The French seem to have it all—culture, fashion sense, great food, even healthy hearts. The last of these enviable qualities poses what has come to be known as the French Paradox: how can the French maintain relatively good cardiovascular health while eating so much fat? The answer, in recent years, has pointed to their relatively high consumption of red wine.

Epidemiologic studies suggest that moderate consumption of red wine reduces the risk of cardiovascular disease. Other studies have made the connection between compounds in grape skins (which are retained in red wine) that prevent oxidation (an important step in the development of atherosclerosis) and improve vascular function.

But many questions have remained unanswered. For example, do other types of alcohol also confer cardiovascular benefits? Does it matter how often you drink, how much you drink, or whether you drink with meals?

Scientists addressed these questions in an article published in the January 9, 2003 New England Journal of Medicine . They found that men who consumed alcohol at least three or four days per week enjoyed a greater decrease in heart disease risk than men who drank only once or twice per week, or who didn’t drink at all. They also found that the amount of alcohol consumed was not all that important, and—putting the French Paradox into question—that beer, liquor, and white wine seemed just as effective in reducing heart disease risk as red wine.

About the Study

Scientists analyzed data from 38,077 men enrolled in the Health Professionals Follow-up Study. The participants, aged 40 to 75 when the study began in 1986, filled out questionnaires regarding diet and medical history at the beginning of the study. They answered questions about their consumption of beer, red wine, white wine, and liquor every four years. The researchers tracked fatal and nonfatal heart attacks in this group from 1986 through 1998.

Men were excluded from this study if they had a history of certain medical conditions including heart attack , angina , stroke , and transient ischemic attack , or if they stopped drinking in the last ten years.

The Findings

Compared with men who consumed alcohol less than once per week, men who consumed alcohol three to four times per week were 32% less likely to have a heart attack, and men who drank five to seven days per week were 37% less likely to have a heart attack. The risk reduction was similar for fatal and nonfatal heart attacks.

The amount of alcohol consumed per day, on average, had very little impact on heart attack risk, with an average daily consumption of 5.0 grams of alcohol (about ½ bottle of beer, ½ glass of wine, or 1/3 of a shot of liquor) having about the same impact on heart disease risk as an average daily intake of 30 grams of alcohol (about three bottles of beer, three glasses of wine, or two shots of liquor).

The choice of beverage—beer, red wine, white wine, or liquor—made almost no difference. Nor did it seem to matter whether the alcohol was consumed with a meal or on its own.

How Does This Affect You?

This study suggests that the frequency of alcohol consumption is a more important factor in reducing heart disease risk in men than the amount or type of alcohol consumed. It also makes the case for light to moderate drinking, with very little additional benefit found in drinking more than one drink every other day.

Whether the findings also apply to women in unclear. While it is true that other studies have suggested a favorable effect of moderate drinking in women, it is also true that women process alcohol differently than men.

If you already drink responsibly, these findings suggest that your risk of heart disease will be lowered if you drink the alcoholic beverage of your choice three to four days per week. However, if you do not drink at all, this study provides no justification for you to start. First, the study is unable to determine why regular consumption of alcohol lowers cardiovascular risk. It may not be the alcohol at all, but some other characteristic of moderate drinkers that the researchers did not anticipate. Second, and more importantly, even minimal drinking, in some people, can lead to a pattern of excessive or binge drinking, which may have catastrophic results. Heavy drinkers have an increased risk of coronary heart disease along with higher rates of depression , certain cancers, liver disease, and motor vehicle accidents.