In a 1991 segment of 60 Minutes, CBS correspondent Morley Safer asked how it could be that the French enjoyed high-fat foods like pâté, butter and triple crème brie yet had lower rates of heart disease than people in the United States.
“The answer to the riddle, the explanation of the paradox, may lie in this inviting glass,” Safer said, raising a glass of red wine to viewers.
Doctors believed that wine had “a flushing effect” that prevented blood clot-forming cells from clinging to artery walls, Safer said. This, according to a French researcher who was featured in the segment, could reduce the risk of a blockage and, therefore, the risk of a heart attack.
At the time, several studies had supported this idea, said Tim Stockwell, an epidemiologist at the Canadian Institute for Substance Use Research. And researchers were finding that the Mediterranean diet, which has traditionally encouraged a glass or two of red wine with meals, was a heart-healthy way of eating, he added.
But it wasn’t until the 60 Minutes segment that the idea of red wine as a virtuous health drink went “viral”, he said. Within a year after the show aired, red wine sales in the United States jumped 40 per cent.
It would take decades for the glow of wine’s health halo to fade.
How our understanding of alcohol and health has evolved
The possibility that a glass or two of red wine could benefit the heart was “a lovely idea” that researchers “embraced”, Stockwell said. It fit in with the larger body of evidence in the 1990s that linked alcohol to good health.
In one 1997 study that tracked 490,000 adults in the United States for nine years, for example, researchers found that those who reported having at least one alcoholic drink per day were 30 to 40 per cent less likely to die from cardiovascular disease than those who didn’t drink. They were also about 20 per cent less likely to die from any cause.
By the year 2000, hundreds of studies had reached similar conclusions, Stockwell said. “I thought the science was in,” he said.
But some researchers had been pointing out problems with these kinds of studies since the 1980s, and questioning if the alcohol was responsible for the benefits they saw.
Perhaps moderate drinkers were healthier than nondrinkers, they said, because they were more likely to be educated, wealthy and physically active, and more likely to have health insurance and eat more vegetables. Or maybe, these researchers added, it was because many of the “nondrinkers” in the studies were actually ex-drinkers who had quit because they had developed health issues.
Kaye Middleton Fillmore, a researcher at the University of California, San Francisco, was among those urging more scrutiny of the research.
“It is incumbent on the scientific community to assess this evidence carefully,” she wrote in an editorial published in 2000.
In 2001, Fillmore persuaded Stockwell and other scientists to help her sift through the previous studies and reanalyse them in ways that could account for some of these biases.
“I’ll work with you on this,” Stockwell remembered telling Fillmore, who died in 2013. But “I was really sceptical of the whole thing,” he said.
As it turned out, the team found a surprising result: in their new analysis, the previously observed benefits of moderate drinking had vanished. Their findings, published in 2006, made headlines for contradicting the prevailing wisdom: “Study Puts a Cork in Belief That a Little Wine Helps the Heart,” The Los Angeles Times reported.
“It upset an awful lot of people,” Stockwell said. “The alcohol industry took huge steps and spent a lot of money to counteract this rather awkward message that was coming out.” Within months, an industry-funded group had organised a symposium to debate the research, and invited Fillmore.
In notes Stockwell saved, Fillmore wrote that the discussion was “hot and heavy, such that I felt like I needed to get my shoe off, banging it on the table”.
And when two conference organisers published a summary of the symposium that said that “the consensus of the conference” was that moderate alcohol consumption was associated with better health, Stockwell said Fillmore “was furious” that her views weren’t represented.
Since then, many more studies, including one Stockwell and his colleagues published in 2023, have confirmed that alcohol is not the health drink it was once believed to be.
In 2022, researchers reported graver news: not only was there no cardiovascular benefit to drinking alcohol, it could even increase the risk of heart issues, said Dr Leslie Cho, a cardiologist at the Cleveland Clinic.
Today, more and more research shows that even one drink per day can increase your chances of developing conditions like high blood pressure and an irregular heart rhythm, both of which can lead to stroke, heart failure or other health consequences, she said.
And alcohol’s links to cancer are clear — something the World Health Organisation has been stating since 1988.
That’s a very different message from the one patients might have heard from their doctors for years, Cho acknowledged. But the consensus has shifted.
No amount of alcohol is safe, the WHO and other health agencies have said, regardless of whether you’re drinking wine, beer or spirits.
So is wine out?
When counselling her cancer patients, Jennifer L. Hay, a behavioural scientist and health psychologist at Memorial Sloan Kettering Cancer Center in New York City, said that many are “absolutely shocked” to learn that alcohol, including wine, is a carcinogen.
In a 2023 study, researchers surveyed nearly 4000 US adults and found that only 20 per cent were aware that wine could cause cancer — compared with 25 per cent who knew that beer could, and 31 per cent who knew that spirits could.
Cho’s cardiology patients are often surprised when she suggests that they should cut back on alcohol, including wine.
“They’re like, ‘What? I thought it was supposed to protect against heart disease,’” she said.
Red wine does contain compounds called polyphenols, some of which can have antioxidant and anti-inflammatory properties.
But no studies, including decades of research on one polyphenol called resveratrol, have definitively linked the amounts that you get from red wine to good health, Cho said. And there’s no good evidence that wine is less harmful than other types of alcohol, she added.
“That can be really hard to hear,” Hay acknowledged.
Whenever she tells people that she studies the risks of alcohol, “a pall falls over the room”, she said.
Hay and other researchers are not suggesting a “prohibition” on alcohol. She just wants people to be informed about the risks.
And for most people, it’s fine to enjoy a glass of wine every now and then, Cho said.
But it doesn’t help your heart, she said. “It’s just time to let go of that belief.”
This article originally appeared in The New York Times.
Written by: Alice Callahan
©2024 THE NEW YORK TIMES
