Feeling a Little Better About Red Wine
What the Science Actually Says About the Health & Longevity Effects
I have a long history with red wine. In addition to enjoying a glass most nights, I’ve made my own wine on and off throughout most of my adult life. I have about 50 grape vines growing in my backyard. I’ve even spent well over a decade cross-breeding different cultivars in an attempt to generate a unique variety. In many ways, wine was my gateway into science, sparking my initial interests in genetics and chemistry. I tell you this for full disclosure; I am biased and hoping to find a reason to justify continuing with one of my favorite hobbies.
I’ve always fancied moderate wine consumption to be responsible. Healthy, even. Red wine is full of compounds known to be beneficial for cardiovascular and neurological health: polyphenols, carotenoids, and yes, resveratrol (even if you’d need to drink a thousand bottles to get a meaningful dose). So it has been a bit of a shock to see the health tides turn on alcohol over the past few years. First came the studies linking alcohol to an increased risk of several deadly cancers. More recently, impacts on brain health have captured the spotlight.
One paper, in particular, gave me pause.
Alcohol Intake Decreases Brain Gray and White Matter Volume
A 2022 study from Remi Daviet and colleagues analyzed brain imaging data from 36,678 healthy individuals and looked for associations with alcohol intake. The results were striking.
As expected, both gray and white matter volumes decreased with age. What was more surprising was the accelerated shrinkage associated with alcohol consumption. Alcohol dose-dependently increased the loss of both gray and white matter across many brain areas. The authors built regression models to estimate the amount of “extra aging” at age 50 associated with different levels of alcohol consumption. Consuming just two units of alcohol per day (about one glass of wine) was associated with two additional years of brain aging at age 50. Increasing that to 4 units resulted in a massive 10.2 year increase in additional aging.
The results were consistent across males and females, remained after adjusting for a large number of covariates, and hold even when abstainers and heavy drinkers were excluded. Yikes.
It’s been a long couple of wine-drinking years since I read this paper. Yes, it made me think twice about my consumption and I’ve dialed it back a bit, skipping that second glass on the weekend. Still, I wondered whether the picture is really as simple as it is portrayed here. Does a glass of red wine have the same effect as a dram of whisky? How about a beer? Surely there must be differences, right?
Red Wine and Organ Aging
Fortunately, Ludger Goeminne and colleagues must have been thinking the same thing, because they dug into potential differences in another recent paper. This study is a tour de force in aging research—one of the first successful attempts to model the aging of individual organs using protein markers in the blood. Here, too, the models were built using a large cohort (n=42,412 individuals) from the UK Biobank. The authors’ machine learning models successfully developed organ-specific aging scores for seven organs and the whole individual, all based on blood levels of proteins released from distinct organs.
That premise alone is striking: that aging might not be consistent across an entire body but, rather, occurs at different rates in different organs, reflecting different genetics and environmental stressors. The idea certainly aligns with what we already know—some people will develop liver disease as they age, while others might develop diabetes or heart failure while their liver is fully intact. Aging and disease are rarely consistent across every organ.
Most relevant here was their investigation into the impact of dietary trends and different forms of alcohol on organ aging. Perhaps not surprisingly, spirits were associated with accelerated aging across the brain (most impact), immune system, intestine, kidney, liver, and lung. Beer and cider had minimal effects. And red wine showed a mild positive association—yes, positive—with slower aging across several organs, including the brain.
While the positive associations between red wine and slower organ aging were modest in effect size, they were highly significant in arteries, brain, the immune system, liver, and lung. Red wine was also associated with decelerated aging in the whole individual (labeled as “conventional” in the table).
The authors also modeled the effect per gram of daily alcohol on the aging of each individual organ (as a function of the associated mortality hazard). Here, alcohol (all forms combined) was associated with accelerated aging in the intestine, kidney, and brain. The strongest association was observed in the intestine, likely driven by the heightened concentration of alcohol that gut tissues are exposed to.
Far more surprising was the direction of change in arteries, where alcohol was associated with decelerated aging. The authors speculate that this effect could be driven by vasodilation (relaxation of arteries) or even clearance of buildup or debris (more on mechanisms in a moment). In any case, this finding aligns with earlier (often controversial) studies linking low to moderate wine consumption with reduced mortality from cardiovascular and cerebrovascular disease.
Wine and the Likelihood of Healthy Aging
I know what you’re thinking. And, yes, correlation is not causation. It’s entirely possible that people who drink red wine gravitate towards other behaviors that promote health, and the associations in the organ aging study were driven by confounding factors. Or, alternatively, the positive associations could have been driven by an artifact of the specific biomarker model, or something unique to the UK biobank population.
Luckily, another recent investigation asked similar questions in an entirely different cohort, using data from the Nurses’ Health Study and Health Professionals Follow-Up Study. This time, the analyses were adjusted for a wide range of covariates, helping to reduce the influence of off-target confounders.
In this study, the authors looked directly at the relationship between dietary patterns and health outcomes in more than 100,000 individuals over 30 years of follow-up. The main take-aways weren’t particularly surprising—higher intakes of fruits, vegetables, and whole grains were predictive of healthy aging, while trans fats, sugary drinks, and processed meats were associated with the development of chronic disease and declines in both mental and physical health. But the alcohol findings were more nuanced.
Consumption of spirits was associated with negative health outcomes across the board, with a moderate effect size. The same was true of beer, although to a much lesser extent. But wine? Here, too, the authors found positive associations with a range of health outcomes, including healthy aging, cognitive and physical function, mental health, freedom from chronic disease, and survival. Since the model was adjusted for numerous covariates, we can have greater confidence that wine consumption is actually driving the effect.
So, what might be going on?
Here’s my take. Generally speaking, alcohol appears to have negative impacts on several organs, most notably the intestine and brain. When we consume alcohol, the gut is exposed to the highest concentrations, leading to toxic effects. In the brain, alcohol interrupts normal neuronal communication patterns, leading to the anxiolytic and depressant effects that many people enjoy, but also likely working against the neurotrophic pathways that encourage neuronal health and growth. Alcohol also has negative effects on sleep quality, which could be another key driver of its brain-related effects. This is easily mitigated by moderating consumption and avoiding it for at least a couple of hours before bedtime.
Each of these negative effects is dose-dependent, meaning that moderate or low consumption will be less damaging than higher levels. Since alcohol levels in target tissues seem to drive the negative effects, consuming alcohol with a meal is probably healthier than drinking on an empty stomach; food dilutes levels in the gut while slowing release into other tissues.
Despite these problems, there are also some real positives. As has been suspected for years, alcohol does seem to have a beneficial effect on arterial health. This is likely driven by the increased production of nitric oxide, which leads to vasodilation. Alcohol also appears to trigger a transient rise in the liver‑derived hormone FGF21, a fasting and stress signal that improves metabolic resilience and even extends lifespan in animal models, though it is still unclear how this might play out in humans.
Moving beyond the alcohol itself, the type of beverage appears to matter. Red wine is associated with better health outcomes than other forms. Why might this be the case? The most obvious explanation is the polyphenol content. Red wine is loaded with phenolic compounds like resveratrol, flavanols (e.g., quercetin), and catechins. These molecules possess a range of well-documented health-promoting properties, several of which are likely relevant at levels consumed with regular wine intake:
Proanthocyanidins, the most abundant polyphenols in red wine, inhibit intestinal amylases and glucosidases. This slows glucose absorption after a meal, preventing spikes and promoting healthy nutrient partitioning. This effect is clinically relevant at doses as low as 100 mg of proanthocyanidins —roughly the amount in a glass of most tannic red varieties.
These same proanthocyanidins also have beneficial effects on arteries, further enhancing nitric oxide production and arterial relaxation. Clinical studies have shown notable reductions in pulse wave velocity, a key biomarker of arterial stiffness.
Polyphenols, including those in red wine, dampen inflammation through several parallel mechanisms. By reducing levels of key cytokines such as TNF-α, IL-1β, and IL-6, red wine polyphenols promote lower baseline inflammatory signaling, which has tremendously good consequences for longevity. The decreased TNF-α, in particular, is intriguing, since nearly every life-extending intervention in mice decreases signaling through this pathway.
Yes, you could probably achieve many of the same benefits by taking a grapeseed extract supplement. But where’s the fun in that?
As more data emerges, I’m feeling a little better about my red wine habit. I’ve definitely moderated my consumption, sticking to a single glass most of the time. I also heed my own advice and drink with a meal, at least a couple of hours before bed.
I’ve also come to accept that not everything we do needs to be the optimal choice for longevity. Sometimes good enough is good enough. At the very least, high-quality, well-powered studies show that moderate red wine consumption doesn’t appear to have any striking negative impacts on health. At best, it might have positive impacts on inflammation and arterial health. In either case, I’ll be enjoying it.
About the author
Jon Brudvig, PhD, is a translational scientist and drug developer who studies longevity interventions like his life depends on it. When he finds time between his roles in pharma and academia, he writes to make health and longevity science accessible for a broad audience.