What About Alcohol?

By now the “French Paradox” is old news. The phrase refers to the fact that despite eating lots of saturated fat and cholesterol (read: cheese, butter, and cream), the French have a relatively low incidence of heart disease. A major reason, researchers suspect, is the generous amount of wine that the French drink. Although the very existence of the paradox itself is currently under question—some researchers believe the French underreport heart disease—the evidence in support of wine and other forms of alcohol is not.

Dozens of studies on white wine, red wine, beer, and hard liquor attest to the heart-protective effects of alcohol. (That’s right, it’s not just wine that’s good for you.) In fact, 60 to 80 percent of the population could benefit from moderate drinking, said Harvard researcher Eric Rimm, Ph.D, during a briefing sponsored by the National Beer Wholesalers Association in 2002. Ina study of more than 80,000 American women, those who drank moderately had only half the heart attack risk of those who did not drink at all, even if the teetotalers were slim, eschewed tobacco, and exercised daily.

How does alcohol help? To start with, it raises HDL. This is true no matter what type of alcohol you drink. One study found that drinking half a bottle of white wine per day for six weeks increased HDL 7 mg/dl—a significant jump—in 12 healthy wormen and men, all of whom had otherwise normal cholesterol levels. Even significantly less alcohol was found to increase HDL up to 2 mg/dl in other studies. Recent research suggests that the heart-health benefit of alcohol is increased if moderate consumption is also consistent—three to seven times per week, rather than sporadic.

Red wine has additional benefits, some of which can be ascribed to powerful antioxidants. Because the skin of the grapes used to make red wine stays in contact with the juice as the wine ferments, more antioxidants, in the form of flavonoids, leach into the wine. (The skins are removed when white wine is made, thus the lower flavonoid content.) Red grape juice also contains flavonoids, but not as much: only about one-fourth to one-third of that found in red wine.

How much is enough to gain heart protection? In one study of 353 men aged 40 to 60 who had had a heart attack, two or more glasses of wine each day reduced their risk of another heart attack by more than half compared to nondrinkers. 

Everything in Moderation

Of course, go overboard with alcohol and the risks quickly outweigh the benefits, particularly in wormen, who don’t metabolize alcohol as well as men. As little as two drinks a day in women could lead to liver disease. And studies find that daily drinking could increase a woman’s risk of breast cancer 30 percent. (Keep in mind, however, that far more women die each year from heart disease than breast cancer. Also, a30 percent increase for a woman at low risk of breast cancer amounts to a change in risk from 10 in 100,000 to 13 in 100,000.) Too much alcohol can also increase the risk of a rare type of stroke called hemorrhagic stroke (involving a burst blood vessel), and binge or heavy drinking can actually damage the heart. Women should limit themselves to no more than one drink a day; men, no more than two. One drink is 4 ounces of wine, 12 ounces of beer (a bottle or can), or 1 ounce of hard liquor.