What kinds of alcohol are best for health?

Dear Alice,

Do any alcohols have any specific benefits? As in, is tequila better than vodka? And is red wine the best choice because of its antioxidants?

Dear Reader,

After opening a bottle of wine, or any liquor for that matter, many cheers to the phrase “salud,” meaning health. While there’s some evidence to suggest that moderate amounts of alcohol may provide protective effects against certain health conditions, such as high cholesterol and heart disease, alcohol also has negative health effects. These include concerns such as liver disease, high blood pressure, and increased risk for motor vehicle crashes (which all could outweigh the potential benefits). Although research is still a bit muddled, it seems that what a person drinks matters less than how much they drink. In other words, the more alcohol an individual consumes (especially if it's in a short period of time), the more likely they may experience the negative effects. For this reason, most United States guidelines on nutrition recommend drinking in moderation or not at all. Read on for more on what the research says about the benefits of certain types of alcohol and what can be said about alcohol’s impact on health in general.

Getting down to specific types, some folks may have noticed that red wine has received a lot of publicity for its potential to improve heart health. Researchers link these benefits to the antioxidants present in the form of anti-carcinogenic polyphenols, including resveratrol, phenolic acids, and various flavonoids (catechin, quercetin, naringenin, apigenin, kaempferol, myricetin, etc.). It’s no surprise that red wine packs a bigger punch as it contains a much higher concentration of phenolics than white wine. However, the content of all wine differs region to region and even winemaker to winemaker. With that said, a serving of grapes has much higher numbers of these polyphenols than red wine, so it’s not recommended to indulge in a glass of red just for these benefits. Other research indicates some health benefits for beer drinkers, especially those that enjoy a Czech style beer. This type of beer contains high amounts of isoxanthohumol, which is a molecule that has been shown to help prevent some types of cancer by preventing cell proliferation (or division). However, this body of research is still too small to give beer a firm stamp of (health) approval. As far as spirits (such as vodka and tequila) goes, there's less evidence touting any health benefits. In fact, a study showed that spirits may be associated with a higher risk of triggering an acute heart attack among people who drink occasionally (as opposed to daily).

As with many of life's pleasures though, enjoying the benefits of alcohol typically requires a dose of moderation. A sip of celebratory champagne or the occasional happy hour drink won't do much to change a person's overall health. Drink too much over time, and alcohol can have a myriad of negative effects on physical and mental health, such as heart and liver damage and increased risk of cancer, obesity, and depression. To make sense of this, researchers often describe the relationship between alcohol use and disease as a J-shaped curve or a dose-response relationship. What this means is that compared with abstinence from alcohol, low–to–moderate average consumption of alcohol is associated with lower risk for certain health conditions, such as heart disease. The other end of the curve shows that higher levels of average alcohol consumption is associated with greater risk for disease compared to the risk for abstainers. With that said, the harmful parts of alcohol, such as ethanol, may nullify the positive effects of other substances on the body, so it really comes down to finding a balance of how much and how often a person drinks.

In addition to the health effects of alcohol, it can be useful to consider some of the behaviors associated with drinking. If this resonates with you, there are a few questions you could consider. Do you just drink a glass of red wine with a meal or take multiple shots at a party? How frequently do you drink? When you drink, how much do you drink? The answers to these questions may help inform what effects alcohol may end up having on the body.

Big picture, if someone doesn't drink regularly or at all, there’s no need to feel like they're missing out on any potential health benefits. There are plenty of non-alcoholic ways to reduce the risk of heart disease and high cholesterol, such as eating well-balanced meals and keeping physically active (which may have greater scientific evidence to support their outcomes). Even among folks who do drink regularly, there are lots of different factors that affect how each person responds to alcohol and experience health risks or benefits. Overall, former drinkers have a 38 percent increase in mortality risk compared to lifetime abstainers. As such, the American Heart Association and the 2015-2020 Dietary Guidelines for Americans don’t recommend that someone starts drinking to improve health if they don’t already drink alcohol. For more information related to alcohol, check out in the Go Ask Alice! Alcohol & Other Drugs archives.

If you do choose to raise a glass — salud!

Last updated Feb 28, 2020
Originally published Jul 24, 2009

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