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09-12-2023

Heavy drinking increases the buildup of ectopic fat around the heart and liver

Research from the Wake Forest University of Medicine has revealed a compelling connection between heavy alcohol consumption and the accumulation of ectopic fat – the type that builds up around essential organs like the heart, liver, and intestines.

“Research shows that an excessive amount of alcohol is not good for heart health,” said lead author Dr. Richard Kazibwe. “Pericardial fat, or fat around the heart, is also associated with an increased risk of cardiovascular disease. We embarked on this study with an aim to decipher how alcohol might be influencing this risk.”

Multi-Ethnic Study of Atherosclerosis

The research was focused on data from the Multi-Ethnic Study of Atherosclerosis (MESA), which has been running since 1999. The primary focus of MESA has been understanding the subtle features of subclinical cardiovascular ailments. These are heart and blood vessel disorders that have not yet manifested in noticeable symptoms. 

Focus of the study 

MESA has been monitoring a diverse group of over 6,500 individuals, spanning from European to Asian descent, between the ages of 45 and 84. The participants were all in good health upon joining the study.

Based on a personal-history questionnaire, the individuals were categorized as one of the following: lifetime abstainers, former drinkers, light drinkers, moderate drinkers, heavy drinkers, or binge drinkers.

CT scans 

The team used Computerized Tomography (CT) scans on a subset of participants. Dr. Kazibwe explained that the scans granted his team the ability to examine internal body fat distribution. 

“The distribution can sometimes give us insights into cardiovascular risk that go beyond traditional obesity measures like body mass index,” said Dr. Kazibwe.

What the researchers discovered 

The study revealed that heavy alcohol and binge drinkers exhibited significantly higher pericardial fat when juxtaposed with non-drinkers. Similar trends were observed with other ectopic depots, most pronounced around the heart and liver.

“Interestingly, the lowest levels of ectopic fat were seen in people who reported light to moderate intake of alcohol,” noted Dr. Kazibwe.

Wine is the least harmful

When they looked at specific alcoholic beverages, the experts found that wine seemed to be the least harmful when compared with hard spirits and beer. The secret? Possibly the polyphenols, beneficial compounds present in wine. 

However, as Dr. Kazibwe pointed out, other factors such as diet, exercise, and even access to healthcare might differentiate wine drinkers from others. “Wine drinkers might have better access to health care and have healthier lifestyles than non-wine drinkers,” he said. 

The pattern between alcohol intake and ectopic fat appeared J-shaped. Dr. Kazibwe said that multiple previous studies have reported a J-shaped relationship between alcohol consumption and cardiovascular risk, where low-moderate alcohol consumption is tied to the lowest cardiovascular risks and excessive alcohol intake is linked to a higher risk.

Study significance

“These findings are significant because both excessive alcohol intake and excess ectopic fat accumulation are known risk factors for cardiovascular disease,” said Dr. Kazibwe. 

“It is also important to emphasize that given the well-documented health concerns caused by excessive alcohol consumption, it is important that people are aware of these potential risks.”

Further research is needed 

Dr. Cashell Jaquish is a genetic epidemiologist and program officer at the NHLBI who also works with the MESA study.

“These findings further solidify the relationship between drinking and cardiovascular risk and shed light on specific sub-clinical disease associated with excessive alcohol intake,” said Dr. Jaquish.

“Additional studies are needed to further clarify the role of ectopic fat distribution in the relationship between alcohol consumption and cardiovascular disease.”

The study is published in the Journal of the American Heart Association

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