• Posted September 18, 2023

Heavy Drinking Tied to Dangerous Buildup of Fat Around Heart, Liver

Before pouring another drink, consider this sobering new research: Heavy drinkers can develop fat around the heart, leading to heart failure and other cardiac problems.

This so-called pericardial fat is associated with increased risk of heart disease.

Researchers also linked heavy drinking to excess fat deposits around the liver and kidneys, which can result in diseases of these organs, too.

"The accumulation of fats in these areas, especially at the heart, has been linked to higher risk of heart disease like heart failure, atrial fibrillation as well as coronary heart disease, which is the major killer of U.S. adults," said lead researcher Dr. Richard Kazibwe, an assistant professor of internal medicine at Wake Forest University School of Medicine in Winston-Salem, N.C.

Alcohol affects how the body handles fat, he said. "Drinking is a known risk for obesity. We know from the past that alcohol can influence metabolism. It can influence levels of hormones in the body that can lead to the distribution of fat in general, but also in various areas of the body," Kazibwe said.

That's how fat ends up surrounding the heart, but if you stop imbibing will that fat disappear? Kazibwe said fat around the liver can be reduced if you stop drinking, but it isn't known if the same is true for fat around the heart.

The bottom line, in his mind, is clear: "Drinking alcohol can increase the risk of heart disease, not to mention the dangers of alcohol drinking in general that may not have anything to do with the heart, like cancer," Kazibwe said. "Drinking less is good for your heart."

For the study, Kazibwe and his colleagues collected data on more than 6,700 people from the Multi-Ethnic Study of Atherosclerosis, a study of heart disease. Volunteers identified themselves as never drinkers, former drinkers, light drinkers (less than one alcoholic drink daily), moderate drinkers (one to two drinks a day), heavy drinkers (more than two drinks a day), or binge drinkers (five or more drinks in a single day).

Participants also had CT scans so the researchers could see fat buildup around the body's organs, which is called ectopic fat.

Kazibwe's team found that heavy drinkers and binge drinkers had significant fat around the heart, compared with people who never drank alcohol. They also had fat around the liver and kidneys, Kazibwe said.

The lowest levels of fat were seen in light to moderate drinkers, he said. The highest levels of fat were seen among those who drank beer or liquor compared to wine drinkers, Kazibwe noted. The beneficial compounds found in wine called polyphenols might explain this finding, the researchers said.

Other characteristics, such as diet and exercise, may also account for the benefit seen with wine, Kazibwe said. However, "wine drinkers might have better access to health care and have healthier lifestyles than non-wine drinkers," he noted.

Dr. Benjamin Hirsh, director of preventive cardiology at Northwell Health's Bass Heart Hospital in Manhasset, N.Y., isn't surprised by these findings.

He agreed that drinking is bad news for the heart.

Alcohol is "filled with saturated fat [along] with high carbohydrates," said Hirsh, who was not involved with the study. "Alcohol is the No. 1 risk factor for high triglycerides," a type of fat in the blood that causes fat deposition.

Also, excess fat, called adipose fat, is a cause of inflammation, which can increase the risk for plaque buildup in blood vessels, he added.

"Drinking more frequently can lead to early heart disease, plaque progression and issues with the liver," Hirsh said. "So people should limit what they drink. Follow the recommended guidelines."

According to the Dietary Guidelines for Americans, men who drink moderately should consume no more than two alcoholic drinks a day, and women should have no more than one a day.

"Frankly, the less amount of drinking you do, the better off you are from a health standpoint," Hirsh said.

The report was published online recently in the Journal of the American Heart Association.

More information

For more on alcohol and heart disease, see the Alcohol and Drug Foundation.

SOURCES: Richard Kazibwe, MD, assistant professor, internal medicine, Wake Forest University School of Medicine, Winston-Salem, N.C.; Benjamin Hirsh, MD, director, preventive cardiology, Sandra Atlas Bass Heart Hospital Northwell Health, Manhasset, N.Y.; Journal of the American Heart Association, Sept. 8, 2023, online