Many were delighted when doctors announced a few years ago that two glasses of wine a night could help prevent strokes, but some physicians are worried Americans may have taken the advice too seriously.
In an advisory to be published in this week's issue of the American Heart Association magazine, Circulation, the group warns it's too soon to reach for that bottle of red as a stroke-prevention medicine. "Although population surveys and in vitro experiments show that wine may have limited beneficial effects, more compelling data exists for less hazardous approaches to cardiovascular risk reduction," it says.
Translation: Wine may or may not be good for your heart; whereas other things you can do are far more certain to be beneficial.
Trouble is, those other preventive measures — a low-fat diet, exercise and regular cholesterol checks — are "kind of boring," jokes the advisory's lead author, Dr. Ira Goldberg, a professor of medicine at Columbia University in New York. Still, he says they are proven methods of lowering cholesterol and stabilizing blood pressure, and a much better bet than wine for preventing heart disease.
There have been a lot of studies in recent medical literature about the beneficial effects of drinking, but because researchers don't yet know what it is about alcohol — or, possibly, its reaction with another substance in the body — it's too soon to advise people to take up drinking, explains Dr. Mariann Piano, a professor of nursing at the University of Illinois at Chicago and member of the advisory committee. "We just have to be careful the wrong message doesn't get out there," says Piano.
Piano is worried that media enthusiasm for the wine-as-medicine hypothesis may be misleading the public. She says eating well and exercising regularly are by far better lifestyle choices than heading for a bar. "We all love to eat and drink, but drinking will never be a strategy" for preventing heart disease, she says.
There have been more than 60 studies linking moderate, average consumption of alcohol to reduced instances of coronary heart disease, according to the AHA. But Goldberg points out that many of these studies do not consider important factors, such as culture, the diet and exercise habits and socioeconomic status of the wine drinkers. Additionally, while moderate alcohol consumption may prove beneficial — especially for men — excessive drinking is associated with higher mortality rates in men and is associated with breast cancer in women. Without considering the whole picture of why wine seems to work well on some people, Goldberg says, it cannot be recommended.
"It's a very challenging situation," agrees Dr. Jeffrey Alexis, an instructor of medicine at Mount Sinai Medical Center in New York who was not part of the AHA advisory committee.
Alexis says some patients do come in after hearing media reports of wine being beneficial and ask if they should start drinking. But because of the potential for negative effects and abuse, says Alexis, doctors are reluctant to recommend alcohol.
"There's a perception in the public that there's a quick fix to preventing heart problems, and that the fix is drinking wine," concludes Goldberg. "But if you are overweight and don't exercise, wine is not going to help."