The detrimental association between alcohol and cancer has been well established: the American Institute for Cancer Research explicitly states that when it comes to cancer, no amount of alcohol is safe.
Yet the notion persists that alcohol is heart healthy, linking the flavonoids and antioxidants such as resveratrol in red wine to fewer heart attacks, even though the links aren't completely understood.
Why would alcohol be considered safe to drink at all for heart health, when the evidence against it for cancer is black and white? The power and money of the alcohol industry and its aggressive marketing campaigns, the omnipresence of alcohol in stores and at sporting events -- they all serve to divert attention from the harms of alcohol on heart health.
But last month the World Heart Federation spoke out boldly about the damage it can cause, citing the increased risk of alcohol for coronary disease, heart failure, high blood pressure and stroke, among other conditions.
Still, confusion remains about the benefits of alcohol, so let’s separate the facts from fiction. Upon considerable investigation of alcohol into the etiology of cardiovascular disease (CVD), there’s increasing scientific skepticism regarding the “J-shaped” relationship that implies moderate alcohol consumption is cardio-protective compared to abstinence or heavy drinking.
In fact, the majority of studies that declare cardio-protection have some design flaws. For instance, additional dimensions of alcohol consumption need to be considered, particularly changes over time in drinking patterns, the timing of drinking, beverage-specific consumption, and the interactions of alcohol with diet. Without this more nuanced examination, it’s not clear what the appropriate public health message needs to be.
Evidence indicates that alcohol drinking patterns change over time; in some cases heavy drinkers may alter their consumption in later life to become light drinkers or even abstainers. But longitudinal epidemiologic studies of alcohol and cardiovascular health have typically relied on one or two measures of alcohol, tacitly assuming that consumption is relatively stable over time.
Little is known about how changes in alcohol consumption over a lifetime influence intermediate CVD risk factors or other intermediate biomarkers in aging adults. There may be “windows of susceptibility” to alcohol during adulthood -- periods when drinking has more impact on health, potentially due to a metabolic milieu characteristic of a particular stage in life.
Public health professionals must redouble their efforts to close the significant research gap on long-term drinking patterns in relation to cardio-metabolic indicators.
But one thing's for certain: USDA dietary guidelines no longer name alcohol as part of a healthy dietary pattern, and the World Health Organization has called for a ten percent relative reduction in the per-capita use of alcohol by 2030.
The tide is turning against alcohol. So as we celebrate Valentine’s Day, the healthier route is to set aside that bottle of wine -- and choose flowers and an edible fruit bouquet instead!
Niyati Parekh, PhD, MS, RD
Professor of Public Health Nutrition;
Associate Vice Provost of Faculty Initiatives in the Office of the Provost