Updated 17th February 2022

Which alcohol is the healthiest to drink in moderation?

Alcohol is certainly not the healthiest drink. But research has found that if you consume it in moderation, some alcoholic drinks may have potential health benefits. 

That’s because of substances called antioxidants, which can lower your risk of developing a number of health conditions and might be good for your gut. 

Before celebrating this news, though, it’s important to be clear that drinking too much alcohol is harmful to your health. 

All wines, beers, and spirits contain a type of alcohol called ethanol. Drinking more than the recommended daily amount comes with an increased risk of many illnesses. These include high blood pressure, cancer, and mental health conditions. 

Read on to find out which alcoholic drinks are the better choice to drink in moderation. 

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How different alcohols score for health

The Dietary Guidelines for Americans classify moderate drinking as: 

  • men: two drinks or less in a day

  • women: one drink or less in a day 

A standard drink varies depending on the type of alcohol:

  • 12 ounces of regular beer (about 5% alcohol)

  • 5 ounces of wine (about 12% alcohol)

  • 1.5 ounces of spirits (about 40% alcohol)

But recommendations differ depending on where in the world you live. 

How your body responds to alcohol is also specific to you and depends on your genes.  

At ZOE, we run the largest nutritional research program of its kind in the world, with over 15,000 participants so far. We know that the best nutrition advice is tailored to your body’s unique responses to food and drink.

The ZOE at-home test analyzes your blood sugar and blood fat responses in combination with the bacteria that live in your gut. Based on your results, you get personalized guidance to help you find the best foods and drinks for your body.

Our program uses a score-based system, and we recently introduced our first scores for different types of alcoholic beverages. These are based on input from ZOE’s panel of experts, including co-founder Prof. Tim Spector, an internationally renowned scientist at King’s College London

Nothing is off-limits with the ZOE program. Our scores are split into four color-coded ranges to help you understand how often you should consume certain foods and drinks.

ZOE scores for alcohol:

  • 0–24: enjoy once in a while

  • 25–49: enjoy in moderation

  • 50–74: enjoy regularly

  • 75–100: enjoy freely

Red wine just makes it into the bottom end of our “enjoy regularly” category, whereas no alcoholic drinks make it into our “enjoy freely” category. 

If you do drink alcohol, we recommend you do so in moderation because drinking more than this is clearly bad for your health, as shown in numerous studies.

Our average scores for popular alcoholic drinks are: 

  • red wine: 54

  • white wine: 39

  • beer: 35

  • spirits (neat): 18

These scores are useful guidelines for many people. 

To find the best food and drinks for your unique metabolism, you can take our free quiz

Why is red wine a better choice for your health? 

Red wine is rich in antioxidants called polyphenols. They come from the grape skins and seeds used in the wine-making process and give its bitter, tannic taste.

The amount of polyphenols in red wine increases during the fermentation stage that produces alcohol, and there is more in red wine than in white wine. 

Large population studies show that although alcohol is generally harmful and increases the risks of all diseases, red wine appears to have a mild protective effect against heart disease.

Research also shows that antioxidants like polyphenols can have a protective effect against cell damage, and scientists have shown that people who ingest high levels of polyphenols in food have a lower risk of diseases including cancer and heart disease

In one study, two groups of people switched to a Mediterranean diet rich in whole grains, nuts, healthy oils, vegetables, and fruits. One group also drank a glass of red wine each day. While both groups saw improvements to their cholesterol levels, those who drank the red wine had significantly better results.

Red wine and the gut microbiome

Research also points to a link between red wine and the gut microbiome, the unique collection of bacteria and other microorganisms that make their home in your gut. 

One large study run by Prof. Spector that involved volunteers in the U.S. and Belgium found that participants who drank red wine had a wider and healthier range of gut bacteria than those who didn’t. No other alcohol had any clear benefits.

The bacteria in your gut play a crucial role by transforming polyphenols into other useful chemicals that can then be absorbed by your body. 

Speaking on a recent ZOE Science podcast, Prof. Tim Spector explains that “polyphenols are actually rocket fuel for your microbes.” 

“If you're drinking hundreds of these polyphenols, despite the alcohol,” says Prof. Spector, “you're feeding your gut microbes further down the chain, and they're paying you back by helping your immune system and your heart and your metabolism in general.”

Common polyphenols in red wine

  • Quercetin is from a group of polyphenols called flavonoids. It’s found in small quantities in red wine as well as in other plants such as onions, blueberries, and tea. Potential health benefits of quercetin may include anti-inflammatory properties. 

  • Anthocyanin is another type of flavonoid that gives red wine its rich color and taste. It may help protect against cell stress and UV damage. 

  • Resveratrol is a polyphenol that may also guard against cell damage and could have a role in promoting heart health. As it’s only found in very small amounts, it’s not clear if it has a significant effect. 

  • Different red wines have unique combinations of polyphenols and varying levels of alcohol. This is based on the types of grapes used, soil type, climate, and production methods. 

Artisan ciders

Outside of the U.S., cider usually refers to alcoholic apple drinks with about the same strength as beer.

Many artisan or craft ciders can contain similar polyphenol levels to red wine, suggesting they may share some of the same health benefits. However, more research into ciders is needed to demonstrate this. 

We haven’t included artisan ciders in our ZOE scores yet, but we are working on it at the moment. 

White wine

White wines don't have the same antioxidant properties associated with red wines. 

That’s because grape skins are generally not involved in the fermentation process, meaning white wines contain only around a tenth of the polyphenols found in red wines.

We have given white wine a ZOE score of 39, which means  “enjoy in moderation.” 

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Beer

Beers fall into two categories: ales and lagers. Factors like the yeast used, the temperature the beer is brewed at, and the brewing time all result in differences in alcoholic strength, taste, and polyphenol content. 

Beer gets an average ZOE score of 34, meaning we recommend drinking it in moderation.

Hops, one of the key ingredients in beer, contain phytoestrogens, plant molecules that mimic some of the effects of the female hormone estrogen in your body. 

While drinking too much beer is definitely harmful, one study found that women who drank a single beer each day over a 6-month period had fewer perimenopause symptoms. But you can also get phytoestrogens from foods like tofu and beans without consuming alcohol.

Another study showed that healthy men who drank one beer per day saw improvements in their blood sugar control. 

However, both of these studies were very small. It’s not possible to rely on them to draw clear conclusions, and further research is needed to back up the results.

Spirits

Spirits differ in alcoholic strength, flavor, and style. This means they also vary in terms of how your body responds to them. 

On average, "neat spirits" — those with nothing added — get a ZOE score of 18, putting them in the “once in a while” category.  We recommend you drink them in small quantities and not often.

Spirits have a much higher concentration of alcohol and a lower amount of polyphenols than wines and beers. 

One study looked at the effects of different types of alcohol on heart health in a group of people in Greece. It found that drinking a moderate amount of alcohol of any type was associated with a lower risk of heart disease, but that drinking spirits offered less protection than wine or beer. 

Many people add sugary mixers to spirits. This is likely to increase blood sugar spikes and subsequent dips that are linked to an increased risk of metabolic health problems in the long term. 

Health risks of drinking alcohol

No alcohol will ever be considered a healthy drink. Any benefits it might have are quickly outweighed by the risks of drinking more than the recommended amount. 

Binge drinking is associated with many health problems, including: 

  • unintentional injuries (car accidents, falls, alcohol poisoning)

  • violence (toward others and yourself)

  • cancer 

  • chronic diseases (high blood pressure, stroke, liver disease, heart disease)

  • mental health conditions like depression and anxiety 

  • alcohol misuse/dependency

Summary

Drinking too much alcohol has been strongly linked to a higher risk of many serious health conditions. However, if you are going to drink, having red wine in moderation is a healthier choice than other alcoholic drinks. 

This is due to its high levels of antioxidants called polyphenols, which have been linked to better heart and gut health. 

White wine, beer, and even spirits may also have some benefits, but their lower polyphenol content means these benefits are less than in red wine. 

Artisan ciders may have similar levels of polyphenols to red wines, but more research is needed into their potential health benefits.

On average, men should aim to have less than two standard alcoholic drinks each day and women less than one. Drinking more than this is not good for your health.

ZOE scientists are involved in the biggest nutritional study of its kind, which can help you to understand your unique responses to different types of foods and drinks. 

Take a free quiz to find out more. 

Sources

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Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet. (2018). https://www.thelancet.com/article/S0140-6736(18)31310-2/fulltext

Antioxidant activity and phenolic profiles of ciders from the Basque Country. Food Bioscience. (2021). https://www.sciencedirect.com/science/article/pii/S2212429221000122 

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Association of drinking pattern and alcohol beverage type with the prevalence of metabolic syndrome, diabetes, coronary heart disease, stroke, and peripheral arterial disease in a mediterranean cohort. Angiology. (2007). https://journals.sagepub.com/doi/10.1177/0003319707306146?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed

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Biosynthesis of anthocyanins and their regulation in colored grapes. Molecules. (2010). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6259108/

Dietary guidelines for alcohol. (2020). https://www.cdc.gov/alcohol/fact-sheets/moderate-drinking.htm

Dietary Guidelines for Americans, 2020-2025. (2020).  https://www.dietaryguidelines.gov/sites/default/files/2021-03/Dietary_Guidelines_for_Americans-2020-2025.pdf

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Moderate alcoholic beer consumption: the effects on the lipid profile and insulin sensitivity of adult men. Journal of food science. (2017).  https://ift.onlinelibrary.wiley.com/doi/10.1111/1750-3841.13746

Moderate consumption of beer (with and without ethanol) and menopausal symptoms: results from a parallel clinical trial in postmenopausal women. Nutrients. (2021). https://www.mdpi.com/2072-6643/13/7/2278/htm

Phenol antioxidant index: Comparative antioxidant effectiveness of red and white wines. Journal of Agricultural and Food Chemistry. (1995). https://pubs.acs.org/doi/10.1021/jf00050a027

Polyphenols: Food sources and bioavailability. The American Journal of Clinical Nutrition. (2004). https://academic.oup.com/ajcn/article/79/5/727/4690182

Quercetin, inflammation and immunity. Nutrients. (2016). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4808895/

Red wine consumption and inhibition of LDL oxidation: What are the important components? Medical Hypotheses. (2002). https://pubmed.ncbi.nlm.nih.gov/12160692/

Red wine consumption associated with increased gut microbiota α-diversity in 3 independent cohorts. Gastroenterology. (2019).  https://www.researchgate.net/publication/335446113_Red_Wine_Consumption_Associated_With_Increased_Gut_Microbiota_a-Diversity_in_3_Independent_Cohorts 

Risk thresholds for alcohol consumption: combined analysis of individual-participant data for 599 912 current drinkers in 83 prospective studies. The Lancet. (2018). https://www.sciencedirect.com/science/article/pii/S014067361830134X

What is a standard drink? (n.d.). https://www.niaaa.nih.gov/alcohols-effects-health/overview-alcohol-consumption/what-standard-drink 

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