For centuries, the healthier populations in the Mediterranean region have enjoyed wine in light to moderate amounts, usually with meals.  Observational studies there and elsewhere have associated judicious alcohol consumption with prolonged lifespan, reduced heart attacks, diminished Alzheimer’s and other dementias, and possibly fewer strokes. 

How does alcohol work?  It tends to increase “good cholesterol” (HDL), has an anti-platelet effect that reduces blood clotting, and may reduce C-reactive protein, a marker of arterial inflammation.  These effects would tend to reduce cardiovascular disease.  Wine provides antioxidant phytochemicals (polyphenols, procyanidins) which may protect against atherosclerosis and some cancers.

What’s the “dose” of alcohol for maximal health benefit?  A light to moderate amount.  An old medical school joke is that a “heavy drinker” is anyone who drinks more than the doctor.  Light to moderate alcohol consumption is one or fewer drinks per day for a woman, two or fewer drinks per day for a man.  One drink is 5 ounces of wine, 12 ounces of beer, or 1.5 ounces of 80 proof distilled spirits (e.g., vodka, whiskey, gin).

The best health-promoting type of alcohol is unclear.  I tend to favor wine, a time-honored component of the healthy  Mediterranean diet.  Red wine in particular is a rich source of resveratrol, which is thought to be a major contributor to the heart-healthy benefits associated with alcohol consumption. Grape juice may be just as good—it’s too soon to tell.

I have no intention of overselling the benefits of alcohol.  If you are considering habitual alcohol as a food, be aware that the health benefits are still somewhat debatable.  Consumption of three or more alcoholic drinks per day is clearly associated with a higher risk of breast cancer in women.  Even one or two drinks daily may slightly increase the risk.  If you are a woman and breast cancer runs in your family, strongly consider abstinence.  Be cautious if there are alcoholics in your family; you may have inherited the predisposition.  If you take any medications or have chronic medical conditions, check with your personal physician first.

For those drinking above light to moderate levels, alcohol is clearly perilous.  Higher dosages can cause high blood pressure, liver disease, heart failure, certain cancers, and other medical problems.  Not to mention psychosocial problems, legal problems, and death. Heavy drinkers have higher rates of violent and accidental death. Alcoholism is often fatal. You should not drink alcohol if you:
            ■  have a history of alcohol abuse
                or alcoholism
            ■  have liver or pancreas disease
            ■  are pregnant or trying to become
                pregnant
            ■  may have the need to operate
                dangerous equipment or machinery,
                such as an automobile, while under
                the influence of alcohol
            ■  have a demonstrated inability to
                limit yourself to acceptable
                intake levels
            ■  have personal prohibitions due
                to religious, ethical, or other
                reasons.

Be that as it may, a study published this year in the American Journal of Medicine showed a 38% lower risk of heart attack, stroke, and death from cardiovascular disease in middle-aged Americans who started a judicious alcohol habit.