Is Wine Fine, or Beer Better?

Wine and Beer Almost 200 years ago, an Irish doctor noted that chest pain (angina) was far less common in France than in Ireland. He attributed the difference to “the French habits and mode of living.” (1)

The comparatively low rate of heart disease in France despite a diet that includes plenty of butter and cheese has come to be known as the French paradox. Some experts have suggested that red wine makes the difference, something the wine industry has heavily and heartily endorsed. But there’s far more to the French paradox than red wine.

The diet and lifestyle in parts of France, especially in the south, have much in common with other Mediterranean regions, and these may account for some of the protection against heart disease.

Some studies have suggested that red wine—particularly when drunk with a meal—offers more cardiovascular benefits than beer or spirits. These range from international comparisons showing a lower prevalence of coronary heart disease in “wine-drinking countries” than in beer- or liquor-drinking countries. (2, 3)

Red wine may contain more and more various substances in addition to alcohol that could prevent blood clots, relax blood vessel walls, and prevent the oxidation of low-density lipoprotein (LDL, “bad” cholesterol), a key early step in the formation of cholesterol-filled plaque.

In practice, though, beverage choice appears to have little effect on cardiovascular benefit. A report from the Health Professionals Follow-up Study, for example, examined the drinking habits of more than 38,000 men over a 12-year period. Moderate drinkers were 30 to 35 percent less likely to have had a heart attack than non-drinkers.(4) This reduction was observed among men who drank wine, beer, or spirits, and was similar for those who drank with meals and those who drank outside of meal time. This study suggests that the frequency of drinking may matter: Men who drank every day had a lower risk of heart attack than those who drank once or twice a week.


1.Black S. Clinical and pathological reports. Newry, England: Alex Wilkinson, 1819.

2.Rimm EB, Klatsky A, Grobbee D, Stampfer MJ. Review of moderate alcohol consumption and reduced risk of coronary heart disease: is the effect due to beer, wine, or spirits. BMJ.1996; 312:731–36.

3.St Leger AS, Cochrane AL, Moore F. Factors associated with cardiac mortality in developed countries with particular reference to the consumption of wine. Lancet. 1979; 1:1017–20.

4.Mukamal KJ, Conigrave KM, Mittleman MA, et al. Roles of drinking pattern and type of alcohol consumed in coronary heart disease in men. N Engl J Med. 2003; 348:109–18.

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