It appears that moderate
Q. Do the protective effects of alcohol extend to dessert wines and liqueurs, or do those have too much sugar?
A. Everyone knows that excessive drinking of alcoholic beverages is bad for your health. That’s why it was kind of surprising when, about 20 years ago, studies began to show that moderate intake of alcoholic beverages might protect against heart disease. “Moderate intake” is defined as up to two drinks per day for men and one drink per day for women. People with moderate intake seem to have lower rates of heart disease than people who rarely drink alcohol (and lower than people who drink too much).
The evidence for this is quite strong, though not definitive. However, a definitive study is not likely ever to be done. That’s because it would require randomly assigning some people to never drink alcohol and others to drink only a moderate amount, every day, for many years. That would be pretty hard to pull off. And it would take thousands of people, studied over a decade or more, which would be pretty expensive.
How does moderate daily alcohol consumption protect against heart disease? For one thing, it raises HDL (good) cholesterol. Also, some alcoholic drinks contain antioxidant chemicals (phenolic compounds and flavonoids). It makes the body more sensitive to insulin, which reduces the risk of diabetes (and diabetes increases the risk of heart problems). It reduces inflammation, thus protecting against heart attacks. Finally, it discourages blood from clotting. That’s important because most heart attacks and strokes occur when a blood clot in an artery shuts off the blood supply to a part of the heart or brain.
You ask about whether the type of alcoholic beverage matters. Most of the studies have included wine, beer, and hard liquor—but not dessert wines and liquors. Different studies have come to different conclusions, but I think the weight of the current evidence is that moderate consumption of any type of alcoholic beverage protects against heart disease. It’s not just red wine, although the evidence is strongest for red wine.
A word of caution: We’ve been talking about the heart benefits of moderate alcohol consumption, but I’m afraid there also is evidence that moderate alcohol consumption (as well as heavier alcohol consumption) may increase the risk of breast cancer in women. So if you’re a woman who is not currently a moderate drinker, and if you have a low risk of heart disease and an increased risk of breast cancer, I wouldn’t recommend starting to drink alcohol for its possible health benefits. Also, if you’ve ever had trouble controlling the use of alcohol or other addictive substances (including tobacco), I’d also advise against taking up drinking in pursuit of health benefits.
—Anthony L. Komaroff, M.D.
Editor in Chief
Harvard Health Letter