I assume you've heard the age old saying that red wine is great for your heart. Some would even go as far as saying that some types of alcohol are useful for many other health conditions. Have we been down-playing the risks of consuming alcohol? Have you ever used it to relax and unwind, or to treat insomnia, anxiety or social phobia? Do you drink because you think it’s good for your heart or because it’s healthy?
I don't want to sound like a party pooper, since I too like a good scotch here and there, but that doesn't mean we should avoid talking about the health implications. I get it, alcohol is an intricate part of our culture, and Acadian Canadians like me have been known to do their fair share of binge drinking.
In many parts of the world, doctors are still recommending alcohol for sleep, anxiety, pain management and even during pregnancy. I'm not one to rain on anyone's parade, but people love hearing good news about their bad habits. So I'm not surprised that people would jump for joy after hearing that alcohol is healthy. If you drink red wine because you love it, then you're an adult and you can decide for yourself, but if you do it for cardiovascular protection or any other medical reason, then you might be surprised to hear what I have to say. In this article, I'll review the pros and cons of alcohol consumption and I'll summarize the latest research on this highly popular beverage.
Marketing Manipulation
People tend to see alcohol very differently than tobacco, even if both have numerous studies linking them to increased risks of multiple chronic diseases and cancers. Tobacco companies have always tried to ward off claims of increased cancer risk by publishing crooked and manipulated findings while using loop holes to avoid disclosing financial incentives. Alcohol companies have been much smarter about their marketing and have taken a totally different approach by being transparent and not purposely trying to lie to the public. They fessed up super quick about associations between alcohol and nutritional deficiencies, cancers and impaired decision making capabilities. They decided to play a different card, stating that alcohol is a balance of risks and benefits to be weighed by responsible adults. In one hand, there are the risks of pretty harsh diseases, like hepatitis, cirrhosis, stomach ulcers and cancers. On the other hand, there are the purported benefits of social connection, relaxation, cultural belonging and celebration. Should we add cardiovascular protection to these benefits?
Misinterpreting The Data
Years ago, there was a series of published studies showing that people who drank moderately seemed to have lower risks of cardiovascular disease. That's right, people drinking 1-2 servings of alcohol were found to be less likely to have a heart attack or die than people who refrained from drinking alcohol at all. The risks of heart attacks and strokes shot back up after drinking more than 2-3 drinks per day. This led to mass spreading of what people thought was great news: "people who drink alcohol moderately are less likely to have heart disease and other health conditions than those who abstain". The crowd went wild and this information spread like wildfire. So much so that even doctors were encouraging patients to drink more wine, since this type of alcohol was already known to have more antioxidants than the other types. If you still think this to be the truth, you're not alone. Many current day healthcare professionals are still convinced that red wine and alcohol in general, when consumed in moderation, is protective for multiple health conditions. Here's how they got it all wrong.
The Infamous "J" Curve
Smart people couldn't understand how certain people were more "protected" against disease if they consumed alcohol, while others had increased risk of illness when they didn't drink at all. What they noticed next was an important flaw in the data interpretation that had been overlooked by the researchers. When looking at the graph underneath, you'll find a classic "J" curve. It appears on the graph that in comparison to people who don't drink alcohol, those who drink moderate amounts daily have a lower risk of being sick or dying. Someone then asked the million dollar question: "are the non-alcohol consumers less sick, or could it be that sicker people who used to drink don't consume alcohol anymore?". This minor nuance made all the difference since researchers now suspected that ex-drinkers that were now currently sick and couldn't drink anymore were mislabeled as people who had never consumed alcohol at all. Bingo. The ex-drinkers that were sick because of alcohol were mislabeled. This made the people who actually didn't consume alcohol look much unhealthier than they really were, and so those consuming 1-2 drinks per day appeared healthier. When the data was reviewed and the findings were adjusted for past alcohol consumption, the relationship between alcohol and disease was perfectly linear, meaning that alcohol use in any quantity was associated with increased risk of disease when compared to people who don't drink, and never had. This linear relationship between alcohol and health was identical to the one seen with tobacco. They re-analyzed the data and relabeled the ex-drinkers correctly instead of labeling them as non-drinkers. Mic drop. That's why we have scientists and researchers constantly questioning data. It took a bright bunch of people to notice this fatal error and to correct it. You would think that this revelation made front page news, but it was too late and it simply fell on deaf ears. People were too happy drinking their heart healthy red wine to notice that the data interpretation had been corrected.
The Risks
Alcohol use, even in minimal amounts, is associated with an increased risk of many health conditions, including:
hepatitis and other forms of liver disease
nutritional deficiencies
obesity
increased cholesterol and triglycerides
hypertension
cancer of the breast, mouth, throat, esophagus, voice box, liver, colon, and rectum
addiction
mental health issues
erectile and other forms of sexual dysfunction
etc.
The Benefits
Alcohol use is deeply ingrained in our culture and I don't want to scare people or fear monger. Much like red and processed meats, or smoking, the benefits are purely psychological, with no known medical reasons to drink in order to prevent any organic or physical disease.
"But red wine has resveratrol" you might add. That's right, and beer is made from whole grains and vodka from potatoes. Even the naturally occurring antioxidants present in alcoholic beverages don't compensate for the carcinogenic and pathological effects of drinking ethanol (which is the organic chemistry name for alcohol, I'm just trying to look smart). The only reason doctors should recommend ethanol, or alcohol, is to reverse intoxication with methanol, contained in windshield washer fluid, which is commonly consumed accidentally or voluntarily. Ethanol displaces methanol in cases of intoxication and can help prevent metabolic acidosis, a life-threatening condition commonly seen in the ER.
We can't ignore the fact the alcohol consumption does lower inhibition and has an anxiolytic effect. It is short lived and is frequently accompanied by rebound anxiety, so one must be careful if self-medicating. Some people claim it helps them sleep, when in reality, it helps them fall asleep, but then distorts sleep architecture, keeping them from attaining a restful deep sleep. Basically, you'll sleep but wake up more tired than before. I don't want to be a buzzkill, but it's important to recognize that alcohol is probably here to stay and people have to be well informed before they consume it regularly or downplay its risks. Even more so if they drink because of the health claims attached to it. Alcohol is so ubiquitous that it can be very easy to minimize daily drinking as being normal or healthy.
Which type of alcohol is healthiest?
If you’re gonna get hammered no matter what, maybe a harm reduction strategy could help. What makes a certain type of alcohol healthier? The antioxidants it contains would be a good starting point, but one shouldn’t dismiss caloric content or how it’s consumed. If you decide to drink a liter of pepsi or 12 red bulls mixed in with your alcohol, that will definitely annihilate any protective powers it may have had. And if you’re drinking a bottle of wine instead of a bottle of beer, you may mistake this for a healthy practice. If we compare the alcohol itself, calorie for calorie, without the added cola or red bulls, then we do have good science helping us determine the least harmful of them all.
Red Wine Every Night At Supper?
For reasons I ignore, red wine seems to get off with a small slap on the wrist. We associate red wine with wealth and luxury, while hard liquors and cheap beer are viewed differently. Some drink 2-3 glasses of wine everyday guilt-free. Would it change your perspective if instead of wine, it was 2-3 beers, or 2-3 shooters of Jack Daniels? Remember this: alcohol is alcohol and whether you disguise yours as red grape juice or clear potato juice or a carbonated hops and wheat drink, their health implications remain the same. But if you're looking for a harm reduction strategy, and not drinking isn't an option, then red wine does seem to have more antioxidant potential and this may make it less harmful, but not healthier, than other varieties.
I don't want to sound like a hypocrite. I do consume alcohol and scotch and rum are my personal favorites, but not because they're healthier. I drink rarely and would never justify alcohol use on the basis of it conferring any protection against disease. It's important to do whatever floats your boat, but having the correct information might help you make a better decision. So if you're curious as to what is a safe amount of alcohol, the data seems to point towards zero. Even very light drinkers have a measurable increased risk of medical conditions when compared to non-drinkers, contrary to what many might believe or recommend.
I apologize for the anti-climactic ending. I wish that the science would say that alcohol is awesome and that you can pour it in your cereal, but unfortunately that's not the case. If you're thinking "a drink won't kill me", you're probably right. I enjoy a drink here and there too, but I drink alcohol because it's part of our culture and because it helps me celebrate special occasions with friends and family, not because I think it's healthy. Not even red wine. Alcohol isn't going anywhere though, so drink responsibly!
What do you think about our government putting health warnings on liquor like they do on tobacco products? Do you think this is overkill, or that we should stop minimizing the health risks of drinking? I'd love to hear your opinion in the comments! Keep it respectful and constructive, and thanks for reading!
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Plant-Based Dr. Jules 💚🌱
