June 14, 2002 -- The summer heat makes you long for a cold one, but does the flurry of press about wine's heart-healthy benefits leave you reaching for the corkscrew instead of a bottle opener or blender? Turns out that a bottle of beer, glass of wine, or even a margarita all have about the same amount of alcohol. And despite wine's popular image, experts say that means they're all probably equally good for your health when consumed in moderation.
"If you drink alcohol, beer, or wine in moderation, it probably does have a reasonably healthy effect," says Gerald Fuller, PhD, a biochemist at the University of Alabama, Birmingham.
Fuller says it's the ethanol, a pure form of alcohol found in all types of alcoholic beverages, that makes the various libations good for you, but only in moderation. That means an average of no more than one drink a day for women or two drinks a day for men. More than that, and the benefits evaporate quicker than the frothy head of a freshly poured beer.
Studies have shown that ethanol can have a variety of positive effects on heart health such as raising HDL (the "good" cholesterol) levels, preventing dangerous blood clots, and allowing the blood to flow more smoothly throughout the body, which reduces the risk of heart attack and stroke.
Alcohol may also boost your health in several other ways as well. Studies have suggested that moderate alcohol consumption can increase insulin sensitivity, which can reduce the risk of diabetes, ward off some types of cancer, and prevent bone loss.
"We do know that ethanol itself has an effect, but there are lots of products in beer and wine such as hops and grape skins that may also have benefits," Fuller tells WebMD. But he says researchers still haven't exactly defined what those effects -- both positive and negative -- may be.
Experts say the health benefits of wine, especially red wine, may have gotten the most attention in recent years because of the popularity of the so-called "French paradox." The paradox refers to a study published several years ago that suggested that the French population's passion for wine may be responsible for keeping their heart disease rates low despite their love of rich, fatty foods.
Since then, researchers have been trying to tease out what exactly in the wine seems to protect against heart disease and stroke. Studies have suggested that it may lie in the antioxidant-rich skins of the grapes used to make wine, but others have shown that antioxidants have little effect on heart health.
Researchers say wine has also been more widely studied than other beverages due to its popularity, especially in Europe, and many of the benefits ascribed to wine may also come with other alcoholic beverages.
Making a Case for Beer
"Beer drinking has equal if not perhaps more health benefits than other types of drinking," says Norman Kaplan, MD, of the University of Texas Southwestern Medical Center in Dallas. Kaplan spoke at briefing last week in New York City about the latest health research on alcohol, which was sponsored by the National Beer Wholesalers Association.
Kaplan says prior studies that claimed wine has special health benefits may have been biased by other lifestyle differences of wine drinkers vs. beer drinkers. But studies in predominantly beer-drinking populations, such as in Germany and the Czech Republic, have found similar reductions in heart disease rates linked to moderate beer consumption.
In addition, Kaplan says beer has additional components, such as vitamin B-6 and folate, that are not found in other types of alcoholic beverages. Those nutrients may play a role in keeping homocysteine levels in check. Abnormal homocysteine levels in the blood have been linked to an increase in heart disease risk.
Too much of a good thing is definitely a bad thing when it comes to alcohol. Alcohol abuse and alcoholism are the biggest causes of chronic liver disease and cirrhosis, which is one of the top 10 causes of death in the U.S.
Heavy drinkers are also at increased risk for certain types of cancer, and drinking is also associated with an increased risk of accidental death and mental health problems such as depression.
There are also certain people who should not drink -- even in moderation -- because they are more likely to develop alcohol-related complications. These groups include pregnant women, people who take medications that may interact with alcohol (such as antihistamines or tranquilizers) or use illegal drugs, and people who have medical conditions such as ulcers or liver conditions that might worsen with alcohol use.
But all in all, most researchers agree that the benefits of moderate alcohol consumption in fighting heart disease outweigh the risks for the majority of people.
"Anything that in moderation can reduce the risk of the No. 1 killer in the U.S. is a good thing," says Eric Rimm, PhD, associate professor of nutrition and epidemiology at the Harvard School of Public Health, who also spoke at the briefing. "Sixty to 80% of the population could do good things for their health by becoming a moderate drinker."