Everything in Moderation
Most of us know what it means to drink too much—although in the recent case of Billy Joel, it took shouting incoherently while in a concert with Elton John and driving his Mercedes off the road before he checked himself into rehab for an "addiction to wine." (In Joel's defense, I'd argue that listening to Elton John sing "Benny and the Jets" could drive anyone to drink in excess.) Moderation, on the other hand, is much harder to categorize—even, it seems, for medical professionals. Just about every doctor I spoke to, including my longtime family physician, had a different idea of what it means to drink moderately. Some of the experts I consulted were vague as to exact amounts; others said a single glass of wine a day "or less" was the limit, which really depressed me.
I'd started thinking about moderation while having my annual physical. My doctor, knowing what I do for a living, had made a few dark remarks about the possible state of my liver. "But I drink in moderation!" I'd protested. "That's what a lot of people in your business say," replied Martin Feuer, M.D., ever the skeptic.
I rarely drink wine during the day, and if I do, I'm usually tasting (and spitting). I do, however, drink wine with dinner every night—an average of two glasses or so, though if the wine is truly outstanding, my husband and I have been known to finish the bottle. By some people's standards, I might belong in the same drying-out place as Billy Joel, while to others (mostly French and Italian), I probably seem like a lightweight.
The fact is, in this country, wine is still treated more like a controlled substance than like a complement to a meal. After all, the same federal agency that monitors guns and cigarettes (the Bureau of Alcohol, Tobacco and Firearms) also governs the production and sale of wine. It wasn't until 1995 that the United States government even acknowledged that wine wasn't an altogether dangerous thing. Before then, federal dietary guidelines decreed there was "no net health benefit" to be found from the consumption of alcohol. After years of research proved otherwise, the government grudgingly revised its dietary guidelines to reflect that drinking wine could afford certain health benefits, though only at "moderate" levels of consumption—"no more than one drink a day for women and two for men."
In countries such as France and Spain, the government measures moderation more generously—up to two drinks a day for women and four for men—yet their populations are healthier than ours and their rates of alcoholism are lower than ours. Though the European approach seemed the more reasonable, I wasn't convinced there should be guidelines at all. Why were governments telling people whether or not to drink wine in the first place, let alone assigning numbers to the acceptable amounts? Trying not to sound defensive, I got on the phone with a few medical authorities to find out exactly what they consider to be moderate drinking.
My first call was to Harvey Finkel, M.D., a clinical professor of medicine at the Boston University Medical Center. Dr. Finkel, who lectures all over the world on wine and health, said he was "a big believer in the benefits of moderate drinking" and sided with the government figures. One glass a day is enough for a woman, said Dr. Finkel. It's a matter of alcohol dehydrogenase—something women have less of than men. (Is there no end to the ways in which we are shortchanged?) Alcohol dehydrogenase, it seems, is the enzyme that breaks down alcohol in the stomach. A person who has too little alcohol dehydrogenase could experience problems. Did Dr. Finkel think I had enough of the stuff to safely process two glasses of wine a day? Possibly, he replied. However, he warned me, "you have to be careful about how you're measuring your glasses."
After promising I'd do so before my next dinner party (how many guests had I already endangered by serving oversize glasses of Chardonnay?), I called Elizabeth Whelan, president of the American Council on Science and Health, a consumer-oriented public-health organization. "Why such an emphasis on excess?" I complained to her, "especially when you consider that the vast majority of people in this country [95 percent] aren't problem drinkers?" Dr. Whelan said it is "the tremendous negativism about alcohol in this country" that makes doctors particularly cautious. But did she think the government's moderation guidelines are fair? They are conservative, she conceded. In fact, when I mentioned my two-glass-a-day habit, she seemed more concerned with the calories I was consuming than the alcohol. "Alcohol is a concentrated form of calories," Dr. Whelan said sternly. "I can't imagine anyone not counting calories when drinking wine."
The last thing I wanted was something more to measure—I was still worrying about the size of my glassware—and changed the subject to Dr. Whelan's interest in wine. She'd mentioned she was planning a visit to Sonoma, where she hoped to do some wine tasting. I thought of asking her if she'd keep to one glass a day but decided to recommend a few wineries for her to check out instead (Dry Creek, Martinelli, Franciscan and Chateau St. Jean , in case you're wondering).
Before we hung up, Dr. Whelan suggested that I call Morris Chafetz, president of the Health Education Foundation, a nonprofit organization that teaches people how to address health issues, especially the consumption of alcohol. Dr. Chafetz, she said, had studied the effects of alcohol on the body for almost five decades and was sure to give me his unvarnished opinion.
Indeed, Dr. Chafetz wasn't afraid to take an unorthodox stance. He soon asserted the rather refreshing view that "alcohol has done far more good than harm" for most people throughout history. He had little affection for the U.S. government's moderation guidelines, calling them "artificial" and "homogenizing." When I asked about my daily two glasses of wine, Dr. Chafetz chided me, "It's not the amount you drink that's important, it's about educating yourself, respecting yourself."
It was getting confusing. Since I respected myself more days than I didn't, by Dr. Chafetz's standard I seemed to be fine. On the other hand, I wasn't sure about how much alcohol dehydrogenase I had. Furthermore, I'd never once considered measuring my wineglasses or counted the calories in a Cabernet. With so many criteria, how could I tell if my drinking is moderate? Enough with the health gurus: For some real answers, I decided to seek the opinions of other wine professionals—winemakers and sommeliers—to find out what they thought moderate drinking would be.
Richard Betts, wine director of the Little Nell in Aspen, Colorado (a town where the residents are as physically fit as they are financially solvent), told me he averages "a bottle a day," between lunch and dinner, and considers it moderate, while in New York, Le Bernardin's top sommelier, Michel Couvreux, reported he often drinks two bottles of wine in a day (did I mention he's French?), though always with food. The women I talked to tended to drink a bit less—pretty much the same as me. Karen King, wine director of New York's Union Square Cafe, said "a couple of glasses of wine" is her moderate norm, as it is for Napa-based winemaker Mia Klein and Sonoma winery owner Julie Martinelli. Even so, though they are all very healthy people, every one of these wine professionals drinks more than the government would call moderate. What would my family doctor say?
I put the question to Dr. Feuer the following week, when he called to tell me the results of my physical. I was, Dr. Feuer said, in excellent health. Did that mean two glasses of wine are a good thing after all? "Consistently drinking wine appears to be beneficial," was all that he'd say.
I told him I'd drink to that.