Oh, for a beaker of the warm South, / Full of the true, the blushful Hippocrene, / With beaded bubbles winking at the brim,” sighed Keats. Chances are, he wasn’t thinking about his arteries. But nearly two centuries later, the U.S. Department of Health and Human Services also took a long look at the poet’s favorite intoxicant and came up with the first pro-alcohol message in the history of federal health policy. According to the department’s just-released update of its Dietary Guidelines for Americans, a drink or two a day may be good for you. “Alcoholic beverages have been used to enhance the enjoyment of meals by many societies throughout human history,” states the background material to the new guidelines. “Current evidence suggests that moderate drinking is associated with a lower risk for coronary heart disease in some individuals.”
OK, Keats said it better. But to wine-lovers and many scientists, this ode to risk-reduction sounds sweet indeed, especially by comparison with the 1990 guidelines, which stated flatly that alcohol “has no net health benefit” and “is not recommended.” “They’re finally acknowledging that there’s a contribution wine can make to a healthy lifestyle,” says Julie Williams, cofounder of Women for WineSense, an advocacy group. After two centuries of living in combat with demon rum, Americans are suddenly being urged to curl up with a nice pinot noir; it’ll make us feel better. The good news keeps on coming: moderate drinkers live longer, moderate drinkers get fewer colds, moderate drinkers have flatter stomachs, moderate drinkers who happen to eat bad oysters don’t get as sick–apparently, moderate drinkers don’t get anything except an occasional backache from lugging cases of bottles around. But it’s the headlines on heart disease that have made the biggest splash. Study after study shows that regular wine drinking cuts your risk of heart trouble by up to 50 percent, and that moderate drinking can be more healthful than not drinking at all. R. Curtis Ellison, who conducts research on wine and heart disease at Boston University, goes farther. Abstaining from alcohol, he says, is a “major risk factor for coronary heart disease.”
Huh? Right up there with obesity and cheeseburgers? Absolutely, says Ellison, some of whose research is funded by the wine industry. But few scientists are quite that confident. The truth is, we really don’t know for sure why those wine drinkers are so healthy; we don’t know whether wine is better for you than other forms of alcohol, and we don’t even know how much drinking is most healthful. When it comes to vino, we’re still a long way from veritas.
Americans’ ideas about wine started to change in 1991, when Morley Safer went to Lyons, France, and came back with a “60 Minutes” story on “the French paradox.” Despite their high-fat diet, Safer reported, the French have only one third our rate of heart attacks; and to explain why, he held up a glass of red wine. That did it. After centuries of relative indifference to wine, sales jumped to a level 44 percent higher than the previous year and stayed strong. “The health message in the French paradox demystified wine,” says Rich Cartiere, editor of Wine Business Monthly. “Until 1992 we produced $0 percent more wine than we could sell; now we’re running out.” Still, that’s not much imbibing. Only about 16 percent of American adults drink wine more than once a week. (Mostly we drink beer–an average of about 10 bottles a week is typical for beer drinkers.)
French food: None of this begins to rival the French; they have the highest level of wine consumption in the world and the highest level of total alcohol consumption. But that’s not to say that a bottle of Beaujolais is the only thing that distinguishes us from them. Serge Renaud of the National Institute of Health and Medical Research in Lyons, who has done much of the research on the French paradox, attributes the longevity of his countrymen to more than wine. The French eat more fruits, vegetables and grains than Americans do. “If you eat french fries and steak every day, with two glasses of wine, you won’t go very far,” he says. But he’s still a passionate believer in the power of wine. He’s about to publish a study of $6,000 middle-aged men whom he followed for 10 to 15 years. Those who drank two to four glasses of wine a day had a 30 to 40 percent reduction in mortality from all causes, compared with those who drank less wine, more, or none at all.
Many researchers agree with Renaud except for his focus on wine, as opposed to other kinds of alcohol. All types of alcohol help keep arteries clear by reducing the stickiness of blood platelets-tiny blood cells that can cling to fatty deposits in the arteries and promote clogging. And alcohol increases HDL, the “good” cholesterol. But as to whether the alcohol has to be wine (as a Copenhagen study showed) or beer (a Hawaii study) or liquor (a Harvard study), the science simply isn’t in yet. Wine gets a health boost from its phenolits, a powerful class of antioxidants, which fight cellular damage that may initiate cancer. But Eric Rimm of the Harvard School of Public Health believes wine got even more of a boost from “60 Minutes.” “Morley Safer only focused on people who researched red wine,” says Rimm. “Now it’s dogma; everyone believes that red wine is the only way to get benefits. But if you’re having one or two beers a night, it’s going to have the exact same cardiovascular effect as the glass of wine.” Rimm and his colleagues have done several studies showing just that.
But how do we tell the drinker from the drink? Scientists agree that the best way to imbibe is moderately, regularly, and with meals. (Food is an important accompaniment because it slows the absorption of alcohol, extending its effect on the platelets over a longer period of time.) Most often, the people who drink that way are drinking wine. And those same people, according to researchers, have gold-star lifestyles. “Wine drinkers are leaner, they exercise more, they smoke less, they’re better educated,” says Ellison. These are all factors that could contribute to wine drinkers’ crystalline arteries. “If you eat a healthy diet and exercise a lot, we don’t know if you’re getting a lot of benefit from drinking,” says Roberta Ferrence, senior scientist at The Addiction Research Foundation in Toronto.
“Moderation” is the mantra of alcohol-for-health research, and rightly so. The new guideline defines moderation as a maximum of two drinks a day for men and one for women. Few quarrel with that recommendation. But in the studies, the subjects who showed the most benefits drank anywhere from two drinks a week (in a Harvard study) to five a day (Copenhagen). “Everyone admits there are problems with how they measure drinking in these studies,” says Ferrence. Charles Fuchs of the Dana-Farber Cancer Institute in Boston says failing to measure when and how alcohol is consumed could affect the results. “If you have six beers on Saturday, versus six glasses of wine across the week, you may see extraordinary differences.”
Suppose all the studies are right. Should everyone start taking wine like medicine-even those who don’t drink already? Not necessarily. The benefits of alcohol do not extend uniformly across the population. The only people who have been shown to get significant coronary benefits from alcohol are those at risk of heart disease-chiefly middle-aged and older men; and postmenopausal women. “If you’re at low risk of heart disease, the risks [of starting to drink] greatly exceed the benefits,” says Michael Criqui of the University of California, San Diego.
Even the most fervent enthusiasts for wine as a health food agree that certain people shouldn’t drink at all. The guidelines describe five risk groups, including people under 21, people with an alcohol problem in the family, people on various medications, people planning to drive or otherwise use their minds at a high level of functioning and women who are pregnant or trying to conceive. (The new guideline does note that an occasional drink during pregnancy is unlikely to be harmful.)
Researchers have uncovered a few additional risk groups as well. Smokers have problems already, but drinking makes them worse, according to Fuchs. “When you put alcohol and smoking together, they actually work synergistically in increasing the risk of many cancers, especially of the esophagus, head and neck,” he says. Several studies suggest that alcohol increases the risk of breast cancer, although the evidence is far from definitive. And some investigators say that simply increasing the number of drinkers in a society will increase the number of alcoholics. “If there were populations where everyone drank moderately, I’d say fine,” says Criqui. “But there aren’t. The proportion of alcohol abusers is a function of the number of drinkers.”
New drug: Adults who enjoy light or moderate drinking should keep right on enjoying it. But drinking solely for health reasons is an unhealthy reason to drink. “If alcohol were proposed as a brand-new drug for heart disease, they’d do clinical trials and they’d find it wasn’t usable, because of the side effects,” says Criqui. And many doctors are unwilling to think of alcohol as medicinal, even in the light of all the positive research. “You never quite understand if [patients] know what a small amount of alcohol is, versus maybe too much,” says Dr. Stephen Deutsch, medical director of the Medical Group of Beverly Hills. “My guess is that most physicians are not recommending alcohol. It’s just a little counterintuitive to everything else we’ve ever learned.”
Besides, the very notion of alcohol as a kind of liquid aspirin, gulped daily to keep your arteries clear, is unutterably depressing. And it’s certainly not the way centuries of healthy wine drinkers have treated their everyday beverage. Champagne may be “rich in antioxidants,” as Renaud says, but only in America would that be considered an invitation to uncork. Let the good times roll–in moderation–but don’t confuse them with taking medicine.
Liquid Planet: Who’s High and Who’s Dry?
Compared with real wine-drinking countries, the United States is practically dry. That may be a reason, scientists say, that our rate of heart disease is higher. NO KIND OF ALCOHOL 43% WINE ONCE A WEEK OR MORE 16% WINE LESS THAN WEEKLY 30% BEER OR HARD LIQUOR ONLY 11% U.S. consumption IN MILLION OF GALLONS WINE HARD LIQUOR 1975 427.9 364.1 1985 413.1 570.8 1994 334.5 459.6 Alcohol consumption and health Legend for Chart: A – CONSUMPTION IN LITERS PER CAPITA: WINE B – CONSUMPTION IN LITERS PER CAPITA: BEER C – CONSUMPTION IN LITERS PER CAPITA: LIQUOR D – LIFE EXPECTANCY E – HEART DISEASE[*] A B C D E France 63.5 40.1 2.5 78 61.1 Italy 58.0 25.1 0.9 78 94.1 Switzerland 46.0 65.0 1.7 78 106.4 Australia 15.7 102.1 1.2 78 173.0 Britain 12.2 100.0 1.5 77 199.7 U.S.A 8.9 87.8 2.0 76 176.0 Russia 2.7 17.1 3.8 69 373.6 Czech Republic 1.7 140.0 1.0 73 283.7 Japan 1.0 55.0 2.1 79 34.7 Mexico 0.2 50.4 0.8 73 36.4
* DEATH RATE PER 100,000.
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