Is alcohol allowed on the Mediterranean diet?

The Mediterranean diet does not explicitly recommend alcohol. However, moderate alcohol intake — in particular, red wine consumed with meals — is a recognized part of the dietary pattern.^[1] Moderate intake is defined as up to 2 drinks per day for men and 1 drink per day for women, and is included as a component in most Mediterranean-diet-scoring indexes.

One study found that people who followed a “moderate Mediterranean drinking plan” including the consumption of red wine with meals had a lower mortality risk compared to people who abstained from alcohol and had low adherence to the Mediterranean diet.^[2] Excluding moderate alcohol intake as a component of the Mediterranean diet reduces the overall association of the diet with mortality risk, with alcohol’s contribution being greater than a low red meat consumption or a high vegetable intake.^[3]

These “health-protective” effects of alcohol (red wine) have been attributed to its polyphenol content (e.g., resveratrol), but this is mostly mechanistic speculation; most people don’t accept that alcohol exerts a health benefit per se. Alcohol — especially in large quantities — is toxic to the brain and can increase the risk of accidental deaths and certain types of cancer;^[4] it’s one of the main risk factors for the global burden of disease.^[5] Thus, while a few glasses of red wine can complement the healthy foods that comprise the Mediterranean diet, an individual’s risk factors, tolerance to alcohol, and personal/religious beliefs should all be taken into consideration. The Mediterranean diet can be incredibly health-promoting in the absence of alcohol.