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Alcohol

The general health viewpoint is that alcohol should be consumed in moderation or not at all. But then we hear that red wine might be good for you. So, where does the truth lie?

The Recommendations

Centers for Disease Control and Prevention
Dietary Guidelines for Americans recommends that if alcohol is consumed, it should be consumed in moderation: up to one drink per day for women and two drinks per day for men
Over time, excessive alcohol use can lead to the development of chronic diseases and other serious problems including:
• High blood pressure, heart disease, stroke, liver disease, and digestive problems.
• Cancer of the breast, mouth, throat, esophagus, liver, and colon.
• Learning and memory problems, including dementia.
• Mental health problems, including depression and anxiety.
• Social problems, including lost productivity, and family problems.
• Alcohol dependence, or alcoholism.

UK National Health Service
Regularly drinking more than 14 units of alcohol a week risks damaging your health. That’s equivalent to 6 pints of average-strength beer or 10 small glasses of low-strength wine.
Spread your drinking over 3 or more days if you regularly drink as much as 14 units a week.
The type of illnesses you can develop after 10 to 20 years of regularly drinking more than 14 units a week include:
• cancers of the mouth, throat and breast
• stroke
• heart disease
• liver disease
• brain damage
• damage to the nervous system

But it’s more complicated than that…

There’s some evidence that low amounts of alcohol are not harmful, or at least that they provide benefits that balance out the negative effects.

Harvard study in 2018: Alcohol and your health: Is none better than a little?
While it’s easy to say “too much alcohol is bad for you”, it’s harder to answer these simple but important questions: Just how much is too much? Is there a health benefit to some drinking compared with none?
In June of 2018, a study published in the journal PLOS Medicine found that among older adults, light drinking (in the range of one to four drinks per week) was associated with a slightly lower risk of death compared with zero consumption.
In August of 2018, a larger study concluded that “For older adults, cancers related to alcohol use were the top causes of death. However, some protective effect related to light drinking was observed for heart disease and diabetes.”
So if you don’t like to drink alcohol, the latest research gives you no “medicinal” reason to start. But, if you drink lightly (and responsibly) and you have no health problems related to it, this study and other recent research is reassuring.

Article at the Mayo Clinic: Alcohol use: Weighing risks and benefits
Understanding the risks and any possible health benefits of alcohol often seems confusing; that’s understandable, because the evidence for moderate alcohol use in healthy adults isn’t certain.
Moderate alcohol consumption may provide some health benefits, such as:
• Reducing your risk of developing and dying of heart disease
• Possibly reducing your risk of ischemic stroke (when the arteries to your brain become narrowed or blocked, causing severely reduced blood flow)
• Possibly reducing your risk of diabetes
Keep in mind that even moderate alcohol use isn’t risk-free. For example, even light drinkers have a tiny, but real, increased risk of some cancers, such as esophageal cancer.
While moderate alcohol use may offer some health benefits, heavy drinking has no health benefits. Heavy or high-risk drinking (for older adults) is defined as more than three drinks on any day or more than seven drinks a week.
If you don’t drink alcohol, don’t start because of potential health benefits. However, if you drink a light to moderate amount and you’re healthy, you can probably continue as long as you drink responsibly.

Article in “Age and Aging”: “Alcohol consumption in later life and reaching longevity”
A study of 5,000 men and women published in February 2020, indicated that:
• Men and women who enjoyed a daily drink were up to 40 per cent more likely to make it to their 90th birthday than those who were teetotal
• The age-extending effects were confined to those who stuck to one drink a day – binge drinkers died earlier.

What about Red Wine?

There’s a common perception that moderate consumption of red wine is actually beneficial. Most dieticians are supportive of the “Mediterranean Diet” and the fact is that it does include consumption of red wine.
But is there real evidence to say that the red wine is beneficial? It seems there is some, but not enough to convince teetotallers to take up drinking.

An article from the Mayo Clinic “Red wine and resveratrol: Good for your heart?” points out that “certain substances in red wine called antioxidants may help prevent coronary artery disease, the condition that leads to heart attacks, but that any links between red wine and fewer heart attacks aren’t completely understood. Part of the benefit might be that antioxidants in red wine may increase levels of high-density lipoprotein (HDL) cholesterol (the “good” cholesterol) and protect against cholesterol buildup. One of these antioxidants, called Resveratrol, is thought to be or particular significance, but that more research is needed.

A study of alcohol use in twins was reported in Gastroenterology in January 2020, with the intriguing title “Red Wine Consumption Associated with Increased Gut Microbiota α-Diversity”.
It concluded that red wine could be good for the gut, increasing the number of different types of helpful bacteria that can live there. The benefits are likely to come from polyphenols (like Resveratrol), and that a glass a fortnight was enough to make a difference.

There’s been some interesting laboratory research on resveratrol, in connection with cancer. In a video available on the web, Professor Dan Burke makes these points:
• There’s an enzyme called CYP1B1 that has been found in cancer cells, for every type of cancer tested, but only rarely found in non-cancer cells.
• When resveratrol enters a cell that contains CYP1B1, it is modified into a chemical piceatannol, which is a known anti-cancer toxin, and causes the cell to commit suicide (apoptosis).
In other words, resveratrol can cause death in cancer cells without harming normal cells. It’s only laboratory research of course, and there’s a question over how much resveratrol in our diet actually escapes the digestive system to get into the body, All the same, it lends some support for the contention that red wine can be beneficial in suppressing cancer. Whether this effect is enough to negate the negative effects of the alcohol is not known.

What do I do?

In the Summer, on a hot day, I love a cold lager, although these days I’ll often make it a zero-alcohol version. In the evening, with dinner, or later, a glass of red wine is tempting.
So I’m not an abstainer, but I do try to keep to the recommended limits.

Sources

NHS on alcohol: https://www.nhs.uk/live-well/alcohol-support/the-risks-of-drinking-too-much/

Harvard study: https://www.health.harvard.edu/blog/alcohol-and-your-health-is-none-better-than-a-little-2018091914796

Mayo Clinic article: https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/alcohol/art-20044551

Mayo Clinic on red wine: https://www.mayoclinic.org/diseases-conditions/heart-disease/in-depth/red-wine/art-20048281

Gastroenterology article (comment at BBC site): https://www.bbc.co.uk/news/health-49480864

Professor Dan Burke video: https://www.youtube.com/watch?v=XzuHbmhTYWQ

Age and Aging study: https://academic.oup.com/ageing/advance-article/doi/10.1093/ageing/afaa003/5730334#198738775

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