If you enjoy wine — whether a good Burgundy, a crisp Chablis, or anything in between — you've probably heard the reassuring narrative: moderate drinking, especially red wine, is good for your heart. It's one of those beliefs that has worked its way so deeply into popular culture that it barely gets questioned. Wine lists at restaurants still sometimes carry a small note about resveratrol. Doctors used to (and sometimes still do) mention the "Mediterranean diet" with its daily glass of wine as a model of healthy living.
The honest answer to the question is: drink if you enjoy it, drink in moderation, but do not drink because you think it's good for your health. The current evidence does not support that conclusion.
Where the Idea Came From
The health-benefits hypothesis has a long history, but it gained momentum from a specific epidemiological observation: populations in Southern France and other Mediterranean countries showed lower rates of cardiovascular disease despite diets high in saturated fat — the so-called "French paradox." One proposed explanation was their regular consumption of red wine. Red wine contains polyphenols, particularly resveratrol, which showed antioxidant and anti-inflammatory properties in laboratory studies. The story had the ideal combination of intuitive appeal, biochemical plausibility, and cultural romance.
Epidemiological surveys reinforced it. Study after study seemed to show a J-shaped or U-shaped curve: abstainers had higher mortality than light-to-moderate drinkers, who had lower mortality than heavy drinkers. If you plotted health outcomes against alcohol consumption, the curve dipped below the zero line before rising steeply. The interpretation was that a little alcohol was actually better than none.
The Problem with the J-Curve
That J-curve has not held up to scrutiny. The problem is confounding — the same biases that make nutrition research notoriously difficult apply here in force.
The most serious issue is the "sick quitter" bias: many people who appear in surveys as "abstainers" are former drinkers who stopped because of illness. When you compare moderate drinkers to this group, you're partly comparing healthy, active people to people who are already sick. Of course the moderate drinkers look healthier — they are, for reasons that have nothing to do with alcohol.
Beyond that, moderate wine drinkers in Western countries tend to differ from non-drinkers in many ways that matter for health: higher socioeconomic status, better access to healthcare, more exercise, better diet, less smoking. These lifestyle confounders are extremely difficult to fully adjust for in observational studies, no matter how sophisticated the statistical models.
What Rigorous Methods Find
The gold standard for causal inference is the randomized controlled trial — give one group wine and another group a placebo, and measure what happens. Long-term RCTs for alcohol consumption are essentially impossible: no one can be randomized to drink or not drink for decades. So researchers have turned to Mendelian randomization (MR) — a technique that uses genetic variants associated with alcohol metabolism as a natural experiment, sidestepping many sources of confounding.
MR studies have repeatedly found that the apparent protective effects of moderate alcohol on cardiovascular disease and type 2 diabetes disappear or reverse when confounding is properly addressed. The U-shaped curve seen in observational studies appears to be largely an artifact of methodology, not a true biological effect.
A large 2023 systematic review and meta-analysis published in JAMA Network Open — covering 107 studies and more than 4.8 million participants — found no significantly reduced risk of all-cause mortality among occasional or low-volume drinkers compared to lifetime non-drinkers once study quality factors were properly controlled (PMID 37000449). A 2024 analysis in Polish Archives of Internal Medicine directly examined whether wine's specific properties could "save the good name" of moderate alcohol consumption and concluded the evidence remains insufficient to recommend any level of drinking for health benefits (PMID 38506256).
The Cancer Risk That Rarely Gets Mentioned
Even setting aside the cardiovascular debate, there is a risk that tends to get buried: alcohol is a Group 1 carcinogen, classified by the International Agency for Research on Cancer alongside tobacco and asbestos. That does not mean one glass equals one tumor — it means the evidence of carcinogenicity in humans is definitive, not merely suggested.
Alcohol is causally linked to cancers of the mouth, throat, esophagus, liver, colon, rectum, and breast. Crucially, the risk starts with the first drink and scales with consumption. There is no threshold below which cancer risk disappears. A 2024 report from the American Association for Cancer Research estimated that more than 5% of all U.S. cancers are attributable to alcohol use. The WHO's European office stated plainly in 2023 that "when it comes to alcohol consumption, there is no safe amount that does not affect health."
This doesn't feature prominently in the popular coverage of wine and health, because "moderate drinking is fine" is a more comfortable message than "even small amounts slightly raise your cancer risk." But it is what the evidence says.
Red vs. White: Does It Matter?
Red wine has higher concentrations of resveratrol and other polyphenols than white wine, which is why red wine specifically has been the focus of most health claims. In laboratory studies, resveratrol does have real biological activity. The problem is that the concentrations required to produce meaningful effects in cell culture are far higher than any normal wine drinking delivers to human tissue. Bioavailability is poor — most resveratrol is rapidly metabolized before it reaches target organs. The human studies have not been able to demonstrate that wine's polyphenol content provides benefits beyond what alcohol alone (or non-alcoholic red wine) would provide.
The Honest Bottom Line
If you like wine, drink it. That's a perfectly reasonable thing to do — it's one of humanity's oldest pleasures, and enjoyment has its own legitimate weight. A glass with dinner is part of a rich, pleasurable life for many people. Moderation (up to one drink per day for women, up to two for men, by most guidelines) keeps the risks at a level that most adults may reasonably accept.
What you should not do is drink wine because you think it is protecting your health. The evidence that it does so does not hold up under rigorous examination. The J-curve, compelling as it looked for decades, was largely a statistical mirage created by confounding. The polyphenol hypothesis, while biologically interesting, has not translated into demonstrated human benefit. And the cancer risk is real and proportional to consumption, with no lower threshold.
Red or white? Whichever you enjoy most. Just don't order it as medicine.