Q. I have read that drinking a glass or two of wine a day can help prevent heart attacks. Is this true for women? I don’t drink that much, should I start?
A.You are referring to the studies that have shown that women who drink one or two glasses of wine – or any kind of alcoholic beverage for that matter – have higher levels of HDL, “good cholesterol”, which protects against heart disease. Since heart disease is the number-one killer of women, anything that can prevent this problem warrants serious consideration.
Still, I don’t think there’s a responsible doctor on the planet who is going to advise a patient who does not drink to begin drinking. Whatever health benefits can be achieved from alcohol are quickly offset by the very real risks associated with problem drinking. Although the studies are inconclusive, women who drink heavily may be at greater risk of getting breast cancer than those who abstain. Heavy drinking is also associated with cirrhosis of the liver, which can be more severe in women. Even moderate drinkers may be at greater risk of getting osteoporosis, a disease that is characterized by the thinning of the bones.
Of special concern is the fact that incidents of solitary drinking among woman are increasing, and especially among older women. In fact, the American Medical Association AMA recently alerted physicians to the fact that alcohol abuse is on the rise in older patients who may use alcohol to cope with depression and loneliness.
Given the downside of alcohol, I believe that if you don’t drink, there is no reason to start. If you do drink, do not exceed two glasses of alcohol a day. (A standard drink is defined as containing half an ounce of absolute alcohol. By this measure, the typical glass of wine is 4-5 ounces, a serving of hard liquor is about 1 ounce.)
There are some women who should not drink alcohol under any circumstances. Among them are women who are pregnant or who are trying to conceive (alcohol can cause severe birth defects), women who have had a history of problem drinking or who come from a family with a history of alcohol addiction, and women who are taking medication that could interact with alcohol.
Marianne J. Legato, MD, Ph. D. (hon. c.), FACP is an internationally renowned academic, physician, author, lecturer, and pioneer in the field of gender-specific medicine. She is a Professor Emerita of Clinical Medicine at Columbia University College of Physicians & Surgeons and an Adjunct Professor of Medicine at Johns Hopkins Medical School. Dr. Legato is also the Director of the Foundation for Gender-Specific Medicine, which she founded in 2006 as a continuation of her work with The Partnership for Gender-Specific Medicine at Columbia University. She received an honorary PhD from the University of Panama in 2015 for her work on the differences between men and women.
At its core, gender-specific medicine is the science of how normal human biology differs between men and women and how the diagnosis and treatment of disease differs as a function of gender. Dr. Legato’s discoveries and those of her colleagues have led to a personalization of medicine that assists doctors worldwide in understanding the difference in normal function of men and women and in their sex-specific experiences of the same diseases.
She began her work in gender-specific medicine by authoring the first book on women and heart disease, The Female Heart: The Truth About Women and Coronary Artery Disease, which won the Blakeslee Award of the American Heart Association in 1992. Because of this research, the cardiovascular community began to include women in clinical trials affirming the fact that the risk factors, symptoms, and treatment of the same disease can be significantly different between the sexes. Convinced that the sex-specific differences in coronary artery disease were not unique, Dr. Legato began a wide-ranging survey of all medical specialties and in 2004, published the first textbook on gender-specific medicine, The Principles of Gender-Specific Medicine. The second edition appeared in 2010 and the third edition, dedicated to explaining how gender impacts biomedical investigation in the genomic era, won the PROSE Award in Clinical Medicine from the Association of American Publishers in 2018. A fourth edition is forthcoming.
She also founded the first scientific journals publishing new studies in the field, The Journal of Gender-Specific Medicine, and a newer version, Gender Medicine, both listed in the Index Medicus of the National Library of Medicine. She has founded a third peer-reviewed, open access journal, Gender and the Genome, which focuses on the impact of biological sex on technology and its effects on human life.
Dr. Legato is the author of multiple works, including: What Women Need to Know (Simon & Schuster, 1997), Eve’s Rib (Harmony Books, 2002), Why Men Never Remember and Women Never Forget (Rodale, 2005), Why Men Die First (Palgrave, 2008), The International Society for Gender Medicine: History and Highlights (Academic Press, 2017), and most recently, The Plasticity of Sex (Academic Press, 2020). Her books have been translated into 28 languages to date.
As an internationally respected authority on gender medicine, Dr. Legato has chaired symposia and made keynote addresses to world congresses in gender-specific medicine in Berlin, Israel, Italy, Japan, Panama, South Korea, Stockholm, and Vienna. In collaboration with the Menarini Foundation, she is co-chairing a symposium on epigenetics, Sex, Gender and Epigenetics: From Molecule to Bedside, to be held in Spring 2021 in Italy. She maintains one of the only gender-specific private practice in New York City, and she has earned recognition as one of the “Top Doctors in New York.”