Should I start having wine with dinner if I don’t drink?

As I have been talking with friends about my book on the health benefits of wine these past couple of months, several have said something like “that’s interesting but I don’t usually drink. Should I start?”  It’s an important question, and the answer not so simple.

For someone who has a history of problem drinking, it is usually a hard “no.” If you can’t limit your wine consumption to a moderate level then don’t drink. But for the rest of us, the evidence suggests that we would be better off in terms of health and longevity if we do include wine in our diet and lifestyle.  From a public health standpoint, it is a more nuanced view; many experts interpret the most up-to-date studies as allowing for the occasional glass as a permissible transgression, not a health benefit. To understand why, start with the J-shaped curve that defines the French Paradox:

Is the French Paradox still true?

The curve has traditionally set the reference point as the risk (of a particular condition such as heart disease, or of premature death) as that of nondrinkers. A daily glass or two is associated with a lower relative risk, with heavy drinking bringing rapidly escalating odds. What happened was that some researchers felt that the nondrinker reference category was skewed by including former drinkers who had to quit because of alcohol-related health issues (called the “sick quitter” hypothesis.) According to this line of reasoning, nondrinkers are comparatively less healthy than moderate drinkers because of this, not because moderate drinkers are actually better off. The “J” becomes more of a hockey stick shape (red line).

How nondrinkers who start may improve their health

The sick quitter hypothesis doesn’t really answer the question however, because it doesn’t tell us what happens to lifelong nondrinkers who start. Fortunately we do have good information on this, one being a study from Australia which tracked drinking habits of more than 13,000 women for up to eight years.[1] For moderate drinkers, their health status worsened if they either decreased or increased their drinking. Long-term abstainers were similar to recent quitters on several measures of health. So what this tells us is that moderate drinkers shouldn’t quit, and sick quitters aren’t skewing the data. Similar findings were reported in the U.S. from a large survey called the Million Veterans Program.[2]

Prospective trials where nondrinkers are given controlled amounts of wine would be even better, but these are harder to come by. There are a few though, including a study from Greece that documented improvement in cholesterol profiles and total blood antioxidant capacity in a group of nondrinkers given red wine daily for a month.[3] Others have observed a reduction in postprandial levels of oxidized fats (the worst kind) in subjects given wine with meals.

So the decision of whether or not to start having a glass of wine with dinner remains a personal choice. All I can say is that you will probably be healthier if you do.

[1] Powers JR, Young AF. Longitudinal analysis of alcohol consumption and health of middle-aged women in Australia. Addiction 2008 Mar;103(3):424.

[2] Song RJ, Nguyen XT et al and VA Million Veteran Program collaborators. Alcohol consumption and risk of coronary artery disease (from the Million Veteran Program). Am J Cardiol 2018 May 15;121(10):1162-1168.

[3] Apostolidou C, Adamopoulos K, Lymperaki E, Iliadis S, Papapreponis P, Kourtidou-Papadeli C. Cardiovascular risk and benefits from antioxidant dietary intervention with red wine in asymptomatic hypercholesterolemics. Clin Nutr ESPEN. 2015 Dec;10(6):e224-e233.

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