Does red wine improve health? The answer isn’t cut and dried.
Wine drinkers, and especially red wine drinkers, love to imagine that their favorite beverage leads to a long, happy life.
But the issue of wine — or really, any alcohol — and health is a complicated one, according to two doctors who recently were asked to separate fact from wishful thinking.
The public perception of red wine as good-for-your-health got started in 1991 when the weekly television show "60 Minutes" aired a segment on the now mostly debunked French Paradox, which postulated that red wine staved off heart disease in the saturated-fat-loving population of France.
In the intervening years, that notion has been tossed out like a curdled sauce. Observers have suggested that fuzzy statistics might have led to an erroneous conclusion, or maybe Americans have more heart disease because we eat more trans-fat than the French, not because they drink more red wine.
And so it goes, our hopes are raised and then dashed by the ongoing research. Resveratrol, an antioxidant found in red wine, is miraculous — or maybe it doesn't do much at all. Wine makes us either gain weight or lose weight, not sure which.
So what are the facts?
One of the physicians who stepped up is David S. Marks, acting chief of cardiovascular medicine and professor and vice chair of medicine and radiology at the Medical College of Wisconsin.
He confirmed there are health benefits that come along with moderate alcohol consumption, and those benefits are "largely cardiovascular."
But he underscored the risks, pointing out that alcohol is the fifth-leading cause of death worldwide and is associated with myriad "adverse health effects," including accidental death, liver disease and alcoholism.
Don't look to this cardiologist for the green light: "I would never encourage any of my patients to start drinking alcohol."
When it comes to wine in particular, he says it shouldn't be considered as "medicinal" or a "source of health."
Instead, he sees moderate wine drinking as something that can be "aligned with health, as part of a healthy, moderate lifestyle."
The other physician who weighed in is Donald D. Hensrud, director of the Mayo Clinic Healthy Living Program in Minnesota.
He answered a battery of questions about alcohol and health. And — just so you don't overfill your glass — he began the discussion by defining "moderate drinking."
For women, it means at most one drink a day; and for men it's two. One drink equals about 12 ounces of beer, 5 ounces of wine or 1½ ounces of 80-proof spirits.
Women are allotted less not only because they tend to be smaller than men, but also because they have less of an enzyme, gastric alcohol dehydrogenase, which metabolizes alcohol.
"So women are more susceptible to the effects of alcohol," he explained.
As to any health benefits specifically associated with wine, there's not much evidence to separate wine from spirits and beer.
"All three seem to have a benefit with regard to heart disease and overall mortality," he said. "Despite the common belief that red wine is the best, there's not much evidence for that."
Alcohol in general — name your poison — raises HDL cholesterol, which is the good kind, and thins the blood.
Those are two of the reasons that light to moderate alcohol consumption is associated with what Hensrud describes as a "25% to 30% decrease in cardiovascular disease, cardiovascular death and overall mortality."
"With heavy drinking, the health advantage disappears," he said.
He doesn't put much stock in resveratrol, that highly touted compound found in red wine. His view is that while this antioxidant may have some slight beneficial effect, it's relatively small compared to the effect of the alcohol.
Wine drinkers can take comfort, however, in this: "People who consume wine have better overall health compared with people who consume beer or spirits."
He's not sure why, but one possibility he suggested is that wine is more commonly consumed with food, which slows absorption of the alcohol.
And what about the link between breast cancer in women and alcohol?
Hensrud said research shows that the risk starts at a relatively low consumption level — just a couple of drinks a week, but he added that the "increased risk is relatively low."
So if you're playing the odds, that risk is balanced against the statistically greater benefit on the cardiovascular side, with "heart disease being much more common."
What's the wisdom with regard to drinking and weight?
Surprisingly, the doctor said studies show that "in general, people who consume moderate amounts of alcohol weigh about the same as abstainers."
But, yes, in heavier drinkers fat tends to accumulate in the mid-section — hence the beer belly.
And Hensrud asked the question that many of us have: Is it OK to drink on a daily basis?"
While light to moderate drinking can improve your cardiac health, "it can also turn into a habit, and habits can come back and bite you. No one sets out to have a problem with alcohol or liver disease. And it's hard to predict who's going to have a problem."
So because "maintaining moderation is a challenge," his recommendation is that you go without alcohol sometimes. He doesn't prescribe an exact alcohol-free schedule — it could be, say, a couple of days a week or one week out of the month — but the goal is to give yourself a "reality check."