Is Red Wine Good for You? What the Evidence Really Says

Few questions divide opinion quite like this one! For years we have been told that a glass of red wine a day was good for the heart. More recently, the headlines have swung the other way, with warnings that there is no safe level of drinking at all. It is no wonder so many of my clients feel confused, or quietly hope the first story was the right one…

In my last blog I looked at what alcohol does to sleep, appetite and energy. This time I want to take a look at the evidence about red wine and health in a little more depth. My aim is not to tell you whether or not to drink. It is to help you understand where the "red wine is healthy" idea came from, why it has changed, and what the research actually supports.

Where Did the Idea Come From?
The story really took off in the early 1990s with the so-called "French paradox". Rates of heart disease in France appeared lower than you might expect given a diet relatively high in saturated fat, and red wine was put forward as one possible explanation.

At around the same time, a large number of observational studies began to show what became known as the "J-shaped curve". When researchers plotted alcohol intake against risk of death or heart disease, light to moderate drinkers often appeared to do slightly better than people who did not drink at all, with risk rising again at higher intakes. This curve was widely reported and shaped public messaging for many years.

The Problem With Observational Studies
Observational studies are incredibly useful, but they can only show an association. They cannot prove that one thing causes another, and in the case of alcohol there were some important problems with the comparison group.

The first is what researchers call the "sick quitter" effect. In many older studies, the non-drinking group included people who had stopped drinking because they were already unwell, or because of a previous problem with alcohol. Comparing moderate drinkers with this group made the drinkers look healthier than they really were.

The second is confounding. In many countries, people who drink moderately, and wine drinkers in particular, tend to have higher incomes, more education, healthier diets and more active lives. All of these protect the heart in their own right, and it is very difficult to fully separate them from the effect of the wine itself.

What Happens When We Correct for These Problems?
A 2023 systematic review and meta-analysis published in JAMA Network Open pulled together 107 cohort studies involving more than 4.8 million people. Crucially, the researchers looked at how well each study dealt with these biases, including whether former drinkers were separated from lifelong non-drinkers. Once study quality was taken into account, low-volume drinking was not associated with a lower risk of death from any cause compared with never drinking. Risk rose at higher intakes, and for women it began to rise at lower levels than for men.

Research also shows that in some East Asian populations, common gene variants make alcohol very unpleasant to drink, so people carrying them naturally drink less. Because these genes are allocated at random at conception, they act a little like a natural trial. A 2019 study in The Lancet, using data from around 160,000 adults in the China Kadoorie Biobank, used exactly this approach. It found no protective effect of moderate drinking on stroke. Instead, stroke risk rose steadily as alcohol intake went up.

This shift is reflected in UK guidance. When the UK Chief Medical Officers reviewed the evidence in 2016, they concluded that any protective effect on the heart was smaller than previously thought and applied to a much narrower group of people. The guidance does not recommend that anyone starts drinking for their health.

But Isn't It the Polyphenols That Matter?
This is a fair question, and it is where some of the confusion comes from. Red wine does contain polyphenols, plant compounds that research shows can have health benefits. The best known is resveratrol, which has shown interesting effects in laboratory and animal studies.

The issue is quantity. A 2007 review of red wines found an average of just 1.9mg of resveratrol per litre, with many wines containing very little at all. Human studies of resveratrol supplements have commonly used doses of 150mg a day or more. To match that from wine, you would need to drink dozens of litres a day, which is clearly not a sensible proposition. And of course, the alcohol (ethanol) comes with every glass, regardless of the polyphenol content.

The good news is that you do not need wine to get polyphenols. Red grapes, berries, cherries, dark chocolate, cocoa, tea, coffee, extra virgin olive oil, herbs and spices all provide them, along with fibre and other nutrients. A colourful, plant-rich diet is a far more reliable way to get them, and it fits beautifully with the Mediterranean-style eating that has strong evidence for heart health. I shared some ideas for this in Top Tips for Everyday Anti Inflammatory Swaps.

So, Should You Drink Red Wine for Your Health?
The honest answer is no, and I would not suggest that anyone who does not drink should start for the sake of their heart. If you want to protect your heart, the strongest evidence points to not smoking, regular movement, good sleep, managing blood pressure and cholesterol, and a diet rich in vegetables, fruit, pulses, wholegrains, nuts, seeds and oily fish. I covered this in more detail in Why Inflammation Matters for Heart Health.

That does not mean you have to give it up. Many people enjoy a glass of wine with a meal or with friends, and enjoyment, connection and celebration are a real part of life. The key is to see it for what it is: something you choose because you enjoy it, rather than something you drink because you think it is good for you. If you do drink, the UK guidance is to keep to no more than 14 units a week on a regular basis, spread over three or more days, with several drink-free days. A standard 175ml glass of 12% wine is 2.1 units, according to the NHS.

Need Some Support?
If you are worried about your heart health, your drinking or your risk of a particular condition, please speak to your GP first. They can check your blood pressure, cholesterol and other markers, and talk through your personal risk. If you would like to talk to someone about your drinking, Drinkline is free on 0300 123 1110.

If you would like personalised support with heart health, energy or building a way of eating that genuinely supports you, why not book in a free call?