HDL cholesterol (TG/HDL-C ratio) and lipid accumulation product (LAP: a continuous marker of lipid over-accumulation determined by waist circumference and triglycerides) have been proposed to be good predictors of cardiovascular disease. The aim of this study was to clarify the relationships between heavy alcohol drinking and lipid-related indices including TG/HDL-C ratio, LAP, and ratio of LDL cholesterol to HDL cholesterol (LDL-C/HDL-C ratio). The subjects were middle-aged male nondrinkers and heavy drinkers (ethanol intake: ≥66 g per drinking day, which is 2–3 times or more than the generally recommended border level of daily alcohol consumption of 20–30 g). The levels of each lipid-related index after adjustment for age, smoking, and regular exercise were compared among nondrinkers, occasional heavy drinkers, and regular heavy drinkers. Log-transformed TG/HDL-C ratio was significantly higher in occasional heavy drinkers (mean ± standard error: 0.445 ± 0.014) than in nondrinkers (0.388 ± 0.004) and regular heavy drinkers (0.359 ± 0.013), and was not significantly different in nondrinkers and regular heavy drinkers. Log-transformed LAP was significantly higher in occasional heavy drinkers (1.51 ± 0.02) and regular heavy drinkers (1.44 ± 0.02) than in nondrinkers (1.34 ± 0.01), and was significantly higher in occasional heavy drinkers than in regular heavy drinkers. LDL-C/HDL-C ratio was significantly lower in occasional heavy drinkers (2.41 ± 0.04) and regular heavy drinkers (1.72 ± 0.04) than in nondrinkers (2.62 ± 0.01) and was significantly lower in regular heavy drinkers than in occasional heavy drinkers. Results of logistic regression analysis, using odds ratios for high lipid indices of occasional or regular heavy drinkers vs. nondrinkers, agreed with the above results of analysis of covariance. Occasional heavy drinkers showed more detrimental and less favorable levels of the lipid indices than did regular heavy drinkers, and thus heavy drinking, even if occasional, should be avoided to prevent cardiovascular disease.
Effects of regular and abusive intake of alcohol at weekends on physiological parameters in Spanish young
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Citation Excerpt :
However, in our study no significant change in HDL-C was observed amongst weekend drinkers. In this way, alterations in serum lipoprotein levels following different patterns of alcohol suggested that ingestion of regular small doses of alcohol increased HDL-C significantly, while binge drinking had no favorable influence on HDL-C.26 In addition, the young people who drink abusive quantities of alcohol two days a weekend showed a significantly higher systolic blood pressure than non-drinkers.
The aim of this study was to evaluate the effects of excessive intake at weekends, on different parameters in young university students.
Cross sectional, descriptive study.
A group of 180 subjects were selected (young males between 18 and 22 years old) and were classified into three groups by their alcohol consumption habits: The control group of non-drinkers (ND; n = 60), the group of one day/weekend drinkers (1D/W, n = 60) and the group of two day/weekend drinkers (2D/W, n = 60). An evaluation of the body composition, a spirometry test (FVC, PEF and MVV), a maximal cycle ergometer test (Heart rate, blood pressure, VO2 max, total watts and time test until exhaustion), a blood sample (GOT, Triglycerides, Total Cholesterol, HDL cholesterol, LDL cholesterol and Glucose) were performed.
It was observed that 2D/W group presented significantly higher levels than ND in the following parameters: total cholesterol [185.66 (16.06) compared to 154.28 (25.53) mg/dl]; triglycerides [113.66 (22.47) compared to 45.75 (12.76) mg/dl]; systolic blood pressure [130 (9.50) compared to 115 (5.77) mmHg] and waist to hip ratio [0.92 (0.08) compared to 0.84 (0.05)], and 1D/W group also showed significantly higher levels of triglycerides [71.04 (24.31) compared to 45.75 (12.76) mg/dl] than ND. Moreover, it was confirmed that the accumulation of triglycerides in weekend drinkers is influenced by smoking and the lack of physical activity, and that the relationship between alcohol drinking and systolic blood pressure could be modified by smoking.
Young people's abusive intake of alcohol at weekends can cause negative changes in various health parameters, similar to those observed in alcoholics that drink regularly during the week.
Dietary omega-3 polyunsaturated fatty acid intake is related to a protective high-density lipoprotein subspecies profile independent of genetic effects: A monozygotic twin pair study
2011, Atherosclerosis
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In the current study, alcohol intake, as calculated from the 3-days food diaries, was unrelated to HDL-C and associated with reduced percentages of HDL2b if it replaced carbohydrates in a multivariate nutrient density model. Earlier studies have reported that the pattern of alcohol drinking may be of major importance, suggesting that regular light to moderate ethanol intake is associated with an increase in HDL-C, but heavy episodic drinking (binge drinking), which is common among the young Finnish population, is not associated with HDL-C in animals or humans [44,45]. Previous studies have reported associations between individual HDL subspecies and cardiovascular risk factors.
Studies on diet and high-density lipoprotein (HDL) subspecies distribution are limited.
We examined the relationship between macronutrient composition and lipoprotein particle size and HDL subspecies independent of genetic effects by studying monozygotic (MZ) twins.
24 healthy MZ twin pairs aged 23–33 years were identified from two longitudinal population-based studies, FinnTwin16 and FinnTwin12. Total energy and nutrient intake were assessed with 3-day food records and physical activity was measured by the Baecke index. HDL subspecies distribution was determined by non-denaturing gradient gel electrophoresis. Associations between diet composition and HDL mean particle size were determined by multivariate nutrient density models adjusted for confounding variables.
Substituting one energy percentage from omega-3 polyunsaturated fatty acids (n-3 PUFAs) for a corresponding amount of energy from other type of fats was related to changes in the relative proportions of the HDL subspecies 2b, 3a and 3b toward a larger mean particle size in men (β ± SE: 1.00 ± 0.26 nm, p = 0.004) and women (β ± SE: 0.90 ± 0.21 nm, p = 0.001). This association remained significant in analyses controlling for genetic and shared environmental influences using within-pair differences of the measures in MZ twin pairs (β ± SE: 0.37 ± 0.14 nm, p = 0.019). Twins with the higher n-3 PUFA intake had significantly higher proportions of large HDL_2b particles and lower proportions of smaller-sized HDL_3a and HDL_3b particles as compared to their co-twins with lower intakes (p < 0.05).
Our data suggest that n-3 PUFA intake is associated with a favorable change in the distribution of HDL subspecies towards larger particles independent of genetic and shared environmental factors.
The French paradox: Possible involvement of ethanol in the protective effect against cardiovascular diseases
2002, Nutrition
Citation Excerpt :
Alcohol can act directly on the liver by increasing apoAI, apoAII, and HDL-C synthesis,53–55 decreasing lipoprotein catabolism,56,57 or modifying the activity of the enzymes that act on lipoprotein metabolism.47 Lipoprotein lipase activity generally is not modified with moderate doses of alcohol46,58 but may be increased,47 leading to enhanced formation of HDL-C. Hepatic lipase is inhibited by alcohol,38 and no change was observed in lecithin:cholesterol acyltransferase activity47 but that activity can be increased38 or decreased59 with moderate alcohol intake. Alternatively, cholesterol ester transfer protein (CETP) activity, which transfers cholesteryl esters from HDL2 to very-LDL and LDL and, reciprocally, triacylglycerol from these lipoproteins to HDL, may be significantly reduced due to alcohol consumption, as shown in studies in moderate drinkers.60,61
OBJECTIVES: This review surveyed the literature on the cardioprotective effects of moderate alcohol consumption.
METHODS: The putative cardioprotective effects of alcohol and other substances in alcoholic beverages are discussed by taking “the French paradox” as a starting point. A survey of the literature highlighted various hypotheses explaining the protective effects of moderate alcohol consumption.
RESULTS: The positive effects of moderate quantities of alcohol have been attributed in part to increased plasma levels of high-density lipoprotein, an inhibition of platelet aggregation, and improved endothelial function. Many investigators have claimed that wine is the significant factor explaining the French paradox. Red wine has been shown ex vivo to inhibit low-density lipoprotein oxidation, increase antioxidant capacity in humans, and reduce susceptibility of human plasma to lipid peroxidation. The non-alcoholic fraction of wine, represented mainly by phenolic compounds, may be the primary factor responsible for this protective effect. However, the protective effects are not restricted to a particular type of alcoholic drink, suggesting that alcohol per se rather than compounds specific to certain beverages reduces mortality risk.
CONCLUSIONS: It is difficult to explain the effect of alcohol on risk factors associated with cardiovascular diseases by a uniform biochemical mechanism. Moreover, its protective effects are counterbalanced by its addictive properties.
Noninvasive detection of vascular dysfunction in alcoholic patients
1999, American Journal of Hypertension
Vasodilation is impaired in various conditions, such as hypercholesterolemia and tobacco use. We evaluated brachial artery flow-mediated vasodilation (FMD) after blood pressure (BP) cuff occlusion using high-resolution B-mode ultrasound in 20 alcoholics, without any coexisting conditions such as smoking, hypertension, or cholesterolemia, after a 3-month period of abstinence. They were compared with a control group of 20 alcohol-free healthy subjects. We measured the diameter of the brachial artery under baseline conditions, during reactive hyperemia (with increased flow causing endothelium-dependent dilatation), and after administration of sublingual glyceryl trinitrate (GTN), an endothelium-independent dilator. We performed an echocardiographic study (Esaote Au3) according to guidelines of the American Society of Echocardiography to assess left ventricular mass (LVM), wall thickness, systolic stress, and diastolic function changes. FMD (% diameter change) was significantly less in the alcoholic patients than in the controls (6.03 ± 3.67 v 13.7 ± 4.65; P < .05), whereas no difference was noted after GTN administration (13.7 ± 7.97 v 16.0 ± 5.12, P = NS). Echocardiographic study showed no differences between the study group for LVM, wall thickness, and systolic stress; diastolic function expressed as E/A ratio inversion was significantly impaired. These data demonstrate an impairment of endothelial-dependent vasodilatation in chronic alcohol abusers, which may contribute to the excess prevalence of cardiovascular diseases in these individuals.
A controlled trial of the effects of pattern of alcohol intake on serum lipid levels in regular drinkers
1998, Atherosclerosis
To determine whether the effects of drinking pattern (predominantly weekend versus daily drinking) have differential effects on serum lipids, 55 healthy male drinkers were recruited on the basis of a regular alcohol intake, 210–500 ml absolute alcohol/week (≈3–6 standard drinks/day), with more than 60% consumed as beer. Fourteen subjects were categorised as predominantly weekend drinkers, while 41 subjects regularly drank on a daily basis. After maintenance of their drinking pattern during a 4-week familiarisation, subjects were randomised to either consume low alcohol beer (0.9%, v/v) only, or to maintain their usual drinking habit consuming full-strength beer (5%, v/v) for the next 4 weeks. They then switched to full-strength or low alcohol beer, respectively, for a further 4 weeks. Their drinking pattern remained constant during the study. In both weekend and daily drinkers, a reduction in alcohol intake (i.e. from 387 ml/week to 88 ml/week for weekend drinkers and from 418 ml/week to 95 ml/week for daily drinkers, respectively, P<0.001) resulted in a similar 0.12 mmol/l fall in HDL-C (P<0.01) with a concomitant significant fall in both apolipoproteins A-I and A-II. In daily drinkers total cholesterol fell by 0.28 mmol/l (P<0.001) and triglyceride by 0.22 mmol/l (P<0.01) with a reduction in alcohol intake, but no change in LDL-C was seen. In contrast, weekend drinkers total cholesterol was unchanged while triglyceride decreased by 0.26 mmol/l (P<0.05) and LDL-C increased by 0.25 mmol/l (P<0.01). Lp(a) increased with a reduction in alcohol intake in both daily (9.1 U/l, P<0.05) and weekend drinkers (27.6 U/l, P=0.07). Previous reports of a more atherogenic lipid profile with episodic versus regular daily drinking were not confirmed in this study and potentially favourable effects of alcohol to increase HDL-C and decrease Lp(a) were shown to be independent of drinking pattern in these moderate to heavy drinkers.

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Research paperEffect of drinking pattern on plasma lipoproteins and body weight

Abstract

Prostaglandins Leukotrienes Med.

Am. J. Clin. Nutr.

Atherosclerosis

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Metabolism

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Research paper
Effect of drinking pattern on plasma lipoproteins and body weight