Why it is important to drink wine moderately and with meals

This review article presents a summary of evidence-based scientific data relating the moderate consumption of wine and other alcoholic beverages to health.  It explains how the type of beverage, regular versus binge drinking, consumption with meals, etc. affects its risks and benefits.

While alcohol abuse is a significant contributor to the global burden of disease and the third most important risk factor globally, there is increasing evidence that light-to-moderate consumption of alcoholic beverages, especially wine, is associated with a lower risk of cardiovascular diseases, and all-cause mortality. Moderate wine consumption is also related to a lower risk of diabetes mellitus, cardio-metabolic complications in diabetic patients, and declining cognitive function.

Unfortunately, many epidemiological studies examining the effects of alcohol are incomplete or lack information on drinking patterns and the type of alcoholic beverage, regular moderate versus binge drinking and drinking with or without meals.  The conclusions of such studies may thus be unclear and limited. The associations of wine consumption with human health are complex and can lead to misconceptions in the general public.

In an attempt to include practical recommendations concerning wine consumption and to minimize the risks of alcohol-related harm, government delegates and/or experts of the Commission IV Safety and Health of the International Organisation of Vine and Wine (OIV) reviewed epidemiological studies examining the effects of alcoholic beverages on human health.

By simultaneously assessing seven measures of drinking patterns (moderate intake of alcoholic beverages, alcohol intake spread out over the week, low spirit consumption, wine preference, red wine consumption, wine consumed during meals and avoidance of binge drinking), the authors observed a lower mortality rate among wine drinkers compared to non-wine drinkers. In addition, some epidemiological evidence suggests that the cardio-protective effects of wine are more evident in individuals who consume wine with food.

The authors discuss various physiological mechanisms of alcohol and phenolic compounds which possibly can explain the advantage of drinking moderate amounts of wine with meals:

• it mitigates oxidative stress and vascular endothelial damage induced by high-fat meals. It may reduce the susceptibility of human plasma and LDL to lipid peroxidation and it protects diabetic patients from meal-induced oxidative stress and thrombosis activation.

• it elevates the plasma uric acid in the period after eating foods. As uric acid is a most powerful antioxidant, it may reduce the oxidative stress, which may contribute to the wine’s protective effects.

• food in the stomach lowers the peak blood alcohol concentration and also boosts the rate of ethanol metabolism and elimination.

• food may also act as a mechanical ‘wash-out’ of alcohol from the oral mucosa, thereby decreasing the risk of ethanol-associated carcinogenesis in the oral cavity and upper gastrointestinal tract.

• wine shows potent anti-microbial activity including human foodborne, medical and oral pathogens. Thus, in addition to improving the microbial food safety, wine consumed with a meal, may also be protective against food poisoning.

The optimal amount of wine for gaining maximal benefits and for minimizing alcohol-related health risks cannot be precisely prescribed, because of large inter-individual differences. Instead, it is more appropriate to talk about the range of wine intake that reflects the term “moderate”. Based on the results of numerous epidemiological and interventional studies, the authors suggested that a daily intake of 200 to 300 mL of an average wine for men (approximately 20 to 30 g ethanol), and 100 to 200 mL for women (approximately 10 to 20 g ethanol), corresponds with the targeted range of light to moderate wine consumption associated with a lower risk of cardiovascular diseases and all-cause mortality. They also stress that drinking patterns are of outmost importance and that risky and harmful drinking patterns including the regular consumption of high amounts of wine, as well as consuming large amounts on a single occasion (binge drinking), should be discouraged. On the other hand, they recommend that individuals drink wine as an accompaniment to food, and alternate it with a non-alcoholic beverage such as water.

Boban M et al,  Drinking pattern of wine and effects on human health: why should we drink moderately and with meals? Food Funct. 2016;7(7):2937-42

Potential conflict of interest: The editor of this newsletter is co-author of this publication.

Link to ISFAR critique here.