Wendy Wolfson
RedwoodAge.com

Are people healthier because they drink wine in moderation, or do they drink in moderation because they live healthier lifestyles?

Multiple studies have indicated that moderate drinkers - a glass of wine a day for women and 2 for men - seem to have less heart disease, dementia and diabetes, and people who abstain from alcohol have a somewhat higher risk. Heavy drinkers, however, have a host of other problems.

But a  recent New York Times article cited Kaye Fillmore, a retired sociologist from UCSF who, after analyzing 54 studies, now questions the direct link between alcohol intake and disease prevention.

According to Fillmore, the protective effect may be due to the other behaviors of the groups studied, as association is not necessarily causation. It is frequently difficult to parse out the effects of behaviors and environmental influences in observational studies.

Moderate drinkers may be healthy because they are moderate in other lifestyle habits, such as exercise, sleep, and watching their weight.

Abstainers, on the other hand, might have quit drinking because of age or other serious health problems such as alcoholism and liver disease.

A 2005 study conducted by the CDC research team of Tim Naimi showed that out of 30 different demographic factors, such as obesity, education, access to healthcare in a heart study, moderate drinkers and abstainers differed by 27 of them. To compare results accurately, one must compare the same populations.

Moreover, in an April 2008 review article in Current Atherosclerosis Reports, doctors Luc Dejousse and J. Michael Gaziano at Brigham and Womens Hospital say that while heavy drinkers are more likely to experience eventual heart failure, studies seem to indicate that light or moderate drinking may be beneficial, or at least do no harm.

No Binging
The key, they say, is to look at drinking patterns. Binge drinking causes problems, but regular moderate drinking doesn't seem harmful. But Dejousse and Gaziano don't see evidence that whether you drink beer, whisky or wine matters - it is the ethanol. Your genes may also influence how well your body can handle alcohol.

The benefits may be marginally clearer for diabetics. Researcher Iris Shai at Ben Gurion University , together with researchers from the Harvard School of Public Health, conducted a study of 109 diabetics to determine if moderate alcohol drinking alcohol improved blood sugar levels.

All that the researchers were able to tell is that diabetics who drank moderately had a significantly lower fasting plasma blood glucose levels, but no difference in their blood glucose levels after meals. She cautioned that people who drank a glass of wine with dinner should subtract the equivalent carbohydrates from their meal. In a recent conversation, she said that her team is embarking another larger, long term study. 

Bottom line, nobody has ever done a randomized study to connect alcohol use with heart disease. So, if you want to start drinking for your health, don't bother.

However, if you consider a glass of chilled chardonnay a civilized ending for the day, go for it, the CDC researchers say, as long as you're not driving and it doesn't interfere with other meds you may be taking.