Q: I’ve heard that alcohol helps prevent heart disease. Should I drink to my health, for my health?

A: Don’t go bottoms up so fast.

First, I must warn you that alcohol consumption is a leading cause of car accidents and traumatic death. Three in 10 Americans will be involved in an alcohol-related car accident at some point in their lives.

In addition, because women do not process alcohol as effectively as men, they will become inebriated faster and develop disease from alcohol more quickly.

Excessive drinking (which is defined as more than four drinks a day, or more than five drinks a day at least five times a month) can lead to cirrhosis (liver disease), hypertension, brain damage, stroke and cancer.

Alcohol-related illnesses constitute the third leading cause of death for women ages 35 to 55. On average, the life expectancy of women who abuse alcohol is shortened by 15 years!

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So, with all this dire information, where did we get the notion that drinking was good for our hearts?

In part, this idea originated in France, where, despite a diet heavy in fats (such as creamy Camembert cheese and rich foie gras), the population has a relatively low incidence of heart disease. It was theorized that wine consumption, particularly of red wine, played some role in this so-called “French Paradox.”

However, subsequent studies have attributed the relatively good health of French people to the fact that their food portions tend to be smaller and that they tend to walk more and snack less.

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Then there was a Nurse’s Health Study of 80,000 female nurses which indicated that one to three drinks a week was associated with a 17 percent lower rate of mortality from heart disease.

But this oft-cited statistic is incomplete. The only women who benefited started off with at least one risk factor for heart disease — high cholestoral, diabetes, hypertension, smoking or a parent who had a heart attack at a young age. For women without these risk factors, drinking neither helped nor hurt.

Meanwhile, the study did show a worrisome correlation between moderate consumption of alcohol and other diseases, including breast cancer.

Fortifying this view was another analysis of 322,000 women which showed that two to five drinks a day increased breast cancer risk by 41 percent compared with non-drinkers. The theory behind these numbers is that alcohol increases estrogen levels by raising production and decreasing breakdown.  (Higher levels of estrogen have been linked to cancer.)

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On balance, then, regular drinking is not a good idea. When my patients who do drink alcohol ask which is the healthiest, I tell them there is some data suggesting that red wine may offer greater benefit than white wine or other forms of alcohol, possibly because the skin and seeds of the grapes that make the wine red are rich in antioxidants.

If you feel your gustatory life is incomplete without a drink accompanying dinner, stop at one and sip it slowly as you eat. This will dilute the alcohol and help lessen its potential negative effects on your body.

And remember, if you up the count to two drinks, it can be the equivalent of four for that man eating dinner with you!

Dr. Reichman’s Bottom Line: An occasional drink is fine, but don’t rationalize heavy drinking by thinking that it is beneficial to your heart.

Dr. Judith Reichman, the “Today” show's medical contributor on women's health, has practiced obstetrics and gynecology for more than 20 years. You willl find many answers to your questions in her latest book, "Slow Your Clock Down: The Complete Guide to a Healthy, Younger You," published by William Morrow, a division of HarperCollins.

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