this reduction in heart disease risk results in a reduced mortality in middle-age and older adults who consume moderate amounts of alcohol.However,at high levels of consumption,the mortality from heart disease and other alcohol-related problems is increased.Wine consumption has been suggested as a reason for the lower incidence of heart disease in certain cultures.The Mediterranean diet,which has been associated with a reduced risk of heart disease,includes daily consumption of wine in moderation(see Chapter 1,Science Applied:How Epidemiology led to Dietary Recommendations for Heart Disease).And one explanation for the French paradox-the fact that the French eat a diet that is as high or higher in saturated fat that the American diet but suffer from far less heart disease-is the glass of wine they drink with meals.The particular benefit of red wine is likely due not only to the alcohol but also to the phytochemicals (phenols) it contains(see Figure F1.5).There are a number of ways that moderate alcohol consumption reduces the rick of heart disease.The most significant is its effect on HDL cholesterol.Moderate alcohol consumption can increase HDL cholresterol by 30% and is believed to account for about half of alcohol's protective effect.Alcohol also lowers the risk of heart disease by reducing platelet stickiness and levels of the blood-clotting protein fibrinogen. Both of these effects reduce the formation of blood clots that can block blood flow to the heart resulting in a heart attack.Smaller benefits have been attributed to alcohol's role in increasing insulin sensitivity and reducing inflammation.Although all of these effect have been documented,the benefit any one individual will gain from moderate alcohol consumption depends on his or her genetic background,health status,and overall lifestyle.