Is Red Wine Really the Healthier Choice?

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While red wine is often believed to be a healthier alcoholic option, a meta-analysis of observational studies challenges that assumption. Analyzing data from 42 studies, researchers found no significant difference in overall cancer risk between red and white wine consumption.

Despite alcoholic beverages being categorized as a Group 1 carcinogen responsible for 741,300 cancer cases in 2020 — 4.1% of total global cancer cases that year — wine consumption is on the rise.

“Red wine has been considered a healthier option because it contains a higher number of antioxidants, including flavonoids and polymeric tannins, than white wine,” wrote co-lead investigator Eunyoung Cho, Sc.D., an associate professor of epidemiology and of dermatology at Brown University School of Public Health.

However, when the body breaks down alcohol, it turns into a chemical called acetaldehyde, which can easily bind to DNA and proteins in cells. This can cause genetic mutations and harmful damage to DNA. Further, some alcoholic drinks already contain high levels of acetaldehyde before they are even consumed.

Investigators noted gaps in research and inconsistent findings among studies that have evaluated whether there are differences in cancer risk among different types of wine. To determine this, they conducted a literature search of PubMed and Embase using specific terms and keywords including “cancer,” “tumor,” “alcohol,” “red wine” and “white wine.” In addition to overall cancer risk, the team included site-specific cancers such as prostate, ovary, colon, female breast, lung, pancreas, brain, stomach, mouth, lymphoma and kidney/urinary tract.

A total of 22 case-control studies and 20 cohort studies, made up of nearly 96,000 participants, were eligible for inclusion.

No significant differences were observed between wine types for overall cancer risk, and an increased risk of breast cancer was observed for both.

However, in the cohort studies, white wine intake was associated with an increased cancer risk in women compared with men. There was also a 22% higher risk of skin cancer among people who drank white wine, but not red wine.

Investigators hypothesized that drinking alcohol may increase the risk of skin cancer because its byproducts, like acetaldehyde, can make the skin more sensitive to light. Additionally, wine consumption is also more common among White individuals, who are already at higher risk for skin cancer. Another possible reason is that heavy wine drinkers may engage in risky behaviors like getting sunburned, using indoor tanning or not wearing sunscreen. This does not, however, explain why white wine was linked to skin cancer and red wine was not.

The team noted the results suggest the need for further investigation into the potential health impacts of white wine consumption.

Limitations of the study included obtaining data about wine intake from self-reported food frequency questionnaires (FFQs), which can be inaccurate. Only six out of the 22 case-control studies used validated FFQs. However, any errors in reporting would likely apply equally to both red and white wine. Additionally, investigators mentioned that case-control studies are more prone to recall bias than cohort studies, though results from cohort studies were also analyzed separately. There were too few studies on certain cancers — such as pancreatic, brain and mouth cancers — to compare risks between red and white wine. Finally, some analyses were based on a smaller number of studies, which may have impacted the accuracy of the findings.

“Our findings provided a critical public health message that drinking red wine may not be any better than drinking white wine in terms of cancer risk,” investigators concluded.