It has been well established that moderate alcohol consumption inversely correlates with cardiovascular morbidity and mortality, whereas binge alcohol drinking increases
cardiovascular disease risk. The aim of this study was to assess in vivo the impact of different drinking patterns on reverse
cholesterol transport (RCT); the atheroprotective process leading to the removal of excess
cholesterol from the body. RCT was measured with a standardized,
radioisotope-based technique in three groups of
atherosclerosis-prone
apolipoprotein E knock out mice: Placebo group, receiving water, which would mimic the abstainers; moderate group, receiving 0.8 g/kg alcohol/day for 28 days, which would mimic a moderate intake; binge group, receiving 0.8 g/kg alcohol/day for 5 days/week, followed by the administration of 2.8 g/kg alcohol/day for 2 days/week, which would mimic a heavy intake in a short period. Mice in the
binge drinking group displayed an increase in total
cholesterol,
high density lipoprotein cholesterol (HDL-c) and non-HDL-c (all p < 0.0001 vs. placebo), and a significantly reduced elimination of fecal
cholesterol. The moderate consumption did not lead to any changes in circulating
lipids, but slightly improved
cholesterol mobilization along the RCT pathway. Overall, our data confirm the importance of considering not only the total amount, but also the different consumption patterns to define the impact of alcohol on cardiovascular risk.