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In his article, Dr. Jonathan Reiner, a CNN medical analyst and professor of medicine and university at George Washington University, recalls the story of his physician-patient with end-stage heart disease who had asked him if it was okay to drink some wine. The patient was nearing the end of his life.
After a while, Reiner answered his question with, “Only good wine.”
Wine has been used for medicinal purposes for centuries. The ancient Greek physician Hippocrates promoted wine for different reasons, including reducing fevers and dressing wounds. Maimonides, a 12th-century scholar, rabbi, and physician, also spoke about the health benefits of wine in moderation. It was also common to prescribe medicinal alcohol during Prohibition in the early 20th century. Alcohol had been legally dispensed at pharmacies for different conditions such as cancer and depression.
Because of this, it was believed that moderate doses of alcohol were associated with a reduced risk of death. But the general belief on alcohol’s effects has started to change.
In his article, Reiner explains, “Humans metabolize alcohol mostly in the liver, where it is converted into acetaldehyde, a known carcinogen. Last July, a study published in Lancet Oncology estimated 4% of the world’s newly diagnosed cases of cancer in 2020, totaling almost 750,000 people, were related to alcohol use. The authors of the study found the cancer risk was highest for people who drank a lot, but even more moderate drinkers still had an increased risk of developing cancer.”
The Lancet published another study of alcohol use in 195 countries in 2018 and found that the risk of all-cause mortality, specifically dying from cancer, is linked with an increase in alcohol consumption. The way to minimize the risk was not to drink at all, the study found.
The World Heart Federation recently issued a policy stating that no amount of alcohol consumption is safe for the heart.
The ironically-named Dr. Beatriz Champagne, who chaired the advocacy committee which produced the report, said, “In brief, our position is that studies showing a significant cardioprotective effect of alcohol consumption have by-and-large been observational, inconsistent, funded by the alcohol industry, and/or not subject to randomized control. Furthermore, any potential cardioprotective effect is negated by the well-documented risks and harms, rendering our judgment that no amount of consumption can be considered good for heart health.”
Reiner also adds, “In addition to its carcinogenic properties, alcohol is also a cardiotoxin, and chronic heavy consumption can weaken the ability of the heart to contract, ultimately leading to potentially fatal congestive heart failure. Even brief episodes of binge-drinking can precipitate atrial fibrillation, a condition in which the heart rate increases and beats out of rhythm.”
At a time when many Americans have increased alcohol consumption during the pandemic, how should one contextualize the World Heart Federation’s new policy?
Reiner recommends, “Start by having an honest conversation with your doctor about how much you drink and how it can potentially affect your health. If you drink alcohol, do so because you enjoy it, not because you believe it’s good for you. The most recent data suggests it is not. And if you do enjoy alcoholic beverages, drink in moderation because there is abundant data showing the more you drink, the greater the risks to your health.”
Reiner brings the story back to his patient. Several months after the patient’s death, his wife delivered a package to his house. In the box was a case of “only good wine” — honoring the patient’s final instructions.
Reiner still has a few bottles left and recalls his patient fondly with each sip.
