What do you mean, Wine isn't good for me?

We are in the midst of the holiday season when eating and drinking more than usual is the norm. For many years we have heard that wine, the elixir of gods, has many beneficial qualities, including reducing the risk of heart disease and dementia. This information came from epidemiological studies, meaning it looks at populations of people and tries to deduce risks based on lifestyle habits. Unfortunately, it's hard to separate the benefits from drinking one or two glasses of wine per day, particularly in people who exercise regularly, maintain a healthy weight, and eat a diet lower in processed food. You can imagine how difficult it must be to tease away one habit from another, especially in people who have mostly good lifestyle habits that are grouped together.  

Okay, here is the bad news: It doesn't look like any alcohol is good for us. That is really disappointing, particularly after watching the series "Drops of God" and feeling that we need to commune with the earth and each other by drinking wine. First, not only does alcohol NOT reduce the risk of hardening of the arteries, but it increases it. Not only that, but the heart is more prone to an irregular heart rhythm called atrial fibrillation with any amount of alcohol intake. The incidence of atrial fibrillation increases with age and puts us at risk for strokes and blood clots. Any amount of alcohol increases blood pressure with the most pronounced elevations occurring with more than two drinks per day, but increases can be measured with even one drink per day. Alcohol increases triglyceride levels and lowers HDL levels, another nail in the coffin (pun intended) as far as heart disease.  

It was the American Cancer Association that began beating the drum of cancer prevention by avoiding alcohol entirely. It turns out, alcohol increases the risk of many cancers, including breast, colorectal, esophageal, liver, stomach, head and neck, and pancreatic cancer. When you add smoking to drinking, the risk is much higher than either one on its own. Once again, these are statistical analyses. Women who drink more than 3 drinks per week have a similar risk to non-drinkers as far as breast cancer, but once you consume at least 1 drink per day, your risk increases to 1.3 times the average, and 2 drinks per day increase your risk to 2 or double the average. When I present these numbers to patients, I often get a blank stare or polite disregard. I must say I completely understand. You can barely watch anything Streaming or on Network television that doesn't include alcohol as part of the plot. Have a hard day? Pour a glass of wine. Having a Bachelor or Bachelorette party, pass the shots. Having a fancy meal, well an expensive bottle of wine or cocktail only makes that better, right? Craft beer, craft bourbon, premium tequila, luxury wine, and high-end champagne all conjure up a special kind of life that we all want to live. When was the alcohol-free party you attended? Perhaps a baby shower.

If we put heart disease and cancer risk to the side, the argument continues that alcohol improves quality of life. I do understand the feeling of relaxation that washes over you when you have a pint for example and that is nice. If you happen to be an older man, or worst of all, a menopausal female, that feeling of relaxation helps you to slip into sleep but several hours later, leads to early awakening and insomnia. For many people, they are drinking alcohol and taking sleeping medication to combat the insomnia that comes with regular alcohol use. The combination of poor sleep and regular use of sleep medication is particularly bad for brain cells. I think we can all agree, we need our brains to function as well as possible. If you are depressed, anxious, or prone to these conditions, alcohol is kindling to those particular fires. We are just beginning to understand the genetic differences in people that may make them more prone to the bad effects of alcohol. For large groups of people who lack alcohol dehydrogenase, the enzyme that breaks down alcohol, drinking means getting a flushed face, rapid heartbeat, and headache with the use of alcohol. For people prone to migraines, red wine is a common trigger. That doesn't sound like quality.

How can it be then, in the Blue Zone series looking at long and healthy communities in the world, the little old lady from Icaria, Greece, when asked what she feels the source of her health is, responds that it is the wine she drinks every day? It could just as easily be the largely plant-based diet rich in legumes, the strong social bonds in the community, the regular outdoor activity, or the high-antioxidant tea people drink every day. Once again, it's not possible to separate one effect from another. Canada took a bold step in July 2020 by updating Alcohol Drinking Guidelines to reflect that the risk of alcohol use occurs as a continuum. The least risk exists with no alcohol use. Beyond that risk increases with as few as 3 drinks per week. American Guidelines are in the process of being updated, with the old guidelines, one drink daily for women and two drinks daily for men (without regard to age or weight) being outdated and not reflecting current research and understanding. During this holiday season, I respectfully suggest that this is a drink for thought....  

For those of you who drink alcohol daily,  I suggest you designate alcohol-free days and reduce the quantity of alcohol you drink to no more than 1 drink per day. Remember one drink is 5 ounces of wine, 12 ounces of beer, or 1.5 ounces of liquor. Drinking alcohol with food to slow absorption is also a good idea. Another simple rule: try not to drink alone. There are new horizons for non-drinkers or simply people interested in drinking less. Mocktail culture is growing with creative non-alcoholic creations featured on restaurant menus. If you are lucky enough to live in Dunedin, Florida, as I do, you could have joined the first annual Mocktail Walk and Contest in September of 2023. Likewise, the next time you are at a brewery, ask about non-alcoholic beer. It turns out that beer, without the alcohol, is an excellent muscle recovery drink thanks to the polyphenols and carbohydrates.