When Oldways introduced the first Mediterranean Diet Pyramid with the Harvard School of Public Health in January 1993, moderate wine drinking was included on the Pyramid.  Since then, there have been a number of studies around consumption of wine or alcohol and health.  For example, Attilio Giacosa’s 2016 paper, “Mediterranean Way of Drinking and Longevity,” published in Critical Reviews in Food Science and Nutrition, concluded: 

“Moderate wine drinking is part of the Mediterranean diet, together with abundant and variable plant foods, high consumption of cereals, olive oil as the main (added) fat and a low intake of (red) meat. This healthy diet pattern involves a “Mediterranean way of drinking,” that is a regular, moderate wine consumption mainly with food (up to two glasses a day for men and one glass for women). Moderate wine drinking increases longevity, reduces the risk of cardiovascular diseases and does not appreciably influence the overall risk of cancer.”


In early 2022, the World Heart Federation and the Coalition for America’s Health issued a policy brief stating that no level of alcohol consumption is healthy.  WebMD reports that the WHF conclusions follow a recent report in The Lancet based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), which found that there is no safe level of alcohol consumption.

Not surprisingly, this view was criticized by a number of scientists, and the American Heart Association (a member of the Coalition) noted that ”moderation is key” when it comes to alcohol, which is defined as no more than one drink a day for women and two for men.”  

Reviewing epidemiological evidence, scientists at the Harvard TH Chan School of Public Health advise that drinking patterns, rather than alcohol type (red wine, white wine, beer, distilled alcohol) is what matters most.  Moderation is key!  Reports from HSPH’s large population studies — Health Professionals Follow Up Study and the Nurse’s Health Study I and II – found moderate consumption of alcohol to be associated with reduced risk of cardiovascular disease.  However, the Nurses Study found all types of alcohol consumption to be associated with an increased risk of breast cancer.  

If you do drink, remember that along with moderation, an overall healthy eating pattern is essential. 


To help you achieve moderation, or if you choose not to enjoy wine, beer or alcoholic drinks, here are some non-alcoholic beverage ideas from cultures and cuisines around the world to add to your repertoire.

Ayran:  Ayran is a refreshing yogurt-based drink with a dash of dried mint and salt. It’s perfect for hot days, or to accompany savory or spicy meals. Not just a Cypriot or Turkish drink, ayran is popular throughout the Eastern Mediterranean and Western Asia.


Kombucha:  Kombucha is a fermented drink, made by adding a combination of yeast and bacteria to sugar and tea, and allowing the mix to ferment.  Gaining in popularity, there are many commercial versions with varying flavors.  It’s thought to be healthful, although some, like the Mayo Clinic are cautioning, saying there is no evidence for its health benefits, and some people have experienced stomach upsets, infections and allergic reactions. 


Tea:  There are practically endless options if you love tea.  Many blends and flavors of black tea, green tea, bubble tea, white tea – caffeinated and caffeine free.  Tea drinking is a delicious ritual in many countries around the world – east and west — and any number of types and blends can be found at the grocery store and specialty tea shops.  In terms of health, the Harvard TH Chan School of Public Health notes that “most traditional teas do not contain a significant amount of nutrients, but are rich in polyphenols. These are plant chemicals that give teas their distinct flavor and aroma and may have health-promoting properties.”

yerba mate—Kellyleblanc

Yerba Mate—Photo courtesy of Kelly LeBlanc

Yerba Maté Tea:  Yerba maté is a caffeinated tea made from the leaves and twigs of an indigenous South American plant. In addition to its distinct flavor, yerba maté is rich in vitamins, amino acids, and polyphenols, which are plant compounds that may improve health.  Medical News Today goes on to report that the research on yerba maté tea’s health benefits is still emerging, but some studies suggest that yerba maté may improve cardiovascular health, counteract the health effects of obesity, and more.  If you’re looking for a boost, Food & Wine magazine advises “yerba maté tastes like a tea and hits you like a coffee.”  Traditionally, the ritual of drinking yerba mate is in a group, from a dried gourd (maté) and using a special straw that filters out the leaves (bombilla).  


Photo courtesy of Jennifer Hill Booker

Hisbiscus Drink :  According to Sunnyatta Amen in the Washington Post, Juneteenth celebrations always feature red foods (strawberries, red rice, red velvet cake, barbeque), and no celebration would be complete with Red Drink, an adaptation of traditional African hibiscus ginger tea. “Red Drink is known by many names throughout Africa, and the Diaspora: bissap in Senegal, sorrel in the Caribbean, rosella in the Horn of Africa and the Middle East, karkade in Egypt, agua fresca de jamaica in Central America, and vinagreira in Brazil.”  Our friend and colleague, Jennifer Hill Booker, has created her own Hibiscus tea that she calls Juneteenth Jubilee Hibiscus Lemonade Punch Mix.  We’ve found it really delicious, no matter the date. 


Mocktails.   The category of non-alcoholic aperitifs and drinks is exploding.  Celebrities like Katy Perry have started companies to sell specially created products.  Amazon features pages of thousands of brands.  Websites tout their best recipes for mocktails – sparkling and nonsparkling that mimic the experience of drinking cocktails.  Put your favorite ingredients + mocktail into a search engine, and you’ll find hundreds of recipes to choose among.  Forbes magazine reported on a Distill Ventures survey of bartenders and consumers in London, New York and Los Angeles that “the biggest trends in bars are drinks without booze, and that consumers are actively seeking better drinks options. 

5 pyramids.jpg

Water.  Of course, there is water, recommended by doctors, dietitians, other health professionals, exercise gurus and many others (including all the Oldways Heritage Diet Pyramids).  No matter whether you choose alcoholic or non-alcoholic beverages, don’t forget that it’s essential to drink water, especially when your body tells you that you’re thirsty.  

We also get hydration from the foods we eat, and most recipes require liquids.  We’ve included a few recipes with this Fresh Friday that call for wine or tea.  Or, check out the recipes on the Oldways website.  

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Robert Gonzalez
What about Apple cider vinegar drinks? Sometimes called switchel or other names that I can’t think of right now. I heard these are good for you too. Braggs brand makes some and they’re quite tasty!
Thanks for your comment Robert! Yes, apple cider vinegar (ACV), or cider vinegar, is great in salad dressings, marinades and vinaigrettes. Unpasteurized ACV contains “mother of vinegar” which makes for the cloudiness in some vinegars and is filled with nutritious enzymes and good bacteria. Traditionally, it has been used in making crab-meat dip, pickling vegetables, dressing cooked beets, and it’s been enjoyed in U.S. Southern cooking as a bright flavoring for all kinds of veggies like collard greens, green beans, black-eyed peas, and cabbage.

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