Wine, doctors, and the French Paradox
Although Hippocrates attributed medicinal properties to wine more than 2,000 years ago, modern interest in the cardiovascular effects of alcohol dates to the late seventies. Coining the term the “French Paradox,” researchers noticed that French people enjoyed excellent cardiac health in spite of diets high in saturated fat. Their investigation pointed to red wine as the “magic” component of the French diet. This touched off four decades of study concerning the cardiovascular effects of alcohol.
Alcohol and heart health
Here is what we know today: in large observational studies, those who drink alcohol in moderation tend to live longer and develop less heart disease than teetotalers or those who drink to excess. “Moderate” alcohol consumption means 1 to 2 drinks per day for men and 1 drink per day for women. The different “doses” between the sexes stem from their different body weights and the slower metabolism of alcohol in women.
The idea that alcohol could be good for the heart makes medical sense. Alcohol tends to increase HDL cholesterol (the “good” cholesterol) and reduces the tendency of blood to clot by its action on platelets. Heartwise, these are good effects.
Red wine vs. white wine
Notice that we are discussing alcohol in general, rather than red wine alone. Red wine gets its color from fermenting the juice together with the grape skins for a longer period than when white wine is made. In addition to the rich color, the grape skins contribute certain chemicals to the fermenting wine, including a variety of antioxidants that could provide health benefits. Of these, resveratrol has received the most study.
While it is theoretically possible that resveratrol and other antioxidants in red wine could confer health benefits, this assertion is unproven. In fact, recent media stories report fabrication and research fraud on the part of an investigator who published several papers purporting to show benefits of resveratrol.
Our take: if there is a key ingredient, it is the alcohol. And heartwise, there is no proven difference between modest consumption of red wine, white wine, beer, or spirits.
Although evidence supports the idea that a daily dose of alcohol can be part of a heart-healthy lifestyle, the truth is that we do not have conclusive proof that alcohol improves heart health. Such proof could come only from a large randomized controlled clinical trial in which subjects were randomly assigned to a daily dose of alcohol or placebo. We doubt scientists will ever complete such a trial.
We must also remember that alcohol is also associated with adverse health outcomes. Alcohol may increase the risks of breast and colorectal cancer, and excess alcohol causes a wide variety of health issues, ranging from liver damage to trauma caused by automobile accidents.
Our prescription: if you drink alcohol, drink in moderation. This means no more than two drinks per day for men and no more than one drink per day for women. A glass of wine (or beer or a scotch) a day can be part of a heart-healthy lifestyle.
Visit Cleveland Clinic’s Heart 411 page for more fun facts about your heart.