How Much Is Too Much Win(e)ing? A Docs Viewpoint

The History of Man (and Woman) is inextricably tied to that of alcohol. The exact date Bacchus delivered is gift is unknown and likely tied temporally to the experience of the first hangover. Nonetheless, Neolithic beer jugs date back to around 10,000 BC which provides evidence for the use of alcohol in its many forms from pre-history into the present. Intentional wine making was clearly established by the Egyptians as far back as around 4,000 BC and it is probably even further back than that date. Since that time wine (and alcohol) has served important nutritional, antiseptic, analgesic and medicinal roles. The uses have run the gamut from personal to social and gustatory to religious.

Throughout this long love affair between us and vino, the benefits of wine consumption have been touted. Today, the discussion is no different and continues to engender debate. Moderate alcohol consumption has been studied and seems to convey some potential health benefits. There is clear cardiovascular benefit (less heart attacks, peripheral vascular disease and hypertension), perhaps some benefit in terms of a reduction in stroke and a decrease in the incidence of Alzheimer’s dementia. There also seems to be some potential benefit against developing gallstones, arthritis, osteoporosis, Parkinson’s disease, certain forms of cancer and type 2- diabetes.

In population based studies, those who consume moderate amounts of alcohol live longer and are healthier than either teetotalers or boozehounds. It appears either extreme is detrimental and the people at either extreme are not really the kind you want to hang around while you’re having a cocktail anyway. But what exactly is “moderate drinking”? In most studies, a “glass” of wine is about 5 ounces. You cannot use the glass that holds 750ml and claim just 1 glass of wine a day. Neither can you “save” your daily drinks and binge on Friday and Saturday. Slow and steady wins the race here. The definitions vary from study to study, but the range of the healthy benefits (and lack of consequences due to overindulgence) seem to be associated with about 1-3 drinks per day. Since there is a mass (as well as a genetic) component to alcohol metabolism, men were able to consume slightly more wine and retain the benefits of consumption without the complications of excess.

According to William Blake, Excess may lead you to the Palace of Wisdom but if she’s pouring your drinks she can lead you right to the transplant list. Excess alcohol consumption can cause irreparable heart and liver damage, affect your ability to clot and contribute to other blood disorders, cause pancreatic damage, gastrointestinal damage and types of encephalopathy. While wine consumption can reduce the incidence of depression and have a beneficial effect on erectile dysfunction, coyote ugly remains another significant hazard.

Despite these and other dangers, alcohol in the form of wine has been with us since it seems Homo erectus stumbled up upon two legs (no doubt to pee in the corner of the cave thinking he was outside). Since the whole experiment with the 18th amendment didn’t work out so well, and we really need the tax revenue nowadays, it seems it will be with us for the foreseeable future. Like any gustatory pleasure; foie or fries, salt or salted pork, enjoyment with wine is in not wine-ing too much.

Michael S. Fenster, MD, F.A.C.C., FSCA&I, PEMBA
Whats Cooking With Doc Blog

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