A decade-long cohort study in Japan has revealed unexpected findings about how alcohol consumption affects cholesterol levels, challenging long-held beliefs about alcohol and heart health. The groundbreaking research, published in The Journal of the American Medical Association (JAMA) Network Open in 2025, examined how changes in alcohol habits influence lipid profiles — key indicators of cardiovascular health.
Study Overview
The study tracked 57,691 adults who underwent annual health checkups at a preventive medicine center in Tokyo from October 2012 to October 2022. Researchers investigated how starting or stopping alcohol consumption impacted cholesterol levels over time.
The study concluded that:
- Quitting alcohol was significantly linked to increased levels of LDL-C (bad cholesterol) and decreased HDL-C (good cholesterol).
- Starting alcohol consumption showed the opposite effect — with decreased LDL-C and increased HDL-C — and these changes were more significant with higher levels of alcohol intake.
Key Findings
The study observed the following trends based on drinking levels:
For those who began drinking:
- Up to 1.5 drinks/day: LDL dropped by 0.85 mg/dL, HDL rose by 0.58 mg/dL
- 1.5 to 3 drinks/day: LDL decreased by 4.4 mg/dL, HDL increased by 2.49 mg/dL
- 3+ drinks/day: LDL fell by 7.44 mg/dL, HDL rose by 6.12 mg/dL
For those who quit drinking:
- Up to 1.5 drinks/day: LDL increased by 1.10 mg/dL, HDL dropped by 1.25 mg/dL
- 1.5 to 3 drinks/day: LDL rose by 3.71 mg/dL, HDL decreased by 3.35 mg/dL
- 3+ drinks/day: LDL increased by 6.53 mg/dL, HDL dropped by 5.65 mg/dL
Study Limitations
Despite its scale, the study had several limitations:
- Self-reported data may be biased due to inaccurate recall or social desirability.
- Genetic and cultural differences specific to the Japanese population could affect alcohol metabolism, making it harder to generalize the findings globally.
- Some participants who quit alcohol might have been heavy drinkers, skewing the results when compared to moderate drinkers.
Experts have also expressed concerns about the methodology. Dr. Stephen Bright, an addiction researcher at Edith Cowan University in Australia (not involved in the study), noted that earlier research claiming cardiovascular benefits from moderate alcohol intake — especially wine — has since been challenged for methodological flaws.
In fact, a 2023 World Health Organization (WHO) statement in The Lancet Public Health emphasized that “no safe amount” of alcohol exists that doesn’t impact health negatively.
Final Takeaway
While this study does not prove a direct causal relationship between alcohol and cholesterol changes, it highlights a significant association. The researchers recommend monitoring lipid levels after changes in alcohol consumption to better manage cardiovascular disease (CVD) risks.
Bottom line: Public health guidance should continue to promote moderation in alcohol use, but cholesterol monitoring remains essential — particularly after stopping alcohol — to ensure heart health is not adversely affected.
