I hope you had a good New Year, whatever you got up to. Mine was fairly quiet, partly because I was on call the following day — which, as it turned out, was busier than expected. That said, I’ve actually had a pretty good run over the festive period work-wise, so in truth it’s going to feel a little tough getting properly back into the swing of things from tomorrow.
I often like to anchor these blogs around an interesting patient I’ve seen that week, but this time there isn’t really a story to share. Instead, I wanted to write about something that’s been quite relevant to me personally over the last couple of weeks: alcohol and the heart. I’ll start by addressing the question – Is there a “safe” amount of alcohol? My short answer is this: there’s no amount of alcohol that can genuinely be described as good for your health. That’s the honest, evidence-based position.
You’ll sometimes hear it said that a small daily glass of red wine is “good for you” because of resveratrol, a compound found in grape skins. This idea is often linked to the so-called French paradox — the observation that rates of heart disease in parts of France were historically lower despite relatively high intakes of saturated fat. The problem is that there’s no good direct evidence that resveratrol from red wine provides a meaningful heart disease benefit in humans, and the amount of wine you’d need to drink to reach doses used in laboratory studies would be enormous — and clearly harmful. In reality, the French paradox is far more likely to reflect overall lifestyle factors — patterns of eating, portion size, physical activity, social connection, and meal structure — rather than red wine itself.
However, this doesn’t mean people shouldn’t drink at all. I certainly do myself, and have done throughout my adult life. I particularly enjoy a good glass of red wine with dinner. What has changed over time is the amount — I drink far less now than I ever used to, and the quality. I would far rather have a glass of really good red wine than a bottle of ‘average’ stuff. If I’m going to consume something I know isn’t great for me, especially with respect to my sleep (which I’ll come on to) I would like to make sure it’s worth the trade!
Over the Christmas period, though, I noticed a familiar pattern creeping in. I wouldn’t say I drank to excess on any given day, but I definitely drank on far more days of the week than usual. Normally I’ll only drink at weekends and not during the week at all. Over Christmas, that rule quietly disappeared.
And that’s what’s made me think seriously about Dry January.
I’ve never done Dry January before, but this year I’m genuinely curious to see how I feel without alcohol for a month. I strongly suspect that next weekend, when it’s cold outside, the fire’s on, and things are relaxed, I’ll crave that glass of red wine. But I’m interested to see what — if anything — changes. One area I’m particularly focused on is sleep.
Alcohol is often thought of as something that helps you drift off, but the reality is that it significantly worsens sleep quality. It disrupts REM sleep, fragments the second half of the night, and leads to earlier waking and poorer recovery. I’ve definitely noticed over the last couple of weeks that my sleep hasn’t been anywhere near as good as usual, and I’m fairly sure alcohol has played a role. Given how important sleep is for cardiovascular health, metabolic health, mood, and exercise recovery, that alone feels like a good enough reason to make a change.
Alcohol and the heart: what actually matters?
From a heart perspective, alcohol can cause problems in a few key ways:
Heart failure: In larger amounts, alcohol is directly toxic to heart muscle and can lead to a weakened heart over time. I should stress that this is typically in very large amounts and/or over a very prolonged period, but I’ve certainly also seen cases where I suspect someone has been susceptible to it and had issues consuming lower amounts.
Heart rhythm problems: Alcohol increases the risk of arrhythmias, particularly atrial fibrillation — something we see very commonly after periods of heavier drinking.
Blood pressure: Regular alcohol intake can push blood pressure up, often subtly and gradually.
I’m often asked about alcohol and coronary artery disease. There isn’t a strong direct causal link there, and it’s not something I focus on particularly. For me, the bigger issues are rhythm disturbance, heart muscle health, sleep, and overall recovery.
None of this is about perfection or abstinence forever. It’s about awareness and balance. Trying a month without alcohol feels like a useful reset — a chance to notice how I feel, how I sleep, and how my energy levels respond. Whether I go back to drinking afterwards, and how much, can be informed by that experience. I suspect even if I feel better off alcohol though, I will go back to drinking. I’ve got a few lovely bottles I’ve been looking forward to! Isn’t human behaviour non-sensical sometimes!
A quick note on polygenic risk scores – just a reminder that there are two weeks left on the current offer for polygenic risk scores. Thank you to everyone who has already been in touch — I’ll be contacting you this week to arrange testing. If you would like to read more about what this is, I have compiled a Polygenic risk score FAQ sheet here
For now, the discounted price is £850, which includes:
The test itself
A full consultation
Interpretation and personalised discussion of the results. This represents a £100 saving on the usual price.
Finally, in this week’s video I discuss a new scientific statement from the American Heart Association on gum disease and heart health.
Thanks, as always, for reading and watching — and I hope the new year has started well for you.