This season I’m dealing with questions that require wisdom to answer properly. The Bible says that wisdom is the principal thing. To act wisely requires knowledge and deep understanding as prerequisites. Wisdom is more, however. Wisdom is often defined as the “best means to the best end.”

What follows is an approximate transcript of the podcast episode.

Today I want to apply the criterion of wisdom to objectively evaluate a substance that is widely and enthusiastically consumed in our culture and in many other cultures around the world. To many foodies the selection of a bottle of wine can make or break the meal. A wine steward is a high status position at fine restaurants. Despite this culture of refinement, however, the reality is that alcoholic beverages are responsible for about 6% of all cancers and 4% of all cancer deaths. What’s going on? Stay tuned for a frank consideration of the world’s most popular psychoactive drug, ethyl alcohol.

You may recall that I’m a microbiologist by training as well as a Christian who believes that the Bible is predominantly written as a factual historical narrative. This means I’ve never had patience with those who maintain that wine in the Bible was not alcoholic. I won’t get into particular scripture verses in this podcast in the interest of addressing the larger question (to us in 2024) of consumption of beverage alcohol.

Alcohol and fermentation go together in most people’s minds. While that’s an oversimplification, it is true that ethyl alcohol is produced by a natural fermentation.

Suffice it to say that fermentation is directly tied to the core of sugar metabolism (called glycolysis). Those who deny the reality of alcoholic wine in the Bible are determined epistemic contortionists. Theirs is not a serious argument and it flies in the face of solid scientific evidence to the contrary.  

Fermentation is (with few exceptions) simply a metabolic way of staying alive in the absence of oxygen. It is wired into the genes of many different microorganisms.

Yeasts, for example, carry out cellular respiration as long as there is sufficient oxygen available. Only when they are deprived of oxygen do they resort to fermentation. Oxygen deprivation occurs when yeast cells are pushed below the surface of liquids (like grape juice) or semisolids like bread dough. Instead of just carbon dioxide and water that they would produce by cellular respiration, they are forced by the lack of oxygen to use a less efficient form of metabolism which produces both CO2 and ethyl alcohol. Yes, you heard correctly. Not just wine but yeast breads are the result of the alcoholic fermentation. The bubbles of CO2 cause the bread to rise and the evaporating ethyl alcohol is part of the smell of bread fresh out of the oven!

Other microbes use fermentation to produce different kinds of organic waste products depending on their genetic wiring. The production of sauerkraut results from the microbial fermentation of cabbage producing a build-up of lactic acid. Cheeses and yogurts are produced by a similar process. Interestingly the lactic acid fermentation can also be switched on in human skeletal muscle. This is a safety mechanism that allows these muscles to continue cycles of contraction when the cardiovascular system can’t keep up with their need for oxygen. This is properly called anaerobic (that is without oxygen) exercise. The price you pay for this anaerobic overexertion is sore muscles due to the accumulation of lactic acid.

The role of microorganisms in producing fermented foods was not understood until Louis Pasteur in 1857 put forward what was then called the Germ Theory of Fermentation. 

Where do the yeasts come from that ferment the sugars in the crushed grapes? They come from the dust blown into the air which then colonizes grape skins. As a few grapes ripen prematurely or are shaken off the vines by wind or animals, the sugars in the decaying grapes in the soil serve as the substrate for a population explosion of yeast. These in turn colonize grapes that are still on the vine. It is a self-perpetuating loop.

Fermentations of various types are inevitable and many of them result in the preservation of foods as in the production of cheeses and sauerkraut as well as meats like pepperoni. Interestingly cocoa is produced through a two-stage fermentation first yielding ethyl alcohol and then this is converted into acetic acid (the main ingredient in vinegar).

Alcohol and Smoking Cause Cancer by the Same Mechanism

Ethyl alcohol is intrinsically toxic to all organisms. The liver needs to detoxify any ethyl alcohol we consume. It is not simply that if you consume enough alcohol, you become intoxicated. An intoxicated person is under the influence we say. Alcohol has built up in their system faster than it can be detoxified in the liver. Detoxification is a process whereby alcohol is transformed into other organic molecules, mainly acetaldehyde. Unfortunately, acetaldehyde is a potent carcinogen. To put this in perspective, “acetaldehyde is the most abundant carcinogen in tobacco smoke.” I don’t think there is any real argument about the health hazards of smoking, and yet here we have the same carcinogen being produced by our metabolism of ethyl alcohol. 

Ethyl alcohol is toxic to the yeast that produce it. As grape juice is fermented by yeast, alcohol builds up, eventually to toxic levels. Ethyl alcohol eventually accumulates to a level which kills the yeast. Depending on the yeast variety this will be somewhere around 12% ethyl alcohol. Not only does the ethyl alcohol kill the yeast that produced the wine, but it also kills other microorganisms that may be in the juice including those that cause disease. (You do remember that the classic method of producing grape juice calls for people to walk barefoot in the vat to crush the grapes?) Wine is antimicrobial because of its alcohol content. This makes it useful in cleansing wounds as well as an alternative to drinking contaminated water.

Contaminated water is still to this day a common vehicle for disease transmission. The availability of reliably safe water is a significant dividing line between developed and less-developed nations. In the past the visible clarity of water was the main way water safety was ascertained. This is not at all reliable. Small settlements are often located near springs or other naturally clean water sources. As populations grow, however, it is far too easy for even these water supplies to be compromised.

Certainly, it would be possible to dilute wine to some extent with contaminated water to kill disease microbes and render the water potable. This can’t be extrapolated without limit, however. Eventually the alcohol would be too dilute to effectively kill or inhibit disease-causing microbes. The maximum dilution that is still effective varies depending on the disease organism in question.

I view the historical data on this issue of what common dilution ratios were in the past as weak and susceptible to cherry picking. Diluting wine in the past was likely to be pure pragmatism to extend a limited supply of wine rather than an intentional effort to purify contaminated water. As was the case with fermentation, the recognition of the causative role of microorganisms in human disease was first recognized by Louis Pasteur in the mid to late 1800’s. There is a tendency to read our present scientific knowledge back into practices of the historical past and make them appear to be better informed than they were.

On the other hand, it has long been recognized that alcoholic beverages like wine and beer are drugs. Paul in I Timothy 5:23 suggests that Timothy treat his stomach problems and other ailments using a little wine in place of water. Proverbs 31:6 suggests strong drink for those who are perishing (that is—dying) much as we use morphine to assuage intense pain in the terminally ill. The same verse suggests wine for those who are deeply depressed (KJV heavy hearted). On the other hand, the verses just prior to this verse (Proverbs 31:4-5) counsel that alcoholic beverages should be off limits for leaders because alcohol will cause them to forget the law and to tend toward injustice.

In modern times, ethyl alcohol has been called by experts in human physiology “a pharmacological grenade.” This refers to alcohol as imbibed before it is metabolized by the liver. In an episode of the NPR broadcast, Fresh Air, neuroscientist Judith Grisel of Bucknell, a specialist in addiction said, “Alcohol is such a mess. It's a tiny, tiny molecule, and it acts all over the brain in so many different pathways. . . . It acts kind of like a sledgehammer or just in a widespread way to disrupt all kinds of cell functioning.” Alcohol is a big-time disruptor. Grenade, sledgehammer—different metaphors but both incredibly destructive pictures.

To balance the picture, I would acknowledge the Bible has positive things to say about wine. It was a part of cultural celebrations. Weddings, for instance. Yes, I believe that Jesus created real alcoholic wine as his first public miracle at Cana. He didn’t make sophisticated grape Kool-Aid. He circumvented the extended time required for the many nuanced and sequenced chemical processes normally required for wine to come to full maturity. His very first miracle showed Him to be the Creator God. Wine, oil, and bread are listed together in Psalm 104:15 as tangible evidence of God’s blessings in an agricultural community. 

Alcohol Consumption Nearly Unavoidable in the Past

Throughout the Bible drunkenness is roundly condemned as sinful. The picture of alcohol consumption is definitely nuanced in Scripture. I believe alcohol consumption was nearly unavoidable in biblical times. Ethanol (ethyl alcohol) production occurs naturally wherever grapes and other sugar containing crops are cultivated. Good stewardship of the harvest requires some method of preservation and wine is the natural result with grape juice. Cooking grapes down into a jam or fruit preserve only temporarily kills yeast and bacteria which might cause fermentation. Unless the product is heat treated in jars and carefully sealed (part of pasteurization) these products will be subject to contamination with yeasts or molds when they cool down.

Fruit juices which are not fermented are a modern phenomenon. Welch’s Grape Juice was created by a dentist, Dr. Thomas Welch, in 1869 by the application of the approach of Louis Pasteur which became known as pasteurization. Welch was motivated to produce a non-alcoholic wine for use in communion. Non-alcoholic grape juice particularly became a phenomenon when samples were offered in the 1893 World’s Fair.

Welch was not trying to start a business. He was addressing a problem when he produced non-alcoholic grape juice. The problem began to crescendo in the 1800’s and has been described as “an epidemic of alcoholism.” It was addressed with the 18th Amendment (aka Prohibition) which was ratified Jan. 17, 1920, in record time with 46 of the 48 states voting in favor as well as super majorities of both the House and the Senate. As one secular history records, “Alcohol was the 20th century’s opioid crisis.” The 18th Amendment showed the unusual solidarity of the American people in trying to stamp out the plague of alcoholism.

Make no mistake, alcohol is addictive. Approximately 12% (1 in 8) of the U.S. population are alcohol dependent (aka alcoholic). About half of the cases of dependence are due to inherited gene variants which make alcohol dependence much more likely. Of course, if you never drink alcohol, you’ll never realize that you could have been an addict. The other half of the causation beyond genetic predisposition is due to prolonged binge drinking. This means that people with no genetic predisposition to alcoholism can rewire their brains to create addictive cravings. Alcohol dependence results in about 180,000 preventable deaths yearly in the U.S. with individuals dying about 24 years prematurely on average.

Alcohol and the “Cancer Cascade”

At the outset of this podcast episode, I quoted an oncologist who pegged 6% of all cancers and 4% of all cancer deaths as being due to alcohol consumption. This includes mouth, throat, and stomach cancers as well as cancers of the liver, bowel, and breast. [Here is an updated new article detailing new data on cancer risks as of 9/18/2024 and this from JAMA.]

This is not some nebulous correlation based only on speculation. As mentioned previously detoxification of ethyl alcohol by the liver produces acetaldehyde in everyone. Acetaldehyde is a known carcinogen. Acetaldehyde sets off a “cancer cascade” that directly damages the DNA in your cells. Of course, your body fights back with great success, but you roll the dice each time you start the cascade with a beer or a glass of wine. 6% of all drinkers eventually lose to cancer. That’s on top of the 12% who will become addicted to alcohol either through genetic predisposition or binge drinking.

You may respond by assuming that your ally is moderation. That’s not really true. You are toying with cancer every time you drink. The WHO (World Health Organization) has recently declared that there is no safe level of alcohol consumption. What about the protective effect of resveratrol in wine? It looks like that was a marketing ploy by the alcohol industry on par with the decades long deceit of the tobacco industry in the past. Whatever protection resveratrol might confer is swamped by the carcinogenicity of acetaldehyde.  

Another way of deflecting this line of argument is to say, “It’s my choice. I can determine what goes into my body.” Indeed, you can, but there are also societal dimensions to the problem. Growing up in the home of drinker who becomes abusive or irrational under the influence is a problem. Living in a home where finances are fractured in pursuit of alcohol is another common problem. A less obvious problem is that your family and friends may be influenced by your normalization of alcohol and yet not dodge the bullet as perhaps you have to this point.

Then there is the societal problem of impaired drivers. The one beer that relaxes you also impairs your driving. Alcohol consumption at any level always impairs and never enhances judgment and motor skills. There is general agreement that in the U.S blood alcohol levels are set too high. Utah recently changed from 0.08 to 0.05% with a significant reduction in alcohol related accidents. Other states are poised to do likewise.

Coming Soon: Warning Labels

There is no reason to suspect that anyone will revive Prohibition. What is happening, however, is a movement in many countries to require warning labels on alcoholic beverages. This was recently reported in a variety of media outlets including this objective and sober article in the Wine Enthusiast.

The first country to do this, interestingly, is Ireland. Famous for its culture of drink, Ireland has recognized this as a public health menace. Beginning in 2026 all alcoholic beverages sold in Ireland must display a warning which reads: “THERE IS A DIRECT LINK BETWEEN ALCOHOL AND FATAL CANCERS.” Nothing subtle there and absolutely provable.

Well, I have laid out the evidence, but you have to decide for yourself. Considering the evidence, is it wise to consume beverage alcohol? Alcohol consumption is merely a cultural phenomenon in our day. No one needs to drink alcohol. Alcohol is a psychoactive drug, not a nutrient. Alcohol metabolism always produces acetaldehyde, a potent carcinogen. Alcohol will wreak havoc either through cancer or addiction in perhaps 1 in 6 who consume it with some regularity. Look at it objectively: If some new beverage previously unknown was sweeping the world in popularity, but carried the baggage of an 18% (that’s cancer plus alcoholism) life altering or life terminating risk—would you jump on the band wagon?

 Perhaps its time to swim upstream against the cultural current.

This podcast episode I’ve thrown a lot of evidence at you. I strongly suggest you go to my blog at deep and durable.com and track down and read the numerous original sources linked to the references there. As you read, seek understanding and a connected causal narrative. I’ve also included below a link to an interesting BBC documentary that I think you’ll find objective and enlightening.