What is the recommended weekly wine consumption for a generally healthy adult with no history of liver disease or alcohol dependence?

Recommended Weekly Wine Consumption for Healthy Adults

For generally healthy adults, women should limit wine consumption to no more than 7 standard drinks (5 oz glasses) per week, and men should limit consumption to no more than 14 standard drinks per week, with at least 1-2 alcohol-free days weekly. 1, 2, 3

Daily Limits Matter More Than Weekly Totals

The pattern of drinking is as critical as the total amount consumed:

• Women should not exceed 1 standard drink (5 oz wine) per day 4, 1, 2, 3
• Men should not exceed 2 standard drinks (10 oz wine) per day 4, 1, 2, 3
• Include at least 2 alcohol-free days per week to reduce overall health risks 1, 2

One standard drink of wine equals 5 oz (150 mL) and contains approximately 12-14 grams of pure alcohol. 4, 1, 2, 3

Why These Limits Exist: The Evidence

Liver Disease Risk Threshold

The risk of cirrhosis increases significantly when daily alcohol consumption exceeds 24-25 grams (approximately 2 standard drinks), with a 2.9-4.9 times higher risk at this level. 1 Even consumption of 12-24 grams per day shows increased mortality risk from liver cirrhosis, particularly in women who are twice as sensitive to alcohol-mediated liver toxicity. 1, 3

Cardiovascular Considerations

While moderate alcohol consumption may have some cardiovascular benefits, the European Society of Cardiology recommends stricter limits: less than 14 units per week for men and less than 8 units per week for women for cardiovascular protection. 1 The American Heart Association aligns with the daily limits of 1-2 drinks per day for women and men respectively. 2, 3

Cancer Risk Cannot Be Ignored

Any amount of alcohol increases cancer risk, particularly for breast, colon, liver, esophageal, and oral cancers. 1, 2, 3 Even 5-15 grams of alcohol per day (less than 1 standard drink) increases breast cancer risk by 5.9%. 2 This is a critical consideration that outweighs potential cardiovascular benefits, especially for younger women. 5

Drinking Pattern Is Critical

Avoid These High-Risk Patterns:

• Binge drinking (≥4 drinks for women, ≥5 drinks for men in one sitting) dramatically increases health risks, including a 64% increased risk of stroke and doubled risk of hemorrhagic stroke, even if weekly totals remain within guidelines. 1, 2, 3
• Daily drinking without breaks carries a 3.65 times higher risk of cirrhosis compared to those who drink less frequently. 1, 2
• Drinking outside of mealtimes increases alcohol-related liver disease risk by 2.7-fold. 1, 3

Safer Drinking Practices:

• Always consume wine with food, particularly important for those with diabetes to prevent hypoglycemia. 4, 2
• Spread consumption throughout the week rather than concentrating it on weekends. 1
• Prefer regular, moderate consumption (such as the Mediterranean pattern of wine with meals) over occasional heavy drinking. 5

Special Populations Requiring Lower Limits or Abstinence

Older Adults (≥65 years):

• Follow the lower limits recommended for women (≤7 drinks per week) regardless of sex due to decreased lean body mass and total body water. 4, 1, 2

Complete Abstinence Required For:

• Pregnant women (no safe level exists) 4, 1, 2
• History of alcohol abuse or dependence 4
• Existing liver disease, pancreatitis, or severe hypertriglyceridemia 4
• Taking medications that interact with alcohol 2
• Patients using insulin or insulin secretagogues should only drink with food to avoid hypoglycemia 4

Common Pitfalls to Avoid

Underestimating pour sizes: A standard 5 oz wine serving is smaller than most restaurant pours or home glasses. 1, 2, 3 Many people consume 1.5-2 standard drinks when they think they're having one glass.

"Saving up" drinks for the weekend: Consuming 7 drinks on Saturday because you abstained all week is binge drinking and carries significantly higher risks than the same amount spread throughout the week. 1, 2

Ignoring alcohol-free days: Daily drinking, even within limits, increases cirrhosis risk 3.65-fold compared to less frequent consumption. 1, 2

The Bottom Line for Clinical Practice

The safest approach for a generally healthy adult is to limit wine to 1 glass (5 oz) per day for women and 2 glasses per day for men, with a weekly maximum of 7 and 14 glasses respectively, and at least 2 alcohol-free days per week. 1, 2, 3 However, given the established cancer risks at any level of consumption, particularly for women, the lowest risk option remains abstinence. 2, 3

For patients with diabetes, these same limits apply, but alcohol must always be consumed with food to prevent hypoglycemia. 4, 2