The Sunday Telegraph - Sunday
I’m a health nut and a wine lover – so how can I enjoy a tipple safely?
For Boudicca Fox-Leonard, sharing a bottle with her partner Harry is as much a part of her life as exercise, despite the health implications. She asks the experts for their advice on lower-risk drinking
The ability to tell a healthy habit from a toxic one is a professional bonus for a lifestyle writer. I speak to the top experts in their field. Often, afterwards, I’ll adjust my own habits.
I prioritise sleep, for instance, having been told that this is a good idea. I cook from scratch. I take the stairs. I even ceased being a vegetarian and started eating tinned, oily fish because one expert terrified me about my future brain health.
My Achilles’ heel, in a life lived striving for harmony with health diktats, is that I drink alcohol. Enjoying a delicious bottle of English sparkling wine is as much a hobby for my partner and me as is climbing up rock faces at the weekend. Not, I hasten to add, in that order.
My cognitive dissonance is clear. Alcohol, the evidence tells us, is a net negative for health. There is no safe drinking level. If you drink less than 14 units a week, this is considered low-risk. Mouth, throat and breast cancer are all related to drinking. As are stroke, heart and liver disease.
The risks are related to the impact alcohol has on our cells as it’s ingested, and then when it reaches the liver, washes all around it and has to be absorbed. The health risks for women are particularly acute. Alcohol can change the way a woman’s body metabolises oestrogen. This can cause blood oestrogen levels to rise. Drinking even small amounts of alcohol is linked with an increased risk of breast cancer, especially post-menopause.
In full knowledge of this, I returned from a recent climbing trip to eastern France with seven bottles of burgundy and six bottles of crémant de bourgogne, after Vivino-ing our way around the area.
I am recalcitrant on this topic, as I suspect many of you who also love wine are. I’m yet to find a de-alcoholised wine that I can find palatable; an experience that pushes optimism off a cliff every time. Non-alcoholic spirits I find more tolerable. Three Spirit, Seedlip, and their numerous contemporaries, all serve a purpose; that mid-week evening or designated-driver dinner, but the full non-alcoholic wagon isn’t my ride.
The question therefore is: how, as both a health nut and a wine lover, can I have my glass of fizz and drink it as well?
THE (FEW) POSITIVES
Let’s get the good news out of the way first. Sociological and longevity studies do show that a little bit of alcohol is associated with living longer. The drink cited in particular is red wine, which is enjoyed by citizens of two “blue zones” (where it is claimed people live longer than average): Ikaria in Greece and Sardinia in Italy.
Could it be down to it containing resveratrol, a life-extending polyphenol? Perhaps, but let’s not fool ourselves into thinking that we wouldn’t be better off having a punnet of berries instead.
It is the element of conviviality that is thought to be so powerful. Loneliness has, after all, been called a carcinogen.
“It seems a small glass of red wine each day around 5pm is the sweet spot for health benefits,” says Dr Federica Amati, a clinical scientist and nutritionist.
Dr Amati recently helped Prof Tim Spector, who enjoys a glass of red with dinner and has advocated drinking red wine for gut health, with research for his new book, Food For Life. She has a more cautious approach than he does: “I do love a delicious glass of red wine, but I also know if I drink it quite late at night it disrupts my sleep. I prefer to have a glass of red wine with lunch. It’s about finding what works for you.”
HOW MUCH IS TOO MUCH?
How many units do you drink a week? The guidance in the UK is 14, equivalent to six pints of average-strength beer or 10 small glasses of lower-strength wine.
“My understanding of the evidence is that one to two small drinks a day is deemed the safest amount,” says Dr Amati. While research suggests men can tolerate two to three drinks, Dr Amati says: “It would be beneficial for everyone’s health if the recommendation was to drink a maximum of two drinks on three different occasions a week.”
Women are more vulnerable than men to alcohol’s effects. “If you’re worried about breast cancer, one of the first things you can do to reduce your risk is stop drinking.”
Both men and women should drink less with age. While the liver is a remarkable organ, able to increase its size by 40 per cent day and night, it will weary under constant bombardment.
“A 20-year-old liver has been through a lot less stress than a 50-year-old liver,” says Dr Amati. “A 20-year-old liver is going to be quicker and more efficient, it’s going to have fewer fatty liver deposits and less stiffening of the tissues, because it’s had to mop up fewer toxins.”
While it means you might be able to drink more and process it faster, that’s not a reason to indulge.
BALANCE YOUR ABV LEVELS
Prioritising wines with a lower ABV has been a must for Susy Atkins, the Telegraph’s wine columnist, for a long time; opting for lighter wines, alongside booze-free evenings.
“I don’t drink a lot of red. Mainly it’s white and sparkling and I do check the alcohol levels to try and keep the units down,” says Atkins.
“I look very hard at labels. People don’t realise the massive difference within table wines; they can range from as little as 5.5 per cent up to about 15 per cent.”
The ones that are really low at the 5.5 end tend to be tipples like Italian asti. Then you hit the rieslings. “Riesling is a brilliant grape for naturally low alcohol levels,” says Atkins.
While Australian and Alsace ones tend to be up near 12 or 13 per cent, Atkins says, “The Mosel region of Germany makes very elegant rieslings that are often 7 and 10 per cent.”
She credits a combination of cooler climate and the riesling grape being able to deliver ripeness and good acidity and balance at those alcohol levels.
Dry sparklers from cool climates are also a good option.
“English sparkling wine and some prosecco and cava are often 11 per cent,” says Atkins. “And even champagne, as long as you go for Brut and not one of the sweeter styles, you’re getting a dry sparkling that should be 12 per cent or under,” she says. “A couple of small glasses of this is not giving you a lot of alcohol and certainly not a lot of sugar.”
If you’re buying a sweet wine with lower alcohol, bear in mind the calories are stacking up in the residual sweetness. “A sweet, lower alcohol riesling is still delivering a lot of calories.”
But if you can find a dry, light wine, says Atkins, “coming in at say 9 or 10 per cent, or off-dry, then it’s relatively low in alcohol and calories”.
‘If you’re drinking for the sake of drinking, that’s a red flag’
CHOOSE QUALITY OVER QUANTITY
There are evenings when one glass of sparkling before dinner would be just the ticket. What to do with the rest? It makes opting to drink less, but better quality, a bit of a conundrum.
Fortunately we also now have the technology to make a good wine last. Coravin has a range of gadgets that pour still and sparkling wine, without having to remove the cork. So you can keep it for weeks, months, even years without it tasting any different.
Their products have revolutionised not only the restaurant wines, allowing them to offer fine wines by the glass, but can also help lengthen the life of your favourite bottles at home.
They aren’t cheap, ranging from £80 to £300, but if you enjoy good wine, it makes sense.
WHAT’S THE HEALTHIEST DRINK?
Red wine, due to its polyphenol content, sits at the top of acceptable alcoholic drinks. It is followed by rosé. Then comes white and champagne.
It gets trickier in terms of negative impact when we go into dark liquors, says Dr Amati. “They contain a chemical called congener, which has a proinflammatory effect, plus the alcohol.”
Vodka, gin and tequilas are basically pure alcohol. “Be mindful and [only] have one or two.”
An unfiltered beer and cider can be high in polyphenols. “They can also be higher in sugar. Again, it’s about being mindful. Have two small glasses.”
The message, ultimately, is that if you’re going to have a drink, have what you like, but know it’s going to have consequences in your body, and try to mitigate them.
WHERE AND WHEN YOU DRINK MATTERS
Drinking shouldn’t be something you’re doing by yourself, but part of socialising. “If you’re drinking for the sake of drinking, that’s a red flag,” says Dr Amati.
The term “alcoholic” might conjure images of a person falling over in the afternoon after drinking a bottle of whisky. But, says Dr Amati, “There are many functioning alcoholics in the UK. A lot of them go to work and have high-powered jobs – but they can’t go a day without drinking.”
Embracing a Mediterranean way of drinking means having a glass of wine with your meal. Or a glass of champagne at a party. “The context of your drinking is important,” says Dr Amati.
There are a few habits that we can adopt to help make drinking part of a healthy diet and lifestyle.
“Some of this isn’t brand new information,” says Dr Amati. “Drinking with a meal. Making sure you remember to have water alongside your alcohol as well.”
Others are a bit more novel. Research she did with Prof Spector for Food for Life looked at the impact of having a probiotic, such as kefir or sauerkraut, before drinking and how it can help mitigate the effect of alcohol.
“It helps lower the absorption rate of the alcohol. A lot of the immediate negative effects come from having a high blood alcohol concentration.”
If you swear by milk thistle, then you might want to try a new generation product that has strong science supporting its promise to support liver function.
Dr Amati has been a scientific advisor for De-liver-ance (loveyourliver.com), which has introduced a liver elixir that helps mitigate the effect of alcohol.
It can immediately reduce alcohol toxins by 42 per cent and is currently the subject of trials at UCL.
“The theory is that the polyphenol content is one thousand times more than a punnet of blueberries, and we think that is helping the liver mitochondria to reduce oxidative stress. They are then able to function and reduce inflammation.”
However, this is not a magic bullet. “At the end of the day, alcohol is neurotoxic and a carcinogen,” says Dr Amati.
TAKING A BREAK
I have always been a lightweight when it comes to the ability to put away the booze. This may be just as well. While tolerance is multifactorial, Dr Amati says that it’s worth remembering that the more we drink, the more our body produces the enzyme that helps us break alcohol down: alcohol dehydrogenase. “Our bodies react by turning on that gene. We need to create dehydrogenase, because there’s more to break down.”
Your alcohol tolerance is not a green light to refill your glass, but rather a signal that you’ve got your foot on the liverdamage accelerator.
Fatty liver disease can be reversed, providing you stop drinking before the condition has a chance to progress too far. “If you quit drinking, recovery can start as soon as a few days to weeks later, but if the damage is extensive, it may take several months,” says Dr Amati. “Your liver should return to normal after two weeks to a month of not consuming alcohol. However, if the liver has sustained long-term damage, it may not always be possible to reverse it.”
If you want to know the state of your liver’s health, De-liver-ance has launched the Liver Clinic, which uses FibroScan technology as well as taking blood samples to assess your liver health and other health markers.
A big part of drinking sensibly is to know yourself and how you feel. “If you had a drink for two days in a row and day three you’re not feeling your best, don’t have a drink that day,” states Dr Amati.
“If you like a drink, and feel like having one, then do so in an informed way, so you can support your body in the best possible way.”