True or False: Drinking a Glass
of Red Wine a Day Can Increase Longevity
by Jacquelyn Rudis
Can drinking a glass of red wine daily lead to a longer, healthier life? Some
research (but not all) has shown that people who consume moderate amounts of
alcohol have a decreased risk of coronary heart disease (CHD) as compared to
abstainers and heavy drinkers. Studies of the French, who are famous for
enjoying both red wine and low rates of CHD, first drew attention to this
particular libation. Further analysis has suggested that although such trends
may exist, the types of people who choose to moderately drink red wine, and
possibly other alcoholic beverages, also live a healthier lifestyle in general.
So is it the alcohol or some characteristic of the alcohol drinker that confers
the health benefits?
Evidence for the Health Claim
According to the American Heart Association (AHA), more than 60 prospective
studies have suggested that moderate alcohol consumption—defined by the
Department of Health and Human Services Dietary Guidelines for Americans as
having no more than one drink per day for women and no more than two drinks per
day for men—may decrease the risk of CHD, ischemic heart disease and stroke, and
other causes of mortality. Research shows that moderate drinkers are at less of
a risk for CHD and other causes of mortality than nondrinkers, and heavy
drinkers are at a much greater risk.
Some of the convincing evidence behind this claim includes:
Researchers Klatsky and Friedman conducted a study in Northern California that
followed 128,934 adults from 1978-1990 and found that people who had one or two
alcoholic drinks per day had a 32% lower risk of dying from CHD than
nondrinkers.
Doll and colleagues conducted a 13-year long study examining 12,000 British
doctors and their mortality in relation to their alcohol consumption. The
researchers concluded that moderate drinking is associated with significantly
lower mortality rates than abstaining from or over-indulging in alcohol.
Fuchs and collaborators followed 85,709 women aged 34-59 for 12 years and found
that light to moderate drinking was associated with a reduced mortality rate,
but mostly benefited women who were at risk for CHD.
Why It’s Good for You
The reasons why moderate alcohol consumption is beneficial have not been
well-established. There is some evidence that moderate amounts of alcohol may
reduce the risk of CHD by increasing levels of high density lipoprotein (HDL),
the “good” cholesterol,” and decreasing the blood’s tendency to form clots.
Furthermore, studies have found an association between moderate alcohol intake
and lower levels of depression, anxiety, and perceived stress. Whether the
consumption of alcohol produced these effects, or visa versa, remains an open
question. It is well known, however, that anxiety and depression lead to
excessive alcohol consumption in certain vulnerable individuals.
What Type Is Best for You?
If moderate alcohol consumption is in fact healthy, how do we choose what drink
to have? Various studies have compared the risks and benefits of drinking wine,
beer, and hard liquor. In what was called the Copenhagen Heart Study, Gronbaek
and colleagues followed 13,285 people ages 30-70 for 12 years starting in 1990.
Results showed that low to moderate wine consumption was associated with lower
risk of dying from cardiovascular and cerebrovascular disease, while similar
liquor consumption actually increased risk.
In 2002, Klatsky followed up on his 1990 study with new data suggesting that
regular, moderate wine drinkers had an approximately 25% lower risk of CHD than
people who regularly drank the same amount of alcohol in the form of beer, and
35% lower CHD death risk than light to moderate drinkers of hard liquor. In a
study comparing waist-to-hip ratios, researchers investigated one possible
mechanism to explain these findings. An elevated waist-to-hip ratio is
associated with an increased risk of diseases such as heart disease and
diabetes. In this study of 12,145 men and women ages 45-64, beer and hard liquor
drinkers had higher waist-to-hip ratios than wine drinkers.
While some researchers have found no difference between drinking red and white
wine, others have found that red wines may exhibit greater benefits than other
wine types. Red wine (which retains the skin of the grape) contains high levels
of polyphenols, which have antioxidant properties that are believed to play a
role in reducing risk of diseases such as cancer, heart disease, stroke, and
Alzheimer’s disease. To what extent these antioxidants are actually involved in
the protective effects of red wine is a subject of open debate.
A recent study from French researches suggest that in patients with established
coronary heart disease drinking wine may increase the levels of omega-3 fatty
acids, which are also known to have protective effects on heart and blood
circulation.
Evidence Against the Health Claim
When analyzing the suggested benefits of moderate alcohol consumption on
longevity, it is important to take into account the health effects of numerous
other factors: diet, education and income level, health habits such as smoking
and exercise, social engagement, and age. Many of the studies previously
described found that although wine drinkers often have lower mortality rates
than non-wine drinkers and abstainers, their lifestyles are also healthier
overall, so it is hard to tell which factors are having the most healthful
effect.
In Denmark (where the Copenhagen Heart Study took place), wine drinkers tend to
consume a healthful, Mediterranean-style diet (high in fresh fruits and
vegetables, fish, and olive oil, and low in meat and dairy products), and have
high socioeconomic status. Klatsky’s California studies recognize that people
who preferred to drink wine rather than beer or hard liquor were more highly
educated, smoked less, and had more controlled drinking habits. Other studies
have found that the benefits of alcohol consumption often depend on drinking
patterns: Drinking slowly and with food has been shown to produce the greatest
health benefits, and moderate wine drinkers reported consuming their glass or
two of alcohol each day with meals.
Many proponents of wine as beneficial to health have pointed to the relatively
low incidence of CHD in France, despite the typical French diet which is
comparable to (or even worse than) other developed countries with high CHD
rates. The French drink the most wine and have the highest level of total
alcohol intake compared to 20 other industrialized countries, yet they also
experience the second lowest CHD mortality rate. This phenomenon has been termed
the “French Paradox”. It is important to note, however, that studies performed
at the individual level have not consistently shown a positive connection
between moderate wine consumption and longevity among the French. It is not
clear, therefore, that a penchant for wine—red or otherwise—adequately explains
the paradox.
Conclusion TOP
While the evidence for the favorable health effects of moderate alcohol
consumption is intriguing and deserves further study, it is unlikely that
doctors will begin recommending a daily glass or two of wine to their patients
anytime soon. There are at least three reasons for this.
First, since there are no randomized controlled trials on the subject (and
probably never will be), it is not possible to prove a cause-and-effect
relationship between alcoholic beverages and longevity. Many researchers and
clinicians remain skeptical that that the alcohol itself is conferring the
benefit. Patterns of drinking may simply be a marker for an unidentified
attribute of the healthy drinker.
Second, the health benefits associated with moderate alcohol intake can also be
obtained through safer habits such as exercise and a well-balanced diet. The
antioxidant content of red wine is similar to that of fresh fruits and
vegetables, and there are medications that can raise HDL levels and thin the
blood more effectively than alcohol can.
Third (and most important), it is not currently possible to accurately predict
who has a tendency to become an alcoholic and who does not. Recommending that
all abstainers start drinking would be placing a significant number of them at
unacceptable risk. For some, alcohol is an addictive drug, and alcoholism is a
devastating condition that destroys lives and puts the public at risk.
The bottom line? If you don’t drink, don’t start. If you drink excessively,
stop. And if you drink moderately, you may continue to raise your glass and
proclaim…”to my health!”
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Image Credit: Nucleus Communications, Inc.
Last reviewed November 2008 by Marcin Chwistek, MD
Last Updated: 11/13/2008