The French paradox was introduced in the 1980s by epidemiologists. It basically told us that the French were eating all the fat and drinking all the wine they wanted and still had better heart health than North Americans.
Epidemiological data can hint at associations but can’t actually tell you that one event (drinking wine) definitely causes another (better heart health). To date, there have been no high quality studies to support the claim that alcohol consumption may be cardioprotective. Thus, there is no clear definition as to what amount of alcohol, if any, offers the greatest benefit (and least risk) for different individuals.
In a population study of 2 million healthy adults in the UK*, researchers followed subjects for 6 years and found that about 6% of them developed cardiovascular disease. They compared the cardiovascular outcomes of moderate alcohol drinkers to non-drinkers and found increased rates of cardiovascular disease (i.e. heart attack, stroke) in non-drinkers. In contrast, a number of meta-analyses** – analyses which pools the results of other studies – did not find any benefit to alcohol consumption.
Binge drinking and heavy alcohol consumption have been associated with worse cardiovascular outcomes in people with or without cardiovascular disease.
With conflicting data, a possible approach would probably be:
For individuals who don’t drink: There isn’t enough medical evidence to support a new drinking habit to improve their heart health.
For individuals consuming less than one drink per day (<15g): You could experience heart health benefits. However, alcohol is a known carcinogen. It has been associated with the development of breast cancer in women, cancers of the mouth and throat, and colon cancer. Therefore, this risk needs to be weighed against the potential benefit.
Other things to consider:
- Stay away from alcohol if your doctor has told you that you have a medical condition that could worsen with alcohol consumption (i.e. cirrhosis/hardening of the liver).
- There has been no data to show that alcohol is beneficial for other types of cardiovascular disease such as stroke or high blood pressure.
A version of this post can also be found at tawnyahansenmd.com
*Bell S DM, Rapsomaniki E, George J, Britton A, Bobak M, Casas JP, Dale CE, Denaxas S, Shah AD, Hemingway H Association between clinically recorded alcohol consumption and initial presentation of 12 cardiovascular diseases: population based cohort study using linked health records. BMJ. 2017;356:j909. Epub 2017 Mar 22.
**Stockwell T ZJ, Panwar S, Roemer A, Naimi T, Chikritzhs T Do “Moderate” Drinkers Have Reduced Mortality Risk? A Systematic Review and Meta-Analysis of Alcohol Consumption and All-Cause Mortality. J Stud Alcohol Drugs. 2016 Mar;77(2):185-98. Collaborators GA. Alcohol use and burden for 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2018;392(10152):1015. Epub 2018 Aug 23.Knott CS CN, Stamatakis E, Biddulph JP All cause mortality and the case for age specific alcohol consumption guidelines: pooled analyses of up to 10 population based cohorts. BMJ. 2015;350:h384. Epub 2015 Feb 10.