Alcohol and insulin sensitivity

Compared to heavy drinking and abstinence, a moderate consumption of alcohol is associated with lower mortality rates due to coronary heart disease. About half of the protective effect of alcohol on cardiovascular risk can be explained by its ability to raise HDL-cholesterol. Alcohol can influence HDL metabolism at more than one site. Since light-to-moderate alcohol intake is associated with enhanced insulin sensitivity and improvement of insulin sensitivity results in higher HDL-cholesterol levels, it is suggested that this is one of the routes taken by alcohol to act upon HDL metabolism. Whether interrelated or not, both the HDL-cholesterol increase and enhanced insulin sensitivity are considered to have a beneficial effect on the process of atherosclerosis. Because of the well-known adverse consequences of excess alcohol use, these facts have not changed public health policy. On the other hand, they may have an impact on advice to selected patients, diabetics or non-diabetics. (C) 1998 Elsevier Science B.V.