Public health officials and scientists continue to debate whether moderate drinking is harmful or beneficial. There is no debate that heavy drinking or binge drinking is harmful to health. Both are.
In the late 20th century, there was a flurry of studies that showed—and a 60-Minutes television segment that popularised the idea—that moderate drinking protected the heart.
Recent studies have questioned the cardioprotective effect of alcohol and indeed some note that any amount of alcohol increases the risk of developing cancer and is harmful to health.
A major problem with studies regarding alcohol and health is that they rarely distinguish the type of alcohol consumed—wine, beer, or spirits—and the pattern of drinking, that is, with or outside of meals.
Those factors are critically important because the type of alcohol consumed and the setting in which it is consumed affects the blood alcohol level, which is what likely drives the effects of alcohol, be them potentially beneficial or harmful to health.
Now, we have an important and well-done study that addresses these factors.
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Drinking wine or drinking wine with meals was associated with lower overall death rates, and with lower death rates specifically from cancer and cardiovascular disease, according to a recently published study by investigators from Spain and the Harvard T.H. Chan School of Public Health.
The study, published in JAMA Network Open, analysed drinking habits of 135,000 UK residents above the age of 60 using data from the UK Biobank, a health registry.
The authors wanted to see the effect of alcohol use on frail older individuals and those with lower socioeconomic status.
Not surprisingly, they found that frail individuals and those from lower socioeconomic status had a great overall chance of dying if they drank alcohol, and a greater chance of dying from cancer or from cardiovascular disease. The more they drank, the higher their risk of death from all causes, as well as from cancer and cardiovascular disease.
What was surprising was when they looked at individuals who drank mostly wine and who drank wine with meals. Wine drinking and drinking only during meals offset the increased risk in frail individuals and those from lower socioeconomic status.
Furthermore, in individuals who were not frail nor in lower socioeconomic classes, wine drinking or drinking only during meals was associated with a reduced risk of death from all causes, as well as from cancer and from cardiovascular disease.
Although the alcohol in wine is the same chemically as the alcohol in vodka or other spirits, the amount that reaches the blood stream depends on the setting in which it is consumed and the concentration of it in the beverage.
Even with rising alcohol levels in wine due to using riper grapes, wine still has a lower concentration of alcohol compared to spirits. And wine is typically consumed over a longer period of time and with meals, both of which will moderate blood alcohol levels.
So, it makes sense that individuals who drink mostly wine or do so with meals, and presumably have lower blood alcohol levels, have better health outcomes compared to individuals with different patterns of alcohol use.
It’s important to point out that this study, like most, only point out associations. They do not establish cause and effect. You cannot conclude from this study that drinking wine with meals will reduce death from all causes, as well as cancer and cardiovascular disease.
Whether the reduction is death is due to wine per se or the type of person who drinks wine moderately with meals — a person who is typically more affluent and may have better overall health habits in general — is still unknown.
Nonetheless, it’s an association that should make wine drinkers smile.
Michael Apstein, MD, FACG, is a wine writer, Decanter contributor and assistant professor of medicine (Gastroenterology) at Harvard Medical School.
