🍷 Sooo… Is Alcohol Good for You or Going to Kill You?

By Chase Merfeld, MS, RDN, LN, CSR

www.ChasingYourHealth.com

A Very Confusing (But Evidence-Based) Breakdown

If your phone recently told you, “Alcohol helps you live longer!”followed immediately by, “Alcohol will also kill you,”you’re not alone. Nutrition headlines love chaos.

I should’ve joined them and titled this blog

“ALCOHOL SAVES LIVES”

Don’t panic — it doesn’t, that is what we call a lie or misinformation if you will. Just keep reading.

Two major things hit at once:

1️⃣ A new National Academies of Sciences, Engineering & Medicine (NASEM) report found that moderate alcohol consumption is linked to lower all-cause mortality and lower cardiovascular disease (CVD) mortality.

2️⃣ Former U.S. Surgeon General Dr. Vivek Murthy called for cancer warning labels on alcohol bottles.

So on Wednesday: wine “might help your heart.”

• in college we used to have wine down Wednesday’s. With this blog I finally get the answer to whether that was healthy or not?

On Thursday: wine “might cause cancer.”

• now on Thursday we would have thirsty Thursdays….. starting to see a pattern here with my college life… but again answers coming…

Perfect. Makes so much sense right!?

So let’s break this down before my wife buys out all the wine at Gist Wine Shop — which, to be clear, I’m not opposed to….

🍺 First: What Does “Moderate Drinking” Actually Mean?

Because for some people, “moderate” means, “Well… I moderately stopped caring after my second glass.”

This is… very much me.

A standard drink is:

• 5 oz wine

• 12 oz beer

• 1.5 oz liquor

Moderate Intake:

• Women: up to 1 drink/day
    Ladies, I apologize. I didn’t write these guidelines, and if I had, you’d absolutely get more than one. Please direct all complaints to science.

• Men: up to 2 drinks/day

This does NOT mean you drink nothing all week and then unleash chaos on Saturday. You can’t bank drinks like PTO hours.

And full honesty here: Mel at Gist and my wife both refer to my wine pours as “The Chase Pour,” because apparently I don’t always follow my own serving-size advice.

A standard 5-ounce pour? Never met her.

But I’m learning. Slowly. One oversized glass at a time.

🧠 The “Good News”: Possible Protective Effects

The NASEM review found:

✔️ Moderate drinkers had lower all-cause mortality

✔️ Moderate drinkers had lower CVD mortality

✔️ Lower heart attack and stroke risk were seen in some studies

Why might this happen?

• Slight increases in HDL (“good cholesterol”)

• Reduced platelet aggregation (less clotting)

• Polyphenols in wine

• Possibly improved insulin sensitivity

• Lifestyle differences (more on that soon)

But these possible benefits appear only in the light-to-moderate range.

More ≠ better.

Nutrition loves to ruin the party like that. Nothing is ever “more must be GREAT”… except vegetables.

Vegetables never betray us.They are the Taylor Swift of nutrition — always delivering the best results.

⚠️ The “Uh-Oh” News: Cancer Risk

Alcohol is a Group 1 carcinogen — meaning strong evidence shows it contributes to cancer development.

Even moderate drinking increases risk of:

• Breast cancer

• Colorectal cancer

• Liver cancer

• Oral & esophageal cancers

And the risk rises dose-dependently. So the more you drink the more at risk you are.

This part of alcohol research has been consistent for decades.

🍷 But What About Wine? (My Wife’s Favorite Question)

Wine gets more positive PR than any alcoholic beverage — but some of it is actually based in science.

Thanks to its polyphenols (resveratrol, anthocyanins, flavonoids), moderate red wine intake has been associated with:

✔️ Higher gut-microbiome diversity

✔️ Improved HDL cholesterol

✔️ Reduced LDL oxidation

✔️ Better endothelial/vascular function

These benefits come from the plant compounds in wine — not the alcohol.

But important reality checks:

• Benefits appear only with light-to-moderate intake

• You can get these same polyphenols from berries, grapes, nuts, tea, dark chocolate, olive oil

• Alcohol’s cancer risk still applies

Wine may offer small perks, but it is not a health strategy.

Think of wine as a garnish — not the main course.

And because many of you know I love supporting local Sioux Falls businesses, I have to shout out Mel Guse, owner of Gist Wine Shop — a natural wine expert and sommelier who could talk circles around me on this topic.

🍷 Does Natural Wine Have More Health Benefits?

Short answer:

Not in a way that changes the fundamental health conversation about alcohol.

Longer answer:

Potential perks:

• Fewer additives

• Slightly lower sulfites (mainly matters if you’re sensitive)

• Sometimes retain more polyphenols due to minimal processing

• Often lower in alcohol (this is the real health difference)

So… is natural wine “healthier”?

Here is my honest (and slightly biased) opinion:

I do feel better drinking natural wines.

But scientifically, natural wines do NOT:

• protect your liver

• reduce cancer risk

• eliminate alcohol’s impact on triglycerides or blood pressure

• bypass hangovers (though mine absolutely seem smaller with natural wine)

• transform alcohol into a “health food”

They do tend to be:

• better tolerated

• sometimes lower ABV

• more complex in flavor

• less processed, which works for some people’s digestion

But alcohol is still alcohol—no matter how fermented, funky, or “natural” the branding sounds.

🦠 Wine and Gut Health

This is where research gets interesting.

Moderate red wine has been shown to:

• Increase gut microbial diversity

• Enhance beneficial bacterial populations

• Improve metabolic markers

Why?

Polyphenols act like prebiotics, feeding good gut bacteria.

But…

• Heavy drinking harms the gut

• Alcohol increases intestinal permeability (“leaky gut”)

• The benefits come from polyphenols — not ethanol

• Whole foods still outperform wine every single time

Wine can complement a gut-healthy lifestyle —

but it will never replace fiber, fermented foods, or plants.

🍷 AND NOW… MY PERSONAL TAKE

Here’s the honest truth: I genuinely enjoy wine.

It brings joy, connection, and community into my life — and those things matter in health just as much as lab numbers.

And yes, science supports that light-to-moderate wine consumption can fit into a healthy lifestyle.

It may even offer small vascular or gut-health perks from its polyphenols.

But even if it didn’t?

Let’s be real:

My wife, Kristi, would NEVER tolerate a life without wine.

If I announced I was giving it up, she would deliver a full motivational keynote in the kitchen — complete with slides, dramatic pauses, audience participation, and maybe even a standing ovation. It would be her Ted Talk…

So yes — wine is staying in my life.

For the polyphenols…

For the joy…

And absolutely for my marriage.

🧬 The Real Twist: Healthy-User Bias

Moderate drinkers often have:

• Higher-quality diets

• More physical activity

• Higher socioeconomic status

• Better healthcare access

• Stronger social networks

• Genetics that help them metabolize alcohol efficiently

These factors also reduce mortality.

So when studies say moderate drinkers “live longer,” we have to ask:

Is it the alcohol… or the lifestyle?

Often, it’s the lifestyle doing most of the work.

Alcohol might play a small role — but it’s rarely the star of the show.

🧬 Alcohol and Your Lipids (HDL, LDL, Triglycerides)

Alcohol impacts different parts of your lipid panel differently.

🟢 HDL — increases

Moderate alcohol raises HDL by:

• increasing APOA-I

• slowing HDL breakdown

• improving reverse cholesterol transport

🟡 LDL — mostly neutral

Moderate alcohol doesn’t typically raise LDL.

Red wine may reduce LDL oxidation.

Heavy drinking can increase LDL and small dense LDL.

🔴 Triglycerides — consistently increase

The biggest metabolic downside.

Alcohol raises TGs by:

• increasing VLDL production

• slowing fat breakdown

• offering easily stored calories

• driving fatty acids into the liver

High TGs = inflammation, fatty liver, and increased CVD risk.

🩸 Alcohol and Blood Pressure

This effect is consistent across decades of research.

❗ Even moderate intake can raise BP

Systolic BP increases ~1–2 mmHg per drink/day.

❗ Heavy drinking greatly increases hypertension risks

Why it happens:

• Sympathetic nervous system activation

• Increased cortisol

• Kidney sodium retention

• Vasoconstriction

• Increased inflammation

The good news:

Cutting back can reduce blood pressure by:

• 3–4 mmHg (moderate drinkers)

• 5–7 mmHg (heavy drinkers)

Equivalent to losing weight or starting exercise.

💡 So… Should You Drink?

Here’s the balanced, RD-approved answer:

If you don’t drink

Don’t start. You’re not missing anything magical

If you do drink

Keep it truly moderate (not Chase-pour moderate).

If you drink for stress

That’s a signal — not a solution. Mental health is so important to our whole health!

If your “moderate pour” is a “Chase Pour” then let’s re-evaluate our portion size I will try my damnest…. moderation is hard when it tastes so good!

🍷 **AND FINALLY… The Answer You’ve All Been Waiting For:

Was Wine Down Wednesday Healthy?**

After digging through the research, polyphenols, cancer warnings, heart benefits, gut health drama, and the emotional rollercoaster that is modern alcohol science… here’s the answer:

✔️ If your Wine Down Wednesday meant 1-2 glass of wine and good company?

Totally fits within light-to-moderate drinking.

Arguably even came with a tiny sprinkle of cardiovascular perk and community connection.

✔️ If your Wine Down Wednesday looked more like bottomless pours, stress relief therapy, and questionable decisions?

That falls firmly outside the “health benefit” window.

(Sorry. Science said it, not me. Although if you’re an RFK Jr fan, you’re probably not consulting science anyway — so carry on.)

✔️ And Thirsty Thursday?

Let’s just say the research is… less supportive of back-to-back alcohol days. In college it was more 3-4 days in a row…

But honestly?

College isn’t known for its commitment to evidence-based nutrition or moderation.

❤️ Chasing Your Health Bottom Line

Alcohol can fit into a healthy lifestyle.

It does not create a healthy lifestyle.

Whole health is built on:

• Nourishing food

• Movement

• Sleep

• Stress regulation

• Emotional health

• Connection

• Genetics

• Consistency

Alcohol is optional — not essential.

Your health is shaped by the habits you build,

not the beverages you sip.

For example: Wine Down Wednesday wasn’t healthy because of the wine, maybe a small part but we didn’t understand that term moderation in college (barely understand it now), —it was healthy because of the moments, the laughter, the friendship, and the break in a chaotic week.

📌 Key Points From the National Academies (NASEM) Report — In Plain English

✅ Possible Benefits (Moderate Drinking)

• Lower all-cause mortality

• Lower cardiovascular mortality

• Lower heart attack and stroke risk

⚠️ Risks

• Increased breast cancer risk

• Higher colorectal cancer risk at upper-end moderate intake

• Alcohol is a confirmed carcinogen

❓ Uncertainties

• Limited evidence for dementia, weight, neurocognition, many cancers

• Observational data can’t prove cause

• Significant confounding: diet, movement, income, genetics

🚫 What the Report Does NOT Do

• It does not recommend alcohol

• It does not say alcohol is “safe”

• It does not offer drinking guidelines other than what I listed before

Bottom line:

Moderate drinking may offer small benefits — but it also carries real risks.

Alcohol is optional. Whole health is not.