The silly season is upon us, and it is a time when many people can overindulge in more ways than one.
In 2023 the Heart Foundation revised one of its more sensitive position statements – Alcohol and heart health – a statement that has a lot of relevance for people in the Christmas and holiday period.
So, what does the science say? Is a glass of red wine good for the heart? What does our new advice mean practically for people, and how do we as health professionals relay this new advice without looking like the fun police?
Why a new position on alcohol?
Like many areas in the food, nutrition and lifestyle space, it’s crucial that the Heart Foundation moves with the times, and their policies and advice reflect the latest evidence.
Thanks to the great work of Lily Henderson (previous National Nutrition Advisor), and our Expert Policy Group we now have a policy development process that is more efficient and cost effective. This new process utilises recent high-quality evidence reviews and polices from other organizations for the Heart Foundation’s policy development. After all, why reinvent the wheel? The emphasis is then put on understanding the evidence in a New Zealand context and customising recommendations for our population.
Our Alcohol policy was last developed in 2013 and over the past 10 years the landscape has changed significantly. There have been large increases in low alcohol, 0% beer, wine, and other drink options, a growth in the sale of low carbohydrate drinks, and a growing trend for people to give up alcohol completely or abstain for certain parts of the year. From a heart perspective there is a responsibility to reflect the strengthening of evidence on the effects of alcohol on the heart, and to provide specific advice for those with heart conditions.
What does the latest science say about the impact of alcohol on the heart?
Our position statement was largely informed by Canada’s Guidance on Alcohol and Health, published in 2023 by the Canadian Centre on Substance Use and Addiction (1). The position statement can be seen here:
Heart Foundation Alcohol Position Statement
In summary, the evidence showed that:
- Drinking alcohol increases your risk of high blood pressure - a major risk factor for heart disease and stroke. There is strong evidence that every 10g increase in pure alcohol per day (equal to 1 standard drink) raises the risk of high blood pressure by 6% (2).
- Given around 20% of adults in New Zealand are living with high blood pressure, there is potential for significant public health gain with reducing alcohol intake.
- Alcohol increases your risk of heart conditions like atrial fibrillation and may also increase your risk of heart failure and ischaemic heart disease.
We also acknowledge that alcohol is linked with several other health conditions, including bowel and breast cancers, two of the most common cancers in New Zealand.
Has the advice changed?
In the 2013 policy we advised that the relationship between alcohol and cardiovascular disease is complex. For most people there will be little, or no, overall benefit to alcohol consumption. However, these guidelines did allow for some low/moderate alcohol consumption.
In the 2023 position, our top line message is that the evidence has strengthened and there is now no safe level of alcohol consumption. If you don’t currently drink any alcohol, then don’t start. If you do drink alcohol, it’s better to drink less.
This new advice reflects much stronger evidence around the risks of consuming of alcohol and is in line with other organisations worldwide (such as the World Heart Federation, the Canadian Centre on Substance Use and Addiction and the Australian Heart Foundation) who have also updated their guidelines.
So, we can put that age-old ‘glass of red wine’ myth to bed – and confirm that all types of alcohol are the same when it comes to their effects on the heart.
Benefits beyond the heart
The benefits of drinking less alcohol extend beyond heart health, and may include:
- saving money
- improving sleep quality
- improving memory and concentration
- helping manage your weight due to alcohol being high in kilojoules (calories)
- helping manage or improve mental health.
Drinking less alcohol also reduces risk of a wide range of health conditions, including breast and bowel cancer (3).
Is ‘no safe level of alcohol’ realistic for people?
The reality is that 4 out of 5 New Zealand adults choose to drink, so for many people this becomes a conversation about less is best and being practical/realistic in relation to where people’s alcohol consumption is at.
New Zealanders need to be informed about the latest evidence on the association between alcohol and heart health, and the conversation for those who drink is about encouraging them to be more mindful on amounts and frequency, and for people to understand that any steps taken to reduce the amount they drink over time will have benefits for heart health.
Tips to reduce alcohol consumption
Ways to reduce alcohol consumption will vary for different people. For many, making the commitment to drink less alcohol is hard to do. Any steps taken by individuals to reduce the amount they drink will benefit their heart health.
Some of our tips include:
- Have alcohol-free weeks and weekends wherever you can.
- Choose alcohol-free activities or make your usual activities alcohol-free.
- Drink slowly.
- For every drink of alcohol, have a drink of water or soda water.
- Try having ‘low’ or ‘zero’ alcohol products in place of full-strength drinks.
- Chat with friends and whānau if you need their support.
Often a gradual stepwise approach can work for people and it’s best to make small steps over time that are realistic and achievable. Overall, the best sorts of changes are ones that stick and fit into our ongoing daily/weekly/monthly routine.
Our blog on making healthy habits stick can be found at Heart Foundation Blog
If alcohol is used as a relaxant, then some ideas to relax without alcohol are:
- Go for a short walk, do a yoga or Pilates class, or your favourite form of physical activity.
- Phone a friend or member of your whānau.
- Read a book or magazine. Listen to an audiobook or podcast.
- Try guided meditation or mindfulness.
Recipes for some great non-alcoholic drinks
We have created some great lower sugar alternatives to alcohol to keep people hydrated. Water, and these options are great to have on hand, especially if entertaining.
Peach Cinnamon Delight
Infused water combinations
Iced Teas
Non-alcoholic cool mint crush mojito
For more information on alcohol, check out our website: Alcohol and the heart
References
- Paradis C BP, Shield K, Poole N et al. Low-Risk Alcohol Drinking Guidelines Scientific Expert Panels. Canada’s Guidance on Alcohol and Health: Final Report. Ottawa Ontario: Canadian Centre on Substance Use and Addiction; 2023.
- Liu F, Liu Y, Sun X et al. Race- and sex-specific association between alcohol consumption and hypertension in 22 cohort studies: A systematic review and meta-analysis. Nutr Metab Cardiovasc Dis. 2020;30(8):1249-59.
- Estruch R, Ros E, Salas-Salvadó J et al. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med. 2013;368(14):1279-90.