In vino veritas – but in moderato sanitas.

First things first: there are no silly questions, especially when it comes to wine. However, some questions about wine and health can be tricky to answer in a way that is both adequate and easily understandable. The wide range of concerns is evident in inquiries such as whether wine can become toxic as it ages or which medications should not be combined with wine consumption.

Three specific questions have frequently come up in conversations, and they seem to be of particular interest. Below, I address these topics concisely while striving to provide clear and accessible answers.

Wine and Diabetes

“Can you recommend wines with low sugar content for diabetics?“

While I cannot and do not wish to name specific wines, let’s focus on the essentials: what effect does alcohol consumption have on diabetes?

According to scientific studies, most table wines or wines labeled dry contain little to no residual sugar and therefore have minimal or no immediate impact on blood sugar levels. However, sweet or dessert wines contain residual sugar and should be avoided by diabetics. Beyond sugar content, diabetics must also consider how alcohol affects blood sugar regulation. The liver naturally produces glucose, but alcohol inhibits this process, temporarily lowering blood sugar levels. Paradoxically, this could be seen as a benefit for diabetics.

However, special caution is required for individuals taking insulin. Since insulin also lowers blood sugar, consuming alcohol in combination with insulin therapy increases the risk of hypoglycemia—a dangerous drop in blood sugar levels. As science states: “The amount of alcohol in a single glass of wine is enough to temporarily inhibit the liver’s glucose production, thereby increasing the risk of a negative blood sugar reaction in combination with insulin therapy, which must be avoided at all costs.” Excessive alcohol consumption can also impair a person’s ability to recognize symptoms of low blood sugar. Therefore, it is essential to monitor alcohol intake and keep an eye on blood sugar levels.

Wine can have beneficial effects but should always be consumed in moderation. I do not wish to discourage diabetics from enjoying a glass of wine—particularly red wine, which contains valuable plant compounds—but it is crucial to be responsible with one’s health. If you wish to include alcohol in your lifestyle, speak with your doctor. Medical professionals have moved away from a strict alcohol prohibition for diabetics, and today, there are ways for diabetics to enjoy wine safely on occasion.

Alcohol and ADH

“Can I tolerate alcohol better if I eat fatty foods beforehand?“

We all know: drinking alcohol on an empty stomach is a “youthful mistake.” And (almost) everyone knows that doing so accelerates the effects of alcohol. To answer this question, let’s turn to science once again, which states: “The way humans metabolize alcohol is linked to a specific group of enzymes known as alcohol dehydrogenases (ADH).”

These enzymes break down alcohol into its components, which the body partially eliminates. The most intensive breakdown occurs in the liver, but around 15% of alcohol is metabolized in the stomach lining before it even reaches the liver. This offers some relief to the liver, but only if the stomach is occupied with digesting food. If the stomach is empty, alcohol is quickly passed to the intestines, where it is rapidly absorbed into the bloodstream. However, when food is present in the stomach, digestion slows down, giving enzymes more time to process the alcohol.

This means that foods requiring longer digestion can indeed slow alcohol absorption. However, excessively heavy meals are not recommended, as they burden the body and often have negative effects on weight.

As with all alcohol consumption, moderation is key. Focus on enjoyment and listen to your body. By doing so, you can maintain a healthy relationship with wine—and one or two glasses can be a harmonious addition to both body and soul.

Wine and Skin Flushing

“Why does my face or neck turn red when I drink wine?“

Facial flushing after consuming wine is often caused by an alcohol flush reaction, particularly common in people with a genetic enzyme deficiency. Affected individuals have lower levels of aldehyde dehydrogenase 2 (ALDH2), an enzyme responsible for breaking down acetaldehyde—a byproduct of alcohol metabolism. When acetaldehyde accumulates in toxic amounts, it dilates blood vessels, leading to visible facial redness.

Beyond flushing, this condition can also cause unpleasant side effects such as headaches, nausea, and dizziness. This genetic predisposition is particularly common among people of East Asian descent (hence the term Asian Flush), but it also affects a portion of the European population.

Another potential cause is rosacea, a chronic inflammatory skin condition. Alcohol—especially red wine—can act as a trigger by dilating already sensitive capillaries, resulting in increased facial redness. People with rosacea should adjust their alcohol consumption accordingly and consult a dermatologist if needed.

Additionally, sulfites, which are commonly used as preservatives in wine, can cause skin flushing or allergy-like reactions in sensitive individuals. While sulfites are present in almost all wines (including organic wines), only a small percentage of people are genuinely allergic to them. Those who react to sulfites may opt for low-sulfite or sulfur-free wines as alternatives.

Conclusion: Wine, Health, and Mindful Enjoyment

Wine is more than just a beverage—it is deeply woven into many cultures, enhances social experiences, and has been linked to potential health benefits for centuries. However, it is essential to recognize that wine’s effects on the body are highly individual.

For diabetics, moderate consumption of dry wine may be an option without significant risk—but always in consultation with a doctor.

Alcohol absorption and tolerance can be influenced by food intake, with easily digestible meals being the best choice.

Skin reactions to wine can be triggered by genetic factors, rosacea, or sulfites—those affected should explore alternative options accordingly.

While science continues to explore the relationship between wine and health, one golden rule remains unchanged: mindful and moderate enjoyment is the best way to balance wine and well-being. Or, as the ancient Romans put it: “In vino veritas – but in moderato sanitas.”

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