Wine and health is never a simple topic

Many physicians accept that moderate wine drinking is okay for you, and may even be beneficial (Debating the health benefits of wine: an update), while others do not. Wine may even be seen as part of a healthy lifestyle (Wineries can tap into growth in health and wellness category). However, the public is often given apparently contradictory headlines, such as these:

• Study finds drinking wine with meals was associated with lower risk of type 2 diabetes
• A drink a day could be associated with brain changes, study finds

It therefore seems worthwhile to review some of the issues here, and try to clarify the situation.

I have written before about the basic issue (Wine and health — why is there so much argument, pro and con?), which is that human bodies are complicated things, and therefore we cannot expect a simple answer to any question about what is good or bad for us. Something that is good for one person may not be good for another person, or may not be good under all circumstances.

This should surprise no-one just at the moment, given the very variable responses that people have had to the SARS-Cov-2 virus. Some people die of Covid-19 (the resulting disease) while others show hardly any symptoms at all (There seems to be a lot of public misunderstanding about the coronavirus). This is precisely as we expect it to be, when dealing with living organisms.

This general issue is exacerbated by a lack of any conclusive data regarding many, if not most, health issues. Even for the current pandemic, with 470 million cases worldwide, and 6 million deaths, we are still not very good at forecasting any given person’s likely response to the virus. We can make general forecasts, for sure, using age, gender, and health issues, but that it as far as it goes. I am an elderly man with high blood pressure and Type II diabetes, so you can image how far away I keep myself from potentially infectious circumstances.

Well, it is even worse for alcohol-related health studies (for some critiques of alcohol studies, see: International Scientific Forum on Alcohol Research). As Lewis Perdue has put it: Wine is healthy. Wine is dangerous. All studies on both sides of this are totally inconclusive. My point here is this: everything is potentially dangerous to a living being. A plate of fish has lots of nutrients, but you can choke on a fish bone. Walking gives you exercise, but you can get run over crossing a road. Breathing is essential, but some gases will poison you. You get the idea.

So, the situation is always inconclusive, in the sense that nothing can be said definitively one way or the other. That is, we can only speak in terms of probabilities. Some things are more likely to be dangerous than others, such as running across a road without looking for traffic. Some things are more likely to be dangerous under certain circumstances but not others, such as inhaling next to a busy highway compared to out in the forest. Humans know (or should know) all of this, having acquired experience while they grew up.

In this sense, any formal pronouncement by a government or semi-government authority is an over-reaction. If the World Health Organization, for example, says a blanket “yes” or “no” to anything, then they are saying nothing more than which way the probability seems to lie for the majority of people.

Tobacco smoking was the classic example — a large amount of data indicates that most heavy smokers will eventually develop lung cancer; and so a warning to everyone was deemed necessary. People can still smoke, but they now know what the nicotine is doing to them, and to those around them. Equally importantly, those around them also know what the potential danger is (I was very glad when both my parents gave up smoking, in my youth).

Of more direct relevance to this blog, the same is true for alcohol. Like nicotine, alcohol is among the potentially most addictive drugs in the world (10 most addictive drugs list); but there is a big difference between one glass of wine and many glasses of wine, consumed consecutively. In particular, a large amount of data indicates that trying to drive a car when drunk is dangerous to the driver, the passengers, and everyone else in the vicinity. So, drink-driving has been banned in most countries, and involves heavy financial penalties.

However, not all governments have agreed on where lies the boundary for being drunk — there is no definitive line that can be applied to all persons. Common official limits for driving are 0.05% or 0.08% blood alcohol content by volume; but I live in a country that uses 0.02%. The main issue for drivers, though, is that there is no general way to work out how many drinks you can have before you reach any given limit — it varies by person, as well as by drink type. So, most Swedes won't drink alcohol at all, when they are the designated driver — it would take about 4 hours to get your blood alcohol down from 0.08% to 0.02% (How long does alcohol stay in your system?).

So, what about the recent media-reported kerfuffles regarding wine drinking?

A classic example of lack of data, or imprecise interpretation of inadequate data, was the recent BBC report on sugar in wine (Two glasses of wine enough to hit daily sugar limit). There was an immediate reaction, of course (Misleading info about sugar content in wines by BBC). People asked the obvious question (How many calories are there really in your glass of wine?), and re-evaluated the data (No, your wine is not packed with sugar).

Note that this has nothing to do with what is indicated on a wine label (Sugar content in wine revealed: health experts deem alcohol labelling ‘woefully inadequate’). Most food consumed by human beings has a list of contents, but this is only sporadic for wine bottles — apparently, only about 40% of people say they actually want such a list (Survey finds scant interest in wine ingredients). Indeed, the only label information that seems to be compulsory is the alcohol content, and even that may not be all that accurate (What’s your tolerance?). In Sweden, the alcohol retailer also lists allergens, the most common of which (for wine) is sulfite.

Even worse, most food has nutrition information (the Nutrition facts label), including protein, fat and vitamin contents, as well as carbohydrates. This is not currently required for wine, although there are moves to make at least part of it compulsory (A perfect storm: Nutri-Score, alcohol and health). I think that it would be very unwise of the wine industry to oppose this sort of idea. Wine is consumed by humans, and those humans must be accurately informed as to what they are consuming — this should not be negotiable.

Recent studies have seriously questioned wine’s relation to health:

• Data from over 350,000 people have really bad news about 'moderate' drinking
• Why the drinks trade should be afraid of WHO
• Positive effects of alcohol on the heart a ‘myth’ says new study
• OIV meets WHO to discuss wine, health and warning labels

In response to this sort of thing, the European Union has recently considered the idea of putting warning labels on alcoholic drinks, just like those on cigarette packets (European Union lurches towards Prohibition). This is extreme, indeed, given the vast difference in evidence for the effects of alcohol versus nicotine. A fuss was made in response to the proposal, not least by the agriculture industry; and the politicians then backed down a bit (Amendments made to alcohol and health recommendations in Europe; EU: No drastic warnings on wine; Close shave for European wine industry).

The official reaction in China has been no better (Kerry Wines fined in China for promoting wine’s health properties).

At the other extreme, there are definitely people who act like wine is healthy. One classic example: 108-year-old woman credits red wine as the secret to her long life. More directly relevant, a recent survey (New study explores motivations and behaviors of U.S. wine consumers before and during Covid-19 lockdown) indicates that 4% of the respondents listed “health reasons” as one of their motivations for drinking wine during the pandemic. Sadly, this may also have lead to problems.

However, as I am emphasizing, things are more complicated than a simple yes / no answer:

• When is the best time of day to drink alcoholic beverages?
• Here’s why you should eat when you drink
• Why does alcohol mess with our sleep?

Some lifestyles promote health, and others demote it. Your own relationship to wine needs to be assessed in relation to your own lifestyle, not to some generic standard for all of humanity. After all, a healthy 75-year-old can have a longer life expectancy than an unhealthy 65-year-old (like me). At least some groups are finally trying to collect data to find out what people think about this: Wine Market Council releases results of study on the role of wine in a Wellness Lifestyle.

Perhaps the most interesting idea is that of the so-called ‘licensing effect’, where those who feel that they have done something ‘good’ (such as go for a run) are more inclined to reward themselves with something ‘bad’ (like an alcoholic drink). Thus, it has been observed that increased fitness can be associated with increased alcohol intake (Do people who exercise regularly drink more alcohol?).

Conclusion

The bottom line is this: everything depends on context. For example, we need water (our bodies are 60% water), but try sticking your head in a bucket of it, and see how you get on. We need to be told clearly where the limits of safety lie, not be given a blanket declaration one way or the other. In short: Don’t blame the booze – serious health conditions are multifactorial.