Beyond the French paradox: the impact of moderate beverage alcohol and wine consumption in the prevention of cardiovascular disease.

Alcohol beverages, particularly red wine, when consumed in moderation reduce the risk of acute CVD and death. Important questions and issues, however, still remain, including the role of beverage type, pattern of drinking, and the risk that moderate drinking can lead to problem drinking. The mechanism for alcohol beverage benefit is complex, and includes an independent benefit of ethyl alcohol. The multiplicity of effects identified for the non-alcohol components of red wine, play a role in improved endothelial physiology and enhance vascular homeostasis. CAD begins in early life, and it progresses over decades. As the complexity of vascular pathology changes with time, so may the healthful effects of alcohol and non-alcohol wine components also vary. Prospective studies of alcohol or wine consumption in the young, middle, and older aged persons would be interesting, but they are laden with obvious sociologic complexities. Meanwhile, it is prudent for physicians to discuss the harmful effects of alcohol with their patients, while at the same time, not discourage a potentially healthy practice of wine in moderation (e.g., with meals). The current literature is consistent in that heavy drinkers would be better off to reduce drinking or abstain, and abstainers or light drinkers, should be advised to avoid heavy drinking [13]. Whether moderate alcohol consumption can be characterized as a pharmacologic intervention or a dietary intercession may be a matter of opinion. I would rather like to believe that the growing scientific interest in wine and better health is a part of adopting a healthy lifestyle that connects our society with nature, to sustain and enhance human life.