This Month’s Featured Article

Happy New Year! Was yours celebrated with a glass of champagne at midnight? With a decadent dinner over which the hopes and dreams for 2023 were summarized and those for 2024 were discussed and agreed to with a toast, preferably with a glass of a bold red wine? For me, these traditions have marked my adult life. Even before I was old enough to enjoy champagne, I was hypnotized by my glamorous French mother pouring it into her Marie Antoinette silver champagne goblets for the guests who came to my parents’ house during the holidays. A champagne toast was – is – about life, love, coming and being together in celebration. I suppose this could be achieved with another sparkling beverage, and that meals can be enjoyed with water or juice or seltzer – no, never mind … I can’t imagine it’s a similar experience. 

In vino veritas

The pleasure of wine is not just its taste or its effect, though these are certainly factors. The pleasure is in the sharing of it. The pleasure is in noting how it interacts with food. The pleasure is in anticipating the way wine enhances the social experience. In vino veritas – in wine there is truth – said Pliny the Elder in AD 77 to reflect where wine takes you with conversation and connection. My sentiments are nothing new. 

I’ve also taken for granted that drinking wine in moderation is a health benefit. Until very recently, studies seemed to pop up regularly supporting the theory that a glass of wine a day – especially red wine – was good for your heart. The island of Sardinia is considered a “blue zone,” where many people live well into their 90s. When trying to determine why, researchers concluded that it was a combination of diet, low-stress lifestyle, and a solid community. Wine was considered an elemental part of the Sardinians’ healthy diet.  

It seemed obvious and uncontentious that a glass of wine was good for you. Maybe not.

It was with shock and, honestly, some fear that I learned earlier this year of the World Health Organization’s increasingly louder message that alcohol is a known carcinogen and that the organization is on a mission to relegate it to a substance that should be avoided, like cigarettes. What?!? My health took a setback just learning this!

Toxic?

According to the World Health Organization, “Alcohol is a toxic, psychoactive, and dependence-producing substance and has been classified as a Group 1 carcinogen by the International Agency for Research on Cancer decades ago – this is the highest risk group, which also includes asbestos, radiation, and tobacco. Alcohol causes at least seven types of cancer, including the most common cancer types, such as bowel cancer and female breast cancer. Ethanol (alcohol) causes cancer through biological mechanisms as the compound breaks down in the body, which means that any beverage containing alcohol, regardless of its price and quality, poses a risk of developing cancer.” 

The WHO is no fly-by-night group of radicals. Founded in 1948, the organization, based in Geneva, Switzerland, is an agency of the United Nations, whose purpose is to connect “nations, partners, and people to promote health, keep the world safe, and serve the vulnerable – so everyone, everywhere can attain the highest level of health.” It serves 194 member states across six regions. The WHO started studying alcohol-related problems in earnest in the late 1970s, with a focus on its effects in Europe but with global implications. 

In January 2023, Dr. Carina Ferreira-Borges, the regional advisor for alcohol and illicit drugs in the WHO regional office for Europe, stated in no uncertain terms, “We cannot talk about a so-called safe level of alcohol use. … Although it is well established that alcohol can cause cancer, this fact is still not widely known to the public in most countries. We need cancer-related health information messages on labels of alcoholic beverages, following the example of tobacco products; we need empowered and trained health professionals who would feel comfortable to inform their patients about alcohol and cancer risk; and we need overall wide awareness of this topic in countries and communities.”

Convincing scientific evidence?

Most recently, in November 2023, the WHO and the International Agency for Research on Cancer issued a joint statement that said, in part, “IARC is the specialized cancer agency of WHO, its main mission being to conduct research to enable effective cancer prevention. … In 1988 alcoholic beverages were identified as a Group 1 carcinogen. … The Continuous Update Project of the World Cancer Research Fund and the American Institute for Cancer Research has also attributed the highest level of causal evidence to the association between the consumption of alcoholic beverages and the development of cancer. … Based on this convincing scientific evidence, the European Code Against Cancer, coordinated by IARC, provides a clear alcohol-related cancer prevention recommendation to European citizens. It states, “If you drink alcohol of any type, limit your intake. Not drinking alcohol is better for cancer prevention.” (Read the full statement and its multiple links at who.int/europe/news and scroll down to November 6. The other news items are fascinating, as well!)

Understandably, and not without potentially dire consequences, the reverberations of these proclamations have been felt around the world. On the heels of the WHO’s strongest statement from January 2023, the Canadian Centre on Substance Use and Addiction issued revised guidelines on what are considered safe levels of consumption of alcohol, advising, in sum, that consuming one to two drinks a week would likely not result in chronic diseases, liver injury, and accidents, but the safest choice is not to drink at all. 

What?!?

Here in the US, the American Cancer Society has also weighed in, with extensive information on its website under the link “alcohol use and cancer.” It outlines that alcohol use has been linked to cancers of the mouth, throat, voice box, esophagus, liver, colon, rectum, and breasts. ACS warns, “Alcohol use is one of the most important preventable risk factors for cancer, along with tobacco use and excess body weight. Alcohol use accounts for about 6% of all cancers and 4% of all cancer deaths in the United States.” According to the American Cancer Society Guideline for Diet and Physical Activity for Cancer Prevention, it is best not to drink alcohol. “People who choose to drink alcohol should limit their intake to no more than two drinks per day for men and one drink a day for women. The recommended limit is lower for women because of their smaller body size and because their bodies tend to break down alcohol more slowly.” (To learn more visitcancer.org/cancer/risk-prevention/diet-physical-activity/alcohol-use-and-cancer.)

This is mirrored by the USDA. The Departments of Agriculture and Health and Human Services issue Dietary Guidelines for Americans. Those issued for 2020-2025 state that “adults of legal drinking age can choose not to drink or to drink in moderation by limiting intake to two drinks or less in a day for men and one drink or less in a day for women when alcohol is consumed. Drinking less is better for health than drinking more.” The official guidelines list conditions of people who should not drink and clearly state, “People who do not drink should not start drinking for any reason.” What constitutes a “drink” according to these guidelines? For wine, it’s five ounces of table wine; three to four ounces of fortified wine; or two to three ounces of a cordial, liqueur, or aperitif. 

Uh oh.

The American Institute for Cancer Research posted a report on its website in February 2022 that concluded that most Americans were unaware of alcohol as a cause of cancer. It conducted a study of cancer risk awareness and found that when people were aware of the risk, they supported adding health warning labels to alcohol packaging. 

The AICR’s position on whether there is any safe level of alcohol consumption where the risk of cancer is concerned is quite clear: “For cancer prevention, it’s best not to drink alcohol.” 

But “alcohol” is a broad descriptor, including wine of course, but also beer, cider, mead, and spirits. What’s the common denominator that determines the risk of cancer? It’s ethanol. Ethanol is a by-product of fermentation, released when yeast eats sugar. Carbon dioxide is also created in this process. Wine typically contains 7-15% ethanol because of sugar levels in grapes. Humans have enzymes that can digest ethyl alcohol. We cannot digest isopropyl alcohol or denatured alcohol, which can be immediately toxic if consumed. 

The ACS does say, “Exactly how alcohol affects cancer risk isn’t completely understood,” and also, “Overall, the amount of alcohol someone drinks over time, not the type of alcoholic beverage, seems to be the most important factor in raising cancer risk. Most evidence suggests that it is the ethanol that increases the risk, not other things in the drink.” The standard portion sizes of drinks defined in the dietary guidelines all contain about a half ounce of ethanol. 

What about the studies that showed wine was good for you?

There’s more to wine than its ethanol content!

Resveratrol to the rescue

Wine contains resveratrol. In a March 2020 abstract published in the National Institute of Health National Library of Medicine titled, Health Benefits and Molecular Mechanisms of Resveratrol: A Narrative Review, the authors summarized: “Resveratrol is a bioactive compound in many foods. Since its anticancer activity was reported in 1997, its health benefits have been intensively investigated. Resveratrol has antioxidant, anti-inflammatory, immunomodulatory, glucose and lipid regulatory, neuroprotective, and cardiovascular protective effects, and therefore, can protect against diverse chronic diseases, such as cardiovascular diseases, cancer, liver diseases, obesity, diabetes, Alzheimer’s disease, and Parkinson’s disease. … Resveratrol, therefore, has been regarded as a potent candidate for the development of nutraceuticals and pharmaceuticals to prevent and treat certain chronic diseases.”

Resveratrol itself is a stilbenoid, a type of phenol. Grape skins and other plants contain polyphenols (poly = many). Resveratrol-rich polyphenols are especially high in red wine, which spends more time with skin contact during the fermentation process. That’s why red wine is cited as the type with the greatest health benefit. 

Antioxidants and anti-inflammatory

In sum, the antioxidants present in the polyphenols in red wine may increase levels of high-density lipoprotein cholesterol, which can protect against cholesterol build-up. This can help prevent coronary artery disease, which leads to heart attacks. This has been the basis of the claim that red wine has health benefits. 

An article on Real Simple magazine’s website from November 2023 lured readers (like me!) with the headline: 9 Red Wine Benefits That Are Backed by Science. The enthusiastic author cited benefits to the heart, brain, eyes, and even teeth. I loved it. Another encouraging finding for me was a post-COVID study from 2022 of people aged 49+ in the UK and how wine affected their susceptibility to the virus. Those who drank one to two glasses of red wine per day were 10-17% less likely to contract COVID-19 than non-drinkers. Frequent beer and cider drinkers, as well as those who consumed more than five drinks of hard alcohol per week, had an elevated risk of contracting COVID-19. The results were attributed to polyphenols boosting the immune system, but diet, exercise, and even income were also contributing factors.

Where does all of this leave us wine drinkers?

There’s always more to learn, and I encourage you to take a look at Wine Spectator’s piece from April 2023 titled, Making Sense of Wine and Your Health. It includes lots of great links. Find it here: winespectator.com/articles/making-sense-of-wine-and-your-health-043023. 

Wine Industry Advisor is another trusted resource for information about the industry, including this topic. An article from November 2023 by Jeff Siegel, a longtime wine writer, presented a grounded commentary on the arguments around health benefits of wine, titled, Down to Zero: Ignoring neo-Prohibitionists Could Prove Dangerous to the Wine Industry. In other words, the best offense is a good defense. And we’d better get on it. Some recommendations?

Take the WHO and this movement seriously. Recognize that they have some valid points. Felicity Carter of The Business of Drinks podcast is quoted in the piece saying, “It’s incredibly important that wine publications take a more responsible attitude towards moderation and health. … I’ve seen too many credulous articles being published that present wine as some miracle potion capable of curing or preventing everything from cancer to dementia. My fear is that one day the anti-alcohol lobby will stand in front of Congress waving a bunch of these articles and claim that the wine trade deliberately lied about the health benefits of wine.”

Moderation. Moderation. Moderation.

A lifestyle of moderation can be very healthy. Studies show the benefits of a more plant-based diet, regular exercise, involvement in community and/or faith, and moderation in the consumption of alcohol. Wine and other alcoholic beverages have been part of our lives from the dawn of civilization. Wine, especially, is associated with accompanying and enhancing foods, which it surely does.

“It’s tired, it’s cliché, it’s boring, but it is what can save wine: Wine goes with food,” declared Paul Tincknell of the Napa Valley consulting agency Ticknell and Ticknell. “It is the choice for dinner, picnic, lunch, whatever. … Wine is not just something to partake on special occasions.” The Mayo Clinic sums up the debate with this: “Experts say not to start drinking alcohol to help your heart. This is especially true if you have alcohol use disorder or if alcohol use disorder is in your family. Too much alcohol can harm the body in many ways. But if you already have a glass of red wine with your evening meal, drinking it in limited amounts may improve your heart health.”

Wine is associated with the everyday enjoyment of the company of others while slowing down and appreciating the simple and fundamental things that bring us together over a meal. Like other foods that define a place, a bottle of wine is not just about what comes from a particular location, but also the environmental effects on that place in any given year. A vintage is a time capsule in a way, and that’s a treasure to be admired and shared. 

Appreciation for all that wine is

Just as wine drinkers wouldn’t be able to make selections without certain information on the labels – wine maker, vintage, varietal and/or varietal blend – might it not be valuable to include nutritional and ingredient information as is done for so many things we consume? Comparing calories, carbohydrates, sugars, even additives could reinforce wine’s choice as a healthier option than many other beverages. Cameron Diaz and Catherine Porter felt this was important when creating their line of Avaline wines. They put the full ingredient list on every label, and are fully transparent about what’s in their wines as well as where and how they’re made. 

Believing in wine (and enjoying drinking) doesn’t mean you should ignore the dietary recommendations around consumption. It’s important to be honest with yourself and your doctors about how much you drink. A health benefit is only as legitimate as how it is understood and applied. 

Health benefits of wine? You’ll find a glass of it on my table at dinner. What you won’t find is processed food, sodas, or excess. At least for the most part. And I’ll rarely say no to a good walk after dinner. Here’s to health and happiness, great food and great conversation, lives well lived in 2024 and beyond. 

Happy New Year. Cheers. •

*Disclaimer: All medical claims made in this article are information provided by the sources listed. The information is general in nature and not specifically meant for any particular individual. You should always seek out medical assistance from a medical professional based on your individual needs and circumstances.