Many people, myself included, count wine as one of the joys in life. Cabernet sauvignon, pinot noir, zinfandel, nebbiolo, sangiovese, cannonau … the list goes on and many seem like dear friends. We all know that there's a line between enjoying some wine and suffering the terrible consequences of alcoholism, but where do you draw that line? Do you have a second, third or fourth glass? Do you drink regularly? As I have to counsel patients on these questions, and deal with my own oenophilia, I turned to science for some answers.
To understand the connection between wine consumption and health, it helps to have an appreciation of the U-shaped curve in medicine. Many aspects of our health can be described by a U-shaped curve, which is the idea that too much or too little of a behavior can be unhealthy, and the sweet spot (at the base of the U), is where you tend to have optimal results. This is true for blood sugar, blood pressure, how much you exercise, and how much you drink.
What you need to know about wine and health:
1. A drink in most research studies is 14 grams of ethanol or 0.6 fluid ounces of pure alcohol. This equates to a 12-ounce beer, a 5-ounce glass of table wine, or 1.5 ounces of hard liquor. If you remember that the typical Dixie cup is 3 ounces, that can help you judge the volume in a pour.
2. “Light to moderate” drinking (defined as 1 drink a day for women, 2 drinks a day for men) is associated with lower rates of overall mortality, heart deaths, diabetes mellitus, heart failure, and strokes and these benefits are easier to demonstrate in people over 50 years of age.
3. Women generally have lower levels of alcohol dehydrogenase, an enzyme in the liver that metabolizes alcohol, and therefore are advised to drink smaller amounts.
4. In an analysis of studies combining data on over 1 million people and overall death rates, the U shaped curve was “sweetest” at “1 to 2 drinks per day for women and 2 to 4 drinks per day for men.” Why? There are many beneficial effects of alcohol, including enhancing insulin action, raising HDL cholesterol, reducing inflammation, and improving arterial function. Red wine is particular is rich in polyphenols, with antioxidant, anti-inflammatory, and antiplatelet actions.
5. In a separate analysis of drinking (and specifically heart deaths) in 250,000 US adults, researchers found that up to 7 drinks per week for women and 14 drinks per week for men was associated with over a 30% drop in mortality.
6. In an analysis of the health benefits of the Mediterranean Diet in almost 25,000 Greeks, moderate alcohol consumption (1 to 3 drinks a day for men and 1 to 2 for women) was the strongest factor in preventing death, with eating little meat and eating more vegetables numbers 2 and 3!
There is no doubt that the U-shaped curve of drinking for health is also a slippery slope that can lead to abuse. The American Heart Association advises people not to start a drinking habit for health gains. Nonetheless, for those that enjoy an alcoholic drink, a daily 5-ounce glass or red wine (or two) has scientific support.
Is drinking for everyone? Clearly not and you should listen to your body. If alcohol doesn't agree with you for any reason, skip it and work on other health prevention measures like diet, exercise and stress management.
Pinot noir is generally credited with having the highest concentration of resveratrol, while cannonau from Sardinia gets a nod for the exceptional longevity on that island.
Long ago, Benjamin Franklin said that “wine makes daily living easier, less hurried, with fewer tensions and more tolerance.” If you will stick to the “sweet spot” and recognize that the dose makes the poison, it may make life longer too.