Context: Moderate alcohol consumption is associated with decreased risk of cardiovascular disease (CVD) and improvement in cardiovascular risk markers, including lipoproteins and lipoprotein subfractions. Objective: To systematically review the relationship between moderate alcohol intake, lipoprotein subfractions, and related mechanisms.
Data sources: Following PRISMA, all human and ex vivo studies with an alcohol intake up to 60 g/d were included from 8 databases.
Data extraction: A total of 17 478 studies were screened, and data were extracted from 37 intervention and 77 observational studies.
Results: Alcohol intake was positively associated with all HDL subfractions. A few studies found lower levels of small LDLs, increased average LDL particle size, and nonlinear relationships to apolipoprotein B–containing lipoproteins. Cholesterol efflux capacity and paraoxonase activity were consistently increased. Several studies had unclear or high risk of bias, and heterogeneous laboratory methods restricted comparability between studies.
Conclusions: Up to 60 g/d alcohol can cause changes in lipoprotein subfractions
and related mechanisms that could influence cardiovascular health.
Systematic Review Registration: PROSPERO registration no. 98955