Monday, May 20, 2024

There is much medical evidence that wine consumption is good for your health

In a recent post (The curious saga of health and drinking wine continues) I commented, with regard to the increasingly vociferous anti-alcohol messages emerging from the World Health Organization and their allies, that: “there is at least as much data refuting their position as there is supporting it.”

In this post I look at some of the recent data supporting the suggestion of health benefits, quoting the best bits from the original publications.

Health benfit of wine

Let’s get one thing out of the way first, though. There is definitely a limit above which alcohol intake is seriously harmful to human health, irrespective of the alcohol source (beer, wine, spirits, etc). This is often known as “binge drinking”.

If we look at this topic briefly (Understanding binge drinking):
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines binge drinking as a pattern of drinking alcohol that brings blood alcohol concentration (BAC) to 0.08% — or 0.08 grams of alcohol per deciliter — or more. This typically happens if a woman has four or more drinks, or a man has five or more drinks, within about 2 hours.
The main issue is the frequency with which this binge drinking happens. Repeated episodes are seriously problematic (eg. 10 standard glasses or more per week). A recent useful discussion of this topic is: Binge drinking is a growing public health crisis. A more formal consideration is this publication: Excessive alcohol use and alcohol use disorders: a policy brief of the American College of Physicians.

This is a topic that should not be ignored, of course. In this regard, it has recently been reported: Which country is home to Europe's heaviest drinkers? In general, there has been a gradual decrease in alcohol consumption in the European Union and the WHO’s European Region, although it does (on average) still have the highest level of alcohol consumption per person in the world. But not usually binge drinking.

Stethoscope and wine glass.

Turning now to more moderate issues, such as a glass of wine with dinner. There are two ways to approach this topic, of course: (i) questioning the claims of a negative effect of moderate alcohol consumption, and (ii) looking at claims of non-negative or even positive effects. Here, I will focus on the latter. The trend in the former (attacks) has recently been put in no uncertain words by Tom Wark (The 8 changes coming to wine in the U.S.):
You can only get punched in the nose by bullshit artists so often before you decide to punch back, and this is exactly what is going to happen in response to irresponsible claims such as “there is no safe level of alcohol consumption”. These claims are akin to “there is no safe amount of auto travel”.
However, let us move on from that. One basic issue regarding health is that wine is usually consumed with food, and therefore it is part of a larger diet. The best-known of these is the Mediterranean Diet, which frequently includes wine. It also includes many other foods that contain acetaldehyde, which is the break-down product of what we call “drinking” alcohol or ethanol (see my post: The curious saga of health and drinking wine continues).

Here, I will focus on things that I have not already covered in previous posts.

Mediterranean diet (with wine).

The basic issue was summarized some time ago by this scientific article: Wine and health — new evidence, which I quote here:
Health benefits of moderate wine consumption have been studied during the past decades, first in observational studies and more recently, in experimental settings and randomized controlled studies. Suggested biological pathways include antioxidant, lipid regulating, and anti-inflammatory effects. Both the alcoholic and polyphenolic components of wine are believed to contribute to these beneficial effects. Although several of these studies demonstrated protective associations between moderate drinking and cardiovascular disease, atherosclerosis, hypertension, certain types of cancer, type 2 diabetes, neurological disorders, and the metabolic syndrome, no conclusive recommendations exist regarding moderate wine consumption.
Discussing one of the pathways that they listed, one interesting extremely positive recent publication is: Research validates anti-inflammatory properties of wine using urinary tartaric acid as biomarker. This experiment was done in conjunction with a Mediterranean diet:
The study successfully establishes urinary tartaric acid as a credible biomarker for wine consumption, providing clear evidence that moderate wine intake, particularly red wine rich in polyphenols, is associated with significant reductions in key inflammatory markers. These findings not only reinforce the potential health benefits of moderate wine consumption in reducing cardiovascular risk, but also highlight the importance of including such bioactive compounds in the diet for their anti-inflammatory properties.
That is very clearly positive. Indeed, one useful publication is a review summarizing other medical publications: Moderate wine consumption and health: a narrative review. It concludes:
Although it is clearly established that the abuse of alcohol is seriously harmful to health, much epidemiological and clinical evidence seem to underline the protective role of moderate quantities of alcohol and in particular of wine on health ... Twenty-four studies were selected for the evaluation of moderate alcohol/wine consumption and health effects ... The analysis clearly indicates that wine differs from other alcoholic beverages, and its moderate consumption not only does not increase the risk of chronic degenerative diseases but is also associated with health benefits, particularly when included in a Mediterranean diet model.
So, wine is the best source of alcohol, health-wise. Another such review, but more restricted in scope, is: The history, science, and art of wine and the case for health benefits: perspectives of an oenophilic cardiovascular pathologist.

Red wine and heartbeat.

One of the issues in this general topic is thus the different types of alcohol being consumed. I have focused on wine here, but even then different types of wine seem to offer different health benefits and risks (What are some of the healthiest wines?), which does not make for easy study. Indeed, it seems that red wine might have more health benefits than white wine (Wine: a glass a day keeps the doctor away?). For a scientific review, see: Red wine consumption and cardiovascular health.

One wine-producer response to reducing wine consumption is, of course, the idea of non-alcoholic wine. This topic has been looked at recently in:
  — The war on wine
  — Making non-alcoholic wine will never be easy — can momentum carry it forward?
  — How non-alcoholic wine and perfume are similar — Giesen winemaker explains
  — The idea of dealcoholised wine is appalling.

There is also the matter of labeling, when the wine bottle does contain alcohol. Ireland is moving ahead with warning labels (see: The bad science at the heart of anti-alcohol labelling in Ireland). On the other hand, Ontario has decided that sales of beer, wine, cider, and ready-to-drink cocktails will be allowed in convenience stores and all grocery stores by 2026, which has engendered its own reaction (Health groups ask Ontario to develop alcohol strategy ahead of looser prohibition).

Louis Pasteur experiments.

As I have noted before (Why we are never going to know whether wine is good for us, or not), part of the problem is the nature of medical experiments. You can imagine that the study of medical causes and their effects is not straightforward, especially if the studies are to remain ethical.[1] This topic is explored further in:
  — The fight over moderate drinking: why studies on effects are unlikely to happen
  — Causal inference about the effects of interventions from observational studies in medical journals.

Nevertheless, people have been drinking wine for thousands of years, and the benefits of doing so have been well documented throughout that time, both medically and anecdotally. Let’s leave it that way — after all, wine drinkers apparently account for 35% of the entire U.S. legal drinking age population (2024 BMO Wine Market Report), and in 2023 the USA was the world’s largest wine consumer (The wine trade in 2023 in six graphs).

1. This is a completely separate issue from so-called junk science; see Flood of fake science forces multiple journal closures; and also “Inoculation” to resist misinformation.