Does the punishment fit the wine? Guilty til proven innocent!
No amount of alcohol is safe, declares the World Health Organization.
By Jeff Wojtowicz, PharmD AWE SOMM CSW WSET Level 2 & 3 Award in Wines
This is a common headline lately that may influence the alcohol guidelines from the US Department of Agriculture.
Wait a minute, what’s the Department of Agriculture got to do with the wine guidelines?!? The famous alcohol guidelines that recommend up to 1 drink per day for women and 2 for men are part of the Dietary Guidelines for America (DGA) published by the USDA, updated every 5 years, and 2025 is that lucky year.
All these headlines have led to the fervor in recent weeks regarding potential changes to the alcohol consumption guidelines in the US. Unfortunately, the media has portrayed this quite negatively, so I’ll put this in perspective.
The USDA requested scientific reports from the National Academies of Science, Engineering, and Medicine (NASEM) and the Interagency Coordinating Committee on the Prevention of Underage Drinking (ICCPUD). These reports were submitted to the US Department of Health and Human Services (HHS) and USDA to decide if changes are needed for the DGA in 2025 (https://www.dietaryguidelines.gov/alcohol/info#how-can-i-get-involved-). Public comments on the reports were accepted from January 15th to February 14th, 2025.
This was a huge undertaking by NASEM and ICCPUD. However, there are some methodological concerns with the reports. I submitted my comments on the DGA website Feb 10, 2025. All comments are publicly available on their website.
After careful review of 300+ pages in these 2 reports, there’s almost nothing specific to wine. What you will see in the summary below is about alcohol in general and ignores the benefits of wine, especially red wine. My conclusion is that red wine in moderation does not have negative health outcomes.
Let’s take a look at the reports.
As a summary, the NASEM found the following with moderate alcohol consumption:
To put this in perspective:
All-cause mortality rate in the US is 750 deaths per 100,000 people (1). A 16% decrease in the relative risk drops this to 630 deaths per 100,000 people.
Breast cancer rate is 13% over a woman’s lifetime in the US (2). A relative risk increase of 10% means the risk is now 14.3%.
Therefore, the only adverse finding from the NASEM regarding moderate alcohol consumption was its association with an increased relative risk of breast cancer. However, there are concerns regarding the methodology used to arrive at this conclusion.
* Concern that the non-drinker category might include former drinkers who stopped due to negative health effects from alcohol which could skew the data. However, investigators anticipate this and design their studies to exclude participants in both non-drinker and drinker categories with a history of the health outcomes being measured before starting the study, thereby eliminating bias. Therefore, the NASEM decision has unnecessarily excluded many relevant studies.
The ICCPUD Report was generated by 6 alcohol researchers with 5 of them focusing on addiction and substance abuse, especially prevention of underage drinking.
As a summary, ICCPUD found the following with moderate alcohol consumption compared to alcohol abstention
*In this focus area, the panel assumed only a 10% underreporting of alcohol consumption. This is notable, as they initially stated that they would assume a 50% underreporting, which aligns with the literature. As a result, the reported risks are inaccurately inflated for individuals who consume alcohol in moderation.
In my systematic review of the literature regarding Long-term Health Outcomes of Regular, Moderate Red Wine Consumption https://www.cureus.com/articles/191941-long-term-health-outcomes-of-regular-moderate-red-wine-consumption, I reviewed 74 studies with the following conclusion:
From this systematic review of the literature, there is no evidence of an association between moderate red wine consumption and negative health outcomes. Across the various outcomes assessed, a beneficial effect of moderate red wine consumption was consistently seen for mortality and dementia, along with certain cancers (e.g., non-Hodgkin lymphoma) and cardiovascular conditions (e.g., metabolic syndrome). For other health outcomes, the association was neutral, i.e., neither harmful nor beneficial.
I provided detailed scientific analysis in my submission to DGA (available on their website) and concluded my submission with the following recommendations:
I would direct the HHS and USDA to carefully review the methodological concerns that I have outlined before making any decision on changes to the DGA. I would also direct HHS and USDA to avoid the temptation to oversimplify the DGA by lumping all alcohol together. There are numerous studies demonstrating health outcomes differences between types of alcohol. While ignoring these studies is taking the easy path, it is not the correct scientific path, it's simply irresponsible. I recommend that no changes be made to the current DGA regarding alcohol consumption until such time that HHS and USDA have taken the opportunity to re-analyze the data from NASEM and ICCPUD and to analyze the data by type of alcohol.
It's clear for wine that this is “guilt by association”, since these reports did not analyze data by different types of alcohol. Wine, especially red wine, is innocent til proven guilty!
Ahmad FB, Cisewski JA, Anderson RN. Mortality in the United States — Provisional Data, 2023. MMWR Morb Mortal Wkly Rep 2024;73:677–681.
American Cancer Society Key Statistics for Breast Cancer 2025. https://www.cancer.org/cancer/types/breast-cancer/about/how-common-is-breast-cancer.html
Seung-Kwon Myung. How to review and assess a systematic review and meta-analysis article: a methodological study (secondary publication) J Educ Eval Health Prof. 2023 Aug 27;20:25