Alcohol Has Been Linked to Cancer. Why Is Red Wine Still Part of the Mediterranean Diet?

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• The Mediterranean diet is generally considered good for your heart, and people on the diet can have one to two glasses of red wine daily.

• But some experts said red wine should be removed from the diet, as alcohol has been linked with cancers and other illnesses.

• A person’s decision to consume alcohol is an individual one, but experts don’t recommend that you start drinking red wine if you don’t already.

People following the Mediterranean diet are encouraged to eat whole grains, lean meat and fish, fruits, olive oil, and more—but could the diet’s inclusion of red wine be undermining its benefits?

Research has suggested that the Mediterranean diet has cardiovascular benefits and may reduce the risk of certain chronic illnesses. But with mounting evidence suggesting alcohol could be risky for your health, red wine’s place in the diet has become more controversial.

“There are definitely some people who think [red wine] should be removed, as no amount of alcohol is really considered to be safe,” Leah Barron, RD, CPT, a dietitian at The Baseline Lifestyle Company in New York, told Health. “But because the current research does suggest some benefit to red wine in moderation, it is a little complicated and something we need a lot more research on.”

Here’s what experts had to say about why red wine has traditionally been included in the Mediterranean diet and what to know about the risks and benefits of drinking it in moderation.

Why Is Red Wine Included in the Mediterranean Diet?

There’s no hard and fast rule regarding how much red wine a person can drink while adhering to the Mediterranean diet—recommendations tend to vary, Barron said.

“But in most cases, it’s one glass—five ounces—a day for women, and two glasses—10 ounces—for men, consumed with food and in a social setting,” Barron said. “The Mediterranean diet does not specifically recommend other types of alcohol, and recommends limiting alcohol in general.”

The reason why red wine is included in the diet while other types of alcohol are not is due to the drink’s popularity in the region where the diet originated.

“The Mediterranean diet is modeled after traditional foods eaten in [certain] countries that border the Mediterranean Sea, including France, Spain, Greece, and Italy,” Barron explained.

Beyond the geographic connection, red wine has also had a lasting place in the Mediterranean diet because it has been linked with health benefits.

“Red wine contains certain components that make it thought of as a healthier alcohol option,” Abigail Collen, RD, CDN, a dietitian at the Mount Sinai Health System, told Health.

In particular, a compound in red wine called resveratrol may reduce the risk of heart disease and cancer, Barron said.

Still, Most Experts Agree Red Wine Isn’t Healthy

Despite the compounds in red wine having positive effects on the body, the benefits in question aren’t so clear-cut.

“Research has shown that people who drink alcohol, specifically red wine, have a decreased risk of heart disease, including decreased cholesterol levels,” said Barron. “However, it is really important to clarify that this is correlation, not necessarily causation—meaning, people who drink red wine in moderation may also be more active and eat a healthier diet in general, which would also contribute to their decreased risk of heart disease.”

In fact, experts largely agree that drinking red wine frequently could detract from our health.

Alcohol is considered a known human carcinogen and has been linked to many cancers—including breast, liver, esophageal, colorectal, and head and neck cancers. Research has estimated that 3.5% of all U.S. cancer deaths were linked to alcohol consumption.

Beyond just cancer, heavy drinking can also contribute to stroke, high blood pressure, and other cardiovascular issues.

In recent years, health authorities—including the National Institute on Alcohol Abuse and Alcoholism—have stressed that there’s no guaranteed safe amount of alcohol.

Related: Moderate Drinking Provides No Health Benefits, Study Finds

Should You Drink Red Wine on the Mediterranean Diet?

While on the Mediterranean diet, whether you should drink in moderation largely depends on your individual circumstances, experts agreed.

“With nutrition, there are very few things that are really black and white," Collen said, which makes it hard to give blanket recommendations around alcohol or any other components of a diet. However, if you don’t drink, experts don’t advise starting.

“I would never recommend someone add in alcohol,” Collen added.

More research on how alcohol affects the body is forthcoming, experts said. Researchers in Spain are currently conducting a large, multi-year study to learn more about how drinking habits affect health, which could provide more context as to whether red wine should be included in the Mediterranean diet. One researcher working on the study said this type of investigation is overdue.

“For me, it’s a scandal that we don’t have, after so many years, a randomized trial with a proper sample size, in order to assess the best level of evidence for alcohol’s risks and benefits,” Miguel Martinez Gonzalez, PhD, adjunct professor of nutrition at the Harvard T.H. Chan School of Public Health, told Health.

The report will hopefully help public health officials make more detailed recommendations around alcohol use, the same way they do other substances, Martinez Gonzalez said.

“Everyone agrees that a high amount of alcohol is always bad for your health,” he said. “But the ‘benefits’ for a small amount of alcohol—that is very controversial.”

Related: What Happens When You Stop Drinking Alcohol?

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