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Alcohol and Health: Does It Matter What You Drink?

When it comes to health benefits, red wine seems to get all the praise. But it’s not that simple
Photo by: iStock/ilyabolotov
Merlot vs. margaritas; beer vs. Brunello: How does your favorite beverage measure up?

Lexi Williams
Posted: November 29, 2017

Wine lovers know that moderate alcohol consumption has been linked with numerous benefits, from healthier hearts to sharper minds and even longer lives. And they should be aware of the negative outcomes associated with drinking as well. But not all beverages are created equal. The pros and cons of drinking often depend not just on whether you imbibe, but also on which type of alcohol you choose.

For three decades now, scientists, medical professionals and the media have focused on red wine in particular when discussing alcohol and possible health benefits, thanks largely to its long list of polyphenolic components, such as procyanidins, quercetin and resveratrol, all antioxidants found in grape skins.

But is the prevailing medical wisdom as simple as: Drink red wine in moderation? Do other forms of alcohol offer benefits? Here, Wine Spectator rounds up the latest scientific research to compare the various health effects of different alcoholic beverages. Read on for a breakdown of the benefits—and risks—of each.

Cardiovascular Health

When scientist Serge Renaud introduced Americans to the French Paradox on an episode of 60 Minutes in 1991, he ignited a nationwide interested in the heart-health potential of red wine. In the years since, researchers from around the world have conducted countless studies to better understand red wine's cardiovascular benefits, and to understand why it's thought to be a better choice than other drinks.

At the heart of many recent studies is resveratrol. In 2008, a team of scientists found that the red-wine chemical has the ability to keep heart tissues young and delay aging, even at concentrations found in an average day's worth of wine. Another study from 2003 tested the effects of resveratrol and small amounts of wine on rabbits with high cholesterol and found that drinking red wine—regardless of its alcohol content—could improve blood flow.

Illustrating red wine's heart-helping benefits, a study from 2004 compared red wine with gin to see which type of drink confers more protection against atherosclerosis, a condition in which plaque builds up and inflames the arteries. In this direct comparison, red wine reigned supreme. Results indicated that the wine had more of an anti-inflammatory affect than the gin, thus lowering known risk factors for the condition.

But it appears red wine isn't the only heart-healthy choice. In 2008, a study of more than 4,000 adults in Greece showed that moderate drinkers (which these authors defined as those who consumed 1.5 to 3 drinks per day) had half the chance of developing metabolic syndrome—a collection of disorders that may lead to heart disease and diabetes—as nondrinkers did. Breaking it down further, compared to abstainers, moderate wine drinkers were 58 percent less likely to develop heart disease, and beer and spirits drinkers were 48 percent and 41 percent less likely, respectively.

Though white wine has fewer polyphenols than red, a 2015 study by a team at Ben-Gurion University of the Negev in Israel showed that both red and white wine could provide drinkers cardiometabolic advantages: Red wine showed a significant boost in HDL cholesterol, while white wine drinkers gained better blood sugar controls.

So if other alcoholic beverages also deliver heart-healthy benefits, does it matter what you drink?

"We know from many research studies over the last few decades that light to moderate alcohol consumption … has been associated with a lower risk of coronary heart disease," Dr. Howard Sesso, associate epidemiologist at Brigham and Women's Hospital and associate professor of medicine at Harvard Medical School, told Wine Spectator. "Many studies indicate that the type of alcohol—red wine, white wine, beer or liquor—likely matters less, and that the alcohol itself is what drives these observed benefits."

In 2015, researchers from Harvard Medical School analyzed data collected in the Atherosclerosis Risk in Communities Study, which tracked the alcohol consumption habits and cardiovascular health of 14,629 adults in four U.S. communities. Their findings showed that those who had up to seven drinks per week—regardless of type—were less likely to develop heart failure than nondrinkers. Dr. Scott Solomon, professor at Harvard Medical School and one of the study's authors, explained that alcohol delivers heart-health benefits because it can elevate good cholesterol levels, decrease blood clotting and administer antioxidants.

While it appears that drinking any type of alcohol in moderation may confer some degree of heart-healthy benefits, with wine, especially polyphenol-rich red wine, you're getting more benefits for your buck, so to speak.

Cancer Risks

Alcohol and cancer have a tricky relationship—drinking has been linked to an increased risk of mouth and throat cancers, liver cancer, colon cancer and breast cancer. According to the American Cancer Society (ACS), when the body breaks down alcohol, ethanol is converted into acetaldehyde, a chemical widely believed to be a carcinogen. But though ethanol is present in every alcoholic drink, specific types of drinks have been associated with an increased or decreased risk of certain cancers.

Bad news first: In 2016, researchers from Brown University looked at data from 210,000 people in the U.S. and found a possible association between drinking white wine and an increased risk of developing melanoma, one of the deadliest forms of skin cancers. Though the cause of this association is unclear, it's possible that since wine has higher levels of pre-existing acetaldehyde than other drinks, it could be riskier. But because the study did not account for other potential risk factors, including perhaps the biggest one of all, sun exposure, this isn't enough information to draw any definite conclusions.

While red and white wines have similar acetaldehyde levels, the antioxidants in red wine may help counterbalance skin cancer risk. In fact, resveratrol in particular has been studied for its potential to destroy human skin cancer cells, though there's no evidence that drinking red wine would be able to confer these cancer-fighting benefits.

It's not just skin cancer. In 2008, researchers found that men who drank one to two glasses of red wine per day were at a lower risk for lung cancer than those who drank white wine, beer or spirits. Though it's possible that these results were due to other lifestyle factors (wine drinkers tend to lead generally healthier lives), the study's co-author speculated that resveratrol, or some combination of the polyphenols found in red wine, have a protective effect that can't be found in other alcoholic beverages.

Next to skin cancer, breast cancer is the most common form of cancer in women in the U.S., according to ACS, and even moderate drinkers might be at risk. However, a study published in 2012 found another instance in which red wine's unique components appear to counter the risks associated with all types of alcohol. Researchers from Cedars-Sinai Medical Center and the University of Southern California found more favorable hormone levels in women who drank red wine as opposed to those who drank white, indicating that components in red wine might make it harder for breast cancer cells to grow.

Another study, this one on men with prostate cancer, showed that while moderate consumption of red wine showed a clearer, lower risk for cancer than that of white wine, drinkers of both types of wine ultimately might fare better than those who mainly consumed beer or spirits. Those who drank low to moderate amounts of beer and liquor appeared to have a similar risk for prostate cancer as nondrinkers. Moderate wine drinkers, on the other hand, enjoyed a 44 percent lower risk.

A study on ovarian cancer risks showed similar results. In the 2004 study, researchers found that women who averaged a glass or two of wine per day had about half the chance of developing the cancer as nondrinkers did, and results for beer and spirits drinkers did not appear to differ much from those of nondrinkers.

In short, while ACS recommendations allow up to one drink a day for women and two for men, based on the above research, making sure those drinks are red wine might be the smartest option.

Weight Management and Diabetes

Ever wonder why you know about the dreaded "beer belly," but have never heard mention of a "wine belly?" It's probably because it's easy to see that the type of alcohol you drink—and how you consume it—indeed matters when it comes to your weight. Most calorie-counters know that beer—which contains around 150 calories per serving—isn't the most diet-friendly drink. Wine, which clocks in at 120 to 130 calories per 5-ounce pour, is a slightly better option for your waistline.

Spirits, which are around 100 calories per 1.5 ounces, appear to be the smartest option—unless you're shaking them up with various sugar-packed cocktail ingredients. But with the right plan to suit your needs, any of these types of alcohol can be incorporated into a healthy diet.

When it comes to diabetes, moderate alcohol consumption in general has been shown to decrease the risk, but recent research has found that wine may confer the most benefits. This year, a study found that moderate, frequent wine consumption was associated with a considerably lower risk of developing diabetes, compared to abstention or infrequent consumption. The data on beer- and spirits-drinkers was limited, but results indicated that beer may lower the risk for men but not women, and spirits consumption pointed to no association for diabetes risk in men, but a higher diabetes risk for women.

Though the researchers cautioned that the beverage-specific correlations still aren't totally clear, this isn't the first diabetes-related study to indicate an advantage of wine over beer and spirits. In 2016, researchers from Wuhan University and Huazhong University of Science and Technology conducted a meta-analysis of 13 studies that estimated the risks between specific types of beverages and type 2 diabetes. They discovered a 5 percent risk reduction for subjects who drank liquor, a 9 percent reduction in those who drank beer, and a 20 percent reduction of risk for wine drinkers. We'll need further research to better understand this correlation.

Dementia and Depression

Research on alcohol's relationship with dementia has been going on for decades, but one of the most recent—and comprehensive—studies comes from earlier this year. The meta-analysis looked at data from a total of 20 dementia-related studies and found that light to moderate alcohol consumption confers a lower risk of dementia than total abstinence. Further, seven of the studies analyzed addressed the specific type of alcohol consumed, and researchers concluded wine (consumed in light to moderate quantities) was the only alcoholic beverage that appeared to possess notable protective effects.

Studies on depression showed similar patterns. Consumption of alcohol—regardless of the type—has been considered both a cause and a symptom of clinical depression, especially in larger-than-recommended quantities. However, a 2013 study showed that one serving per day of any type of alcohol was associated with a 28 percent lower risk of depression. With wine, the chances were even lower at 32 percent.

Why? A 2015 study on resveratrol's anti-inflammatory properties might have the answer. Researchers from the University of South Carolina School of Medicine found that the red-wine polyphenol has the potential to reduce brain inflammation caused by stress, alleviating depression-related symptoms. However, this study was conducted on lab rats, not humans, and used concentrations of resveratrol that far exceed the amount found in a day's worth of wine.

Liver Health

Alcohol isn't great for the liver, and heavy alcohol use can lead to cirrhosis, the deterioration and scarring of the liver. But it's possible that wine, and most notably red wine, might not be as harmful as other options. A 2015 study on nearly 56,000 participants found that wine consumption was linked to a lower risk of cirrhosis than consumption of beer or spirits.

Around the same time, another study linked ellagic acid, an antioxidant commonly found in (you guessed it) red wine, with liver health. In that study, even low doses of ellagic acid was able to burn some of the fat in a fatty liver, a function that could save those with fatty liver disease from experiencing steatohepatitis (inflammation of the liver), cirrhosis and even liver failure.

Even the Common Cold!

Wine may even give you a leg up in the fight against a head cold. In a Spanish study from 2002, researchers found that people who consumed 14 glasses of wine a week were half as likely to develop a cold than those who drank beer, spirits or no alcohol at all.

What you choose to drink is just one of dozens of factors that may impact your health, including your environment, immune system, genetics, and your age. And it seems that the amount you consume impacts your health more than the type of drink. In nearly every study mentioned above, the key to unlocking the health benefits from any type of alcohol has proven to be moderation. So if you're toasting to a long, healthy life, go ahead and raise your glass—of wine, or beer, or spirits—but enjoy it responsibly.

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