Tuesday, December 29, 2009

A toast to health with champagne?

Red wine is usually credited with providing the health benefits of drinking, because so many of the compounds associated with specific biochemical properties come from the skins and seeds of the vinifera grape. Since red wine is made by fermenting the whole berry, skins, seeds and all, these molecules are extracted into the nascent wine. Resveratrol in particular is increasingly touted as the explanation for the French Paradox, despite mounting evidence that it is the combination of substances in wine working together synergistically that best fits the data. In any case, white wines and champagne get short shrift in the health story, but new evidence suggests we should take another look.

It is true that champagne contains relatively little resveratrol, the miracle molecule. But it does contain two other potent antioxidants, tyrosol and hydroxytyrosol. If you are a student of the Mediterranean diet, you may have heard of these as being the principal antioxidants in olive oil. Since wine and olive oil are both primary components of the Mediterranean diet, it is likely that these compounds play a much larger role than resveratrol, which is present in only small quantities even in red wine. This was confirmed in a recent study from the University of Connecticut, in which rats were given either red or white wine and then induced to heart attack. Both types of wine conferred equal protection against damage to the heart, via antioxidant reactions.

So let’s toast to the New Year with champagne, to health, long life, to friends and family, and to the poor rats who unwittingly devoted their lives to science.

Monday, December 21, 2009

What’s red and white and fights the blues?

Although the holidays are a festive time of year, for some it can be depressing. Those with drinking problems have a particularly difficult time, and I cannot in good conscience recommend alcohol as a therapy for the seasonal blues. There is some intriguing evidence however that substances in wine can help fight depression.

Two studies from the same lab at the University of Santiago in Spain looked at the activity of the wine-derived compound resveratrol, and a cousin molecule called “trans-epsilon viniferin” (which is 2 resveratrol molecules linked together) on release of the neurotransmitter serotonin. This is the same molecule that many prescription antidepressants target, and with both wine substances the levels of serotonin were elevated in the same way. Another target of antidepressants called MAO inhibitors, were similarly found to have a parallel effect from the wine derivatives. A limiting factor is that these studies were in brain tissue from rats, so it is a big leap to conclude that it will have the same effect in humans. However, we do know that resveratrol gets into the brain and has other positive effects so it certainly merits further research.

Although resveratrol levels are generally higher in red wines, white wines may have a beneficial effect as well. A study done a few years ago at a French laboratory evaluated the effects of champagne consumption in a set of human subjects. Interestingly, they observed that people tend to either have high or low baseline serotonin levels. In those with low levels (who may be at higher risk for depression) the serotonin levels were increased by more than 50% after moderate consumption of the bubbly. They also observed increases in another neurotransmitter molecule called dopamine, which may also have salutary effects.

In any case, the evidence suggests that if you don’t have a problem with alcohol, you should consider getting in the mood for some wine this season. Here’s wishing everyone a happy and healthy holiday.

Tuesday, December 15, 2009

of wine and chocolate

What a treat to meet and have dinner with Fran Bigelow, founder of the famous Fran’s Chocolates here in Seattle last night. She is of course the creator of President Obama’s favorite chocolates, and her gray salt caramels are renowned. She is truly gracious, talented, and smart.

I enjoyed talking with her about the similarities of wine and chocolate, and learned a few things. I knew that dark chocolate and wine contain many of the same polyphenols, the antioxidants that explain why they are both good for us. There is a lot of scientific literature supporting the healthful properties of both chocolate and red wine. But what I didn’t know was that chocolate, like wine, is the product of fermentation. The polyphenols aren’t present in significant quantities until the beans undergo fermentation, before roasting and processing. They do however vary in taste by place of origin, just as wines are known to express what is called terroir.

Appreciation of fine chocolate has similarities to wine also, in that all of the senses are used. It has aromas, textures (wine aficionados call it “mouth feel”), and of course complex tastes. But winemakers are done when the wine goes into the bottle, whereas the chocolatier then goes on to create visually appealing creations. Both are of course best thought of as foods, and health foods at that, but wine frames the meal as chocolate completes it.

Monday, December 7, 2009

Why wine should be part of your healthy holiday diet

The holidays are always a tricky time of year for those concerned about healthy eating, which of course should be all of us. We gather around food and drink, celebrate all that is good in our lives, and toast to friendship and goodwill. And we hit the buffet, usually not featuring low-cal and low fat options, so it is no wonder that average weight gain this time of year in the range of 10-15 pounds is the norm. Fortunately, there is one sacrifice that we don’t have to make. Red wine might actually help minimize the weight gain and other adverse effects of high fat meals.

First the general advice: Scan the buffet first, before getting in line, so you can save room on your plate for healthier choices. Make portion control your mantra, and try for a mix of carbohydrates and proteins along with higher fat foods. Don’t deprive yourself of what you like, just don’t have as much of it. Another helpful suggestion is replace sweet with spicy.

Standard advice usually also includes a caution to keep alcohol consumption in check. This can’t be argued with, but several lines of evidence point to the beneficial reasons to make red wine your holiday beverage of choice. For one, compounds in red wine tend to help moderate blood sugar levels, a major culprit in weight gain. Wine drinkers tend to have less trouble with weight gain overall, and some recent research shows that it actually works at a cellular level to control fat metabolism. Fatty foods also do a lot of their damage by releasing free radicals into the blood stream, and wine works to counter this as well. And finally, while wine may not count as a low-calorie drink, it is better than mixed drinks both in terms of sugar content (none in dry red wine) and the way the calories are processed.

So enjoy yourself this holiday season and share some good red wine with family and/or friends. And come to think of it, Age Gets Better with Wine makes a great present.

Friday, December 4, 2009

Big Thank-you to the Indian Wine Academy

I'm just back from my trip to India for an international plastic surgery conference where I was presenting a paper, but I must say that one of the highlights was the opportunity to speak about my book Age Gets Better with Wine at a dinner meeeting of the Indian Wine Academy. A very big thank-you to Subhash Arora for the invitation and the wonderful dinner at Ciro Restaurant in New Delhi this past Monday evening. There is very sophisticated group of wine lovers in India to be sure. One member, Arun Varma, who heads a marketing and travel service company, even had me convinced that wine drinking could be incorporated into Ayurvedic medicine. Why not?
So what about Indian wine? It is a young industry, and there is a lot of potential. Growing regions in the north, where the climate is more temperate, are largely undeveloped but I wouldn't be surprised to see some really good wines in the not-too-distant future.

Monday, November 16, 2009

more on the new French Paradox

I know we have covered the new French paradox recently but I came across a fact that put it into sharp focus: No country in the world has cut its alcohol consumption more over the past 4 decades than France except the United Arab Emirates, where even possession of alcohol is banned.* Even more surprising is that beer and spirits consumption has held steady, so what has vintners really seeing red is that the reduction is entirely in wine. Talk about a paradox!

Chalk it up to the disappearance of the leisurely meal. A key to healthy drinking is to consider wine as a part of a meal – in fact I have an entire chapter in Age Gets Better with Wine titled “Wine is a Food.” The average French meal is now said to be down to 38 minutes, barely an appetizer and aperitif before. And the French apparently frequent McDonald’s more than any other country in Europe. But others are taking up the slack: Spain formally classified wine as a food in 2003. And Spain has become not only one of the world’s great food and wine destinations, but a leader in the science of wine & health.

*From a chapter in Mark J. Penn's excellent book Microtrends.

Wednesday, November 11, 2009

The problem with resveratrol

We continue to hear a lot about resveratrol these days. If you follow news releases on wine and health topics (which I do so you don’t have to) it seems that all of the goodness of wine can be attributed to this miracle molecule from wine grape skins. It is a pretty compelling story when you look at all of the basic science research on the subject, which offers tantalizing prospects of a cure for Alzheimer’s disease, cancer, heart disease, diabetes, even the common cold (see below). But there’s a problem.

To begin with, scientists first looked to wine-derived compounds because of all of the data showing a correlation between moderate drinking and lowered chances of having any of the above-mentioned diseases. When researchers discovered that resveratrol activates enzymes called sirtuins that extend lifespan in certain organisms, the door to a whole new area of scientific inquiry was opened. What resveratrol does in a Petri dish seemed to explain the benefits of drinking wine, and so now dozens of manufacturers are offering resveratrol supplements as a way to get wine’s goodness without the alcohol. So what’s the problem?

The thing is, there isn’t enough resveratrol in wine to explain why wine drinkers are so much healthier and live longer than teetotalers on average. It has been calculated that some 200 bottles would be required to get the daily dose required to cause the same effect in people as it does in lab rats. And, as we have pointed out here before, resveratrol isn’t very well absorbed after oral ingestion anyway. So clearly there must be something else going on. Several papers do offer a possible explanation: when resveratrol is given in combination with other wine polyphenols, the effects are often multiplied. And alcohol in the right amounts has specific heart-health benefits too.

A similar thing happened with vitamins. Their discovery a hundred years ago was the biggest advance in nutritional science of the 20th century, as I believe polyphenol science will be for the 21st. But when vitamins were extracted out their natural sources (usually fruits and vegetables) and given as supplements, no benefits in terms of age-related diseases were found. That bears repeating: No benefits to taking antioxidant vitamins, period. The same may turn out to be true for wine. So just eat your vegetables and drink your wine.

Tuesday, November 3, 2009

Cold & flu season ahead: Got wine?

By all accounts, the coming flu season is going to be a doozy unless we all get our H1N1 vaccination soon. There’s always the plain old cold too of course. I can never remember whether we are supposed to starve a cold and feed a fever or the other way around, but new findings suggest that regardless of the symptoms, respiratory viruses can be kept at bay by drinking wine.

It’s not as farfetched as it sounds. A few years ago, researchers in Spain looked into the question of how wine drinking habits relate to the risk of colds. Their subjects were 4000 faculty members of five universities across the country, who were tracked during cold & flu season for the number and severity of illnesses. When the data was cross-referenced to drinking patterns, they found that consumers of at least 2 glasses of wine a day were only half as likely to contract a viral illness as nondrinkers, and the correlation was stronger for red wine drinkers than for white. What’s more, the duration of illness was shorter for those who did contract a cold or flu.

There are a couple of explanations for this. One of course is that wine drinkers may have other healthy habits that put them at less risk (researchers call these “confounding variables”) but well designed studies such as the Spanish one take these into account. A more interesting possibility is that compounds in red wine have a direct effect on cold and influenza viruses, and there is good evidence to support that. One red wine compound called quercetin was tested against flu viruses and found to be more potent than oseltamivir (Tamiflu®), at least in the laboratory. It appears that the effect is quite specific, by interfering with viral replication. A more familiar wine extract, resveratrol, has also been fairly well tested against cold and flu viruses and found to be effective (again in a laboratory setting.)

What hasn’t been demonstrated is whether these compounds have any effect in supplement form. Resveratrol in particular is better-absorbed from wine in the mouth than pill form in the stomach. So my advice is wash your hands frequently, stay home if you are ill, and by all means have a glass or two of red wine with dinner.

And look for my book Age Gets Better with Wine in bookstores soon, or on Amazon.com or barnesandnoble.com now!

Tuesday, October 27, 2009

Age Gets Better with Wine has arrived!

Napoleon is credited with saying that champagne is deserved in victory, and necessary in defeat. I say it is time to celebrate because the second edition of Age Gets Better with Wine is here! The timing couldn't be better, with all of the controversy about resveratrol and so many companies trying to convince us that we just need to take a pill with "all of wine's benefits" and skip the part about drinking wine. If that's your view, you really need to read the book. It is availablke at http://www.amazon.com/ and http://www.barnesandnoble.com/. Check out the cool cover design.

Tuesday, September 29, 2009

The new paradox: why does France discourage wine drinking?

Although my book Age Gets Better with Wine is focused mostly on the science of healthy wine drinking, in the course of researching wine and health the topic of social policy about drinking is unavoidable. Frankly, regulators in the U.S. have made a mess of it over the years, but the French? It’s the French after all who demonstrated to the world that a habit of red wine with meals is not only a key to enjoying life, but to a healthier one too. But in recent years signs have appeared that even as Americans increase their consumption of wine, the French are slipping. And their government is all for it, or so it appeared.
Earlier this year France’s National Cancer Institute, a branch of the health ministry, released a report indicating that any level of consumption of alcohol increases cancer risk, and so abstinence is to be recommended. As one would expect, there was widespread concern that such a policy sent the wrong message. Winegrowers were frankly outraged, and members of the medical establishment began coming forward with a more broad-based view. Even if the findings regarding cancer risk were valid (there is plenty of evidence that it may not be entirely so), an abstinence recommendation fails to take into consideration all of the other benefits of wine, such as with cardiovascular disease (the original French paradox), Alzheimer’s, diabetes, and on and on. The net benefit of healthy wine drinking most certainly outweighs a narrowly defined cancer risk.
Fortunately, it appears that common sense will prevail at the highest levels of French government, at least on this issue. According to a report in Decanter.com, the French High Council for Public Health has now officially disavowed the Cancer Institute’s report. And French president Sarkozy recently announced that new, stricter regulations on advertising alcoholic beverages were to be relaxed. The French may have banned indoor smoking (hard to believe but true), but surely someone must have known that a program of national abstinence just wasn’t going to fly. It may be flattering to see the French emulating America, but trust me, the prohibition thing didn’t really work.

Wednesday, September 23, 2009

Reason #101 to drink wine

We arrive at last at number 101 of the healthy reasons to drink wine, and I should point out that they have been in no particular order. Trying to decide the most important reasons would be pointless, and even the decision to limit the list to 101 is arbitrary. So with a toast, here we go:
101. In my book Age Gets Better with Wine, I review the science of aging and how wine has revealed secrets that have eluded kings and philosophers seeking the key to life extension for millennia. We have shown how wine drinkers live longer on average, and have lower rates of the diseases that plague us as we get older. But ultimately, it isn't just being healthy and living long, it's a matter of quality of life. Now we have evidence from an Italian study that wine drinkers do indeed have higher scores on quality of life measures as they age. So it turns out that age really does get better with wine.

Monday, September 21, 2009

Almost there: Reason #100 of 101 healthy reasons to drink wine

100. Jeanne Calment of Provence lived longer than anyone else on record, some 122 years, 8 months and 3 days. She was born before the telephone was invented and her death was a global news story broadcast over the internet. Throughout her life she enjoyed red wine on a daily basis and was fond of dark chocolate. Coincidence? Maybe, but why take a chance?

Wednesday, September 16, 2009

Don't lose your SIRT: resveratrol and the promise of lifespan extension

We are closing in on the list of 101 healthy reasons to drink wine, and my book "Age Gets Better with Wine" will be on bookshelves soon. (You can pre-order it at any of the major retailers now.) So we turn now to one of the most exciting aspects of wine, one which has opened a new frontier in anti-aging research. Resveratrol from red wine was identified a few years ago as the only significant natural activator of a family of enzymes called sirtuins, coded by the SIRT gene (hence the name). A long list of specific benefits are being discovered for sirtuins, beyond what resveratrol and other polyphenols do independently, and we will list only a few of them here.
96. It has been known for many years that caloric restriction - reducing an organism's caloric intake by around 40% of what it would normally consume - will extend its life by a similar percentage. Sirtuins were found to be the key to this effect, and when researchers discovered that by feeding the subject resveratrol the effect could be replicated without caolric restriction it made headline news worldwide. So far this has only been demonstrated in fairly primirive creatures, however, and it remains to be seen whether it works in people.
97. Sirtuins are responsible for maintaining metabolic balance. Activation of sirtuins by resveratrol may be one of the ways by which wine drinkers tend to be healthier overall.
98. As a separate but related phenomenon, sirtuins appear to mitigate the diseases of insulin resistance (the most recognizable being type 2 diabetes.) This is in addition to the independent effects of wine polyphenols on diabetes.
99. The growth of new blood vessels is called angiogenesis, and it is important to maintain the vitality of muscles and other organs that are in constant metabolic use. Failure of angiogenesis is one of the ways the heart muscle weakens with aging, and sirtuins appear to promote heart health by facilitating new channels of blood supply. Anything we can do to encourage this is obviously beneficial.

Thursday, September 10, 2009

Wine as an antibiotic: #95 of 101 healthy reasons to drink wine

95. Every few years there is a news story about an outbreak of E. coli infection, which is a bacteria that can cause significant illness. But just as wine drinkers tended to be better protected against typhus in the old days, there is evidence that red wine is an effective antibacterial agent for E. coli. In this case, the active compounds are quercetin and an aromatic called caffeic acid, according to another paper from Argentina. Again, more reason to drink whole wine.

ACE your high blood pressure test with wine

94. Resveratrol gets all the attention but it is far from the only healthy thing in wine (in fact it is a relatively minor component.) Another class of compounds call oligomeric proanthocyanidins (let's just call them OPC's) have a unique mechanism for lowering blood pressure. Researchers at the University of Buenos Aires found that they inhibit an enzyme called Angiotensin Converting Enzyme which contributes to hypertension in many people. Prescription ACE inhibitors are available as well, but who wouldn't rather drink a glass of red wine? It does have to be red, and it does have to be wine, because OPC's come almost exclusively from the seeds and alcoholic fermentation is required for extraction.

Tuesday, September 8, 2009

More wine on the brain: healthy reason #93 to drink wine

93. We continue to hear about all of the ways by which wine might be good for the brain: activating memory and learning enzymes, untangling the plaques associated with Alzheimer's disease, and so on. But some have cautiously pointed out that the polyphenols that mediate these effects might not actually get into the brain tissue. Our central circuitry is protected by what is called the "blood-brain barrier" so that toxic molecules can't wander in at will. This of course also creates difficulties in getting medications and helpful nutrients across. Indeed, studies have shown that after oral ingestion, wine polyphenols might not get in to any great degree, suggesting that what we see in a test tube might not be happening inside the brain.
But recent findings from Purdue University show that with regular daily consumption, levels do begin to accumulate in about a week to 10 days. So all of the things we have been saying about regular moderate consumption find more support here.

Sunday, September 6, 2009

Now hear this: wine prevents hearing loss

92. Loss of hearing is no laughing matter, and it can occur from either age-related decline or acoustic trauma (loud noise.) A few years ago, a group or researchers decide to see if resveratrol could play a role. Ealry indications were that becaue oxidative damage contributes to hearing loss, antioxidants such as resveratrol could be helpful. However, a more direct way to test it is with noise-induced hearing loss. A group of rats (hard rock fans, no doubt) were recruited to test whether resveratrol could prevent hearing loss induced by standardized noise exposure. It turns out that indeed it does, as if we are surprised.

Wednesday, September 2, 2009

Where there is no wine, love perishes

Publication of the second edition of Age Gets Better with Wine is almost here, and so we are closing in on completing the list of 101 healthy reasons to drink wine. A few more thoughts from our ancestors before we get to the cutting edge science that has caused such a stir.
90. The Greek playwright Euripedes penned Where there is no wine, love perishes, and everything else that is pleasant to man. A bit dramatic perhaps but that was then the whole idea of drama and comedy was invented by the Greeks, in order to show the benefits and the hazards of moderate vs. excessive wine consumption.
91. The Roman romantic poet Ovid wrote It warms the blood, adds luster to the eyes, and wine and love have ever been allies. Some 2 thousand years later, Italian researchers indeed proved scientifically that women who drink wine have healthier sex lives.

Monday, August 31, 2009

Wine and civilization: more reasons to drink wine

87. Ernest Hemingway wrote that "wine is one of the most civilized things in the world." I say that not only is that true, but wine may have made civilization as we know it possible. When hunter-gatherer societies first congregated into villages and cities, the notion of septic systems hadn't been worked out so water supplies became of questionable safety. The practice of adding wine to water made it safer to drink, as Louis Pasteur observed a few thousand years later.
88. Wine became further entrenched in civilization during the golden age of Greece. Plato, who articulated so many of the tenets on which modern societies are organized, brought great thinkers together in what were called "symposia" which derives from the words "to drink together." Many of our most cherished institutions were conceived during these drinking sessions.
89. The notion of moderation is also an ancient one. The Roman orator Pliny the Elder noted "Nothing is more useful than wine for strengthening the body, and also more detrimental to our pleasure if moderation is lacking." Wine was firmly entrenched in Roman society, and in fact the expansion of the Roman Empire was possible because of the fact that the Romans has worked out the necessity of wine added to water to ensure potability.

Thursday, August 27, 2009

Something else to digest about wine: good for the GI tract

85. When I was in my general surgery residency before training in plastic surgery, we did a lot of surgery for peptic ulcers, which are prone to bleeding and causing major problems. Advice for dealing with ulcers always included things like avoiding spicy foods and alcohol. some years later, it was determined that most ulcers are associated with a particular type of bacteria, not simply excess acid. As it turns out, wine polyphenols inhibit this bacteria (called Helicobacter pylorii), so better advice is to drink wine. Another one of those counterintuitive things about healthy drinking.
86. In the same vein, another problem is refulux of gastric acids into the esophagus, which over time causes changes in the esophageal lining leading to a particularly nasty type of cancer. Interestingly, red wine seems to thwart these changes, another counterintuitive finding.

Wednesday, August 26, 2009

Something to smile about

84. Wine contains compounds that inhibit the toxins from bacteria in the mouth that form plaques leading to cavities. Who know purple teeth were healthy teeth?

Tuesday, August 25, 2009

More on wine and the brain: surviving stroke

83. Wine drinkers are less likely to have the most common type of stroke, which is caused by blood clotting in the arteries to the brain as with heart attack. Since stroke is a major cause of disability and death, any benefit here is worth celebrating.
84. When the clot causing a stroke (or a heart attack) is dissolved, blood rushes in bringing oxygen to the cells that have been suffering for lack of it. Some of these cells will have already died, but many are capable of surviving if blood flow is restored soon enough. Paradoxically though, the toxins that have been building up are released with the restoration of blood flow, causing further damage. (This is know as ischemia-reperfusion injury.) Resveratrol and other wine polyphenols have been shown to dramatically improve cell survival after ischemia-reperfusion.

Friday, August 21, 2009

Wine and Alzheimer's disease: drink for brain health

In this section we consider one of the major epidemics of our times, Alzheimer's disease. With the baby boom generation graying, the millions of new cases of this debilitating problem loom ominously. Drug therapies to date have had disappointing results. Fortunately, there is some evidence that wine drinking and other lifestyle factors can have an effect. So our count of 101 healthy reasons to drink wine continues with:
79. The Canadian Study of Health and Aging found that wine, coffee, regular exercise, and anti-inflammatories like ibuprofen were associated with the lowest risk of Alzheimer's.
80. The Copenhagen City Heart Study, a 15-year follow-up of more than 1700 subjects, found that wine consumption but not beer or spirits correlated with lower risk of Alzheimer's.
81. The Catholic University of Rome multicenter study found that drinking up to 2 bottles of wine per day for men and one for women correlated with higher scores on standardized testing of mental acuity and lower risk of Alzheimer's. (It must be pointed out that this level of consumption would have a range of detrimental effects in other categories, but it is a testament to the beneficial effects of wine on the brain nonetheless.)
82. The Bordeaux study, with perhaps the most dramatic findings of all, found that wine drinkers had an 80% lower risk of developing Alzheimer's disease in a population age 65 and older.

Wednesday, August 19, 2009

Winning the rat race with wine

78. How does wine help the brain? One answer might be the ingredient quercetin, which may help with spatial learning and memory. Researchers at Nanjing University in China reported that mice given quercetin did a much better job at remembering how to navigate a maze. It was attributed to activation of enzymes in a part of the brain called the hippocampus, one of the key areas for memory.

Tuesday, August 18, 2009

Is alcohol good for the brain?

77. Continuing our line of thought on wine and the brain, we turn to the question of alcohol's effects. Haven't we always assumed that alcohol kills brain cells, and so any positive aspects of drinking must be weighed against this? True, at high doses alcohol (as with anything for that matter) is toxic, but a recent review from Loyola University pointed to experimental evidence that moderate alcohol levels exert direct "neuroprotective" actions; that is, in addition to promoting healthy blood vessels that improve blood flow to the brain, the direct effects of alcohol on nerve cells are protective, at least in moderate amounts.
Add this to the list of healthy effects of alcohol in moderation where cardiovascular disease is concerned, and keep it in mind the next time you see an ad for some supplement touting "all the benefits of wine without the alcohol" because that is of course not possible.

Thursday, August 13, 2009

Are wine drinkers smarter?

76. Sure, wine drinkers may think they are smarter, but before you write it off as smugness, consider that there is actually a documented correlation between IQ and preference for wine. In the Netherlands, all young men are required to register for the draft, a process which includes an extensive battery of physical and mental tests. One well-known study cross-referenced the IQ results with beverage preference, finding a clear linear relationship with wine; the smarter you are, the more likely you are to be a wine drinker. The results held up when repeated at intervals several years later. So either wine makes you smart (which is possible based on effects of wine polyphenols in the brain) or smart people are attracted more to wine (a better explanation of the data from this study). Either way, it's a win-win.

Wednesday, August 12, 2009

Just sip it: #75 of 101 healthy reasons to drink wine

75. Many of the benefits of drinking wine have been attributed to resveratrol and the other polyphenols, and with good reason. The list of beneficial properties of resveratrol could probably fill our list of 101 reasons to drink wine by itself. And to judge by the number of companies marketing resveratrol supplements, you would think that drinking wine has become a quaint custom of a bygone age since it seems no longer necessary in order to reap the benefits. But not so fast! As I have pointed out, there is a lack of clinical studies confirming resveratrol's usefulness as an oral supplement, and one of the reasons may be that it is very poorly absorbed from the digestive tract. It is however taken up quite well through the lining of the mouth, so by sipping your wine, swirling it around to get the full flavor essence, you are actually getting more resveratrol in your system than by swallowing quickly. So those expensive pills are probably just making a more expensive end product of digestion, if you catch my drift.

Saturday, August 8, 2009

wine is a food

The new movie "Julia and Julia" which highlights the life of Julia Child, reminds me of what an incredible contribution to food and wine that she made. In an interview with the Wine Spectator, she once said "Life is too short to drink bad wine." She famously ended each of her cooking shows with a cheerful "bon appetit" taost holding a glass of wine, at a time when wine with meals was not part of the American lifestyle. In my book Age Gets Better with Wine I have a chapter called Wine is a Food, which I belive to be absolutely true. It is a healthful, nutritious part of a meal, and better for you that most of what passes for food these days. So item #74 in our list of 101 healthy reasons to drink wine: Wine is a Food.

Tuesday, August 4, 2009

the inflammation age

Over the past couple of decades, the importance of chronic inflammation as a mediator of aging has become clear. All those antioxidants we hear so much about are ultimately targeted at inflammation. One dramatic example is the case of cardiovascular disease, where the process of plaque buildup in arteries is now known to relate more to inflammatory processes than simple buildup of cholesterol sludge. So the role of wine as a potential means of controlling inflammation may provide an explanation for some of its anti-aging properties.
71. There are several "markers" of inflammation in the blood, one of the more useful being c-reactive protein. High levels of this correlate to an inflammatory state and premature aging. Diets high in flavonoids such as quercetin (in red wine) result in lower c-reactive protein levels.
72. Research out just this month demonstrates the potent anti-inflammatory capabilities of resveratrol. Scientists in Scotland gave a group of mice a potent inflammatory trigger, to mimic the effects of septic shock. A second group pre-treated with resveratrol had a much diminished response, by blocking the production of two molecules known to be particularly destructive.
73. A diet study from Chile found that adding wine produced a much greater effect at reducing inflammation than adding vegetables, though the two together was best.

Monday, August 3, 2009

wine and skin

I am just back from giving a lecture on wine and health at the meeting of the Society of Wine Educators, a convenient excuse to escape the record 103 degree heat in Seattle! So thoughts turn to fun in the sun. Conveniently, wine plays a role in skin health which I will enumerate as we continue through the list of 101 healthy reasons to drink wine:
69. A study from Australia, where skin cancer is a major issue, found that those who drink wine have a lower incidence of precancerous skin lesions called actinic keratoses (AK's). Only a half glass per day, on average, lowered the incidence by 27%.
70. Wine polyphenols have been put to good use in skin care. Several studies have documented that resveratrol and other wine compounds can reduce the damage caused by UV exposure, the major cause of premature aging of the skin.

Monday, July 27, 2009

wine and women

Someone famously once said "Who loves not wine, women and song remains a fool his whole life long." So in our count of 101 healthy reasons to drink wine, leading up to the release of the second edition of Age Gets Better with Wine, we turn our attention to wine and women.
66. According to a recent study from the University of Florence, Italy, women who drink wine have better sexual health than nondrinkers or mixed beverage drinkers. Using a study tool known as the Female Sexual Function Index, they studied more than 700 women from Tuscany. (Women consuming more than 2 glasses a day were excluded due to the possible confounding effect of alcohol on libido.) Women who drank wine had the highest overall scores on this comprehensive test of sexual health. No surprise there if you ask me, but these things have to be proven I suppose.
67. Postmenopausal women who have a high flavonoid intake (these are the polyphenol compounds from red wine and some vegetables) have a lower risk of cardiovascular disease. While this may seem obvious, given all that is known about heart health and wine, the problem had not been previously addressed specifically for postmenopausal women in much detail.
68. Some wine-derived compounds have estrogen-like properties. (Plant-derived chemicals with estrogenic effects are called phytoestrogens, a familiar one being soy.) The trick is to mimic the favorable actions of estrogen in post-menopausal women (lower osteoporosis, heart disease, healthier skin, etc) while minimizing the adverse effects (possible increased risk of breast cancer.) Such compounds are called selective estrogen receptor modulators, or SERMS. One recent study found that wine-derived phyoestrogens activated longevity genes. The fact that estrogens have this capability may explain why women live longer than men on average.

Monday, July 20, 2009

Is wine good for the liver?

65. While it is common knowledge that alcohol abuse leads to cirrhosis of the liver, this next item on our count up to 101 healthy reasons to drink wine reveals that in the right amounts wine is actually a good thing for liver health. A condition know as "Non-Alcoholic Fatty Liver Disease" or NAFLD is becoming more prevalent and is one of a spectrum of conditions that may lead to cirrhosis. Doctors used to assume that NAFLD patients were simply concealing their heavy drinking. It turns out that the incidence of NAFLD is lowest among wine drinkers, being equal in nondrinkers and spirits drinkers.

Tuesday, July 14, 2009

wine and diabetes

We resume the count up to 101 healthy reasons to drink wine, to launch the second edition of Age Gets Better with Wine due out August 17 from the Wine Appreciation Guild.
60. Resveratrol from wine has insulin-like effects, according to a study from Taiwan. In a study of diabetic lab rats, they found that resveratrol was effective at lowering blood sugar and fats such as triglycerides. Further, it delayed the onset of insulin resistance, a hallmark of type 2 diabetes.
61. Resveratrol slows memory loss associated with diabetes, at least in lab rats. The infamous maze test of memory was used, with better retention among the rats given resveratrol.
62. Another manifestation of diabetes is called peripheral neuropathy, in which the nerves lose function. This results in loss of sensation and other problems. Resveratrol appears to offer some protection against diabetic neuropathy, at least in a lab model. (Like the actions listed above, this has not been tested or proven in humans using resveratrol supplements.)
63. One of the most serious complications of diabetes is stiffening of the arteries, leading to imparied circulation. Resveratrol, in a lab experiment, helped maintain supple arteries in diabetic animal subjects.
64. Perhaps most serious of all the conditions related to diabetes is loss of contractile function of heart muscle cells. Of course the reason I bring this up is because, again in a lab animal model, resveratrol slows this weakening of the heart.

Sunday, July 12, 2009

Wine, Carole King, and a good cause

As many of you know, I am on the board for the Washington Wines Festival, which just concluded our annual fundtaising event for Camp Korey, the local affiliate of Paul Newman's Hole in the Wall Gang Camps for kids with serious medical issues. Without a doubt, the highlight was the Saturday evening concert by the gracious and unbelievably talented Carole King. Her 1971 album "Tapestry" was the best selling ablum by a solo artist until Michael Jackson's "Thriller." Great wines, wonderful food by top chefs, all for a meaningful cause. wine really does bring people together.

Wednesday, July 8, 2009

A nice figure: More reasons to drink red wine

57. To test the role of wine in weight control, researchers in Spain studied a group of lab rats on a high-fat, high-calorie diet. Half of the animals were given red wine in addition, which prevented weight gain over an 8-week period. In fact, they were similar to a control group on a normal diet. Cheers to that.
58. A study of men and women in Paris evaluated the role of alcohol and obesity. Wine drinkers were found to have a J-shaped curve, meaning that when consumed in moderation wine is associated with more normal weight. Got wine?
59. Back to Spain for a report on a weight loss diet called the "Spanish Ketogenic Mediterranean Diet." This was a non-calorically restricted regimen consisting of virgin olive oil as the principal source of fat, moderate red wine intake, green vegetables and salads as the main source of carbohydrates and fish as the main source of proteins. Participants acheived not only a significant reduction in weight but also improvement in their cholesterol and triglycerides.

Monday, July 6, 2009

Three more reasons to drink wine: counting down to 101.

54. Resveratrol from wine suppresses age-related decline in physical performance, at least in mice. Using a mouse prone to rapid aging, scientists have discovered that the loss of muscle mass and related diminishing of physical abilities can be countered by resveratrol and exercise. So yes you still need to exercise, but this fits neatly with other data regarding resveratrol and athletic performance.
55. Resveratrol at concentrations attainable through healthy wine drinking, increases the level of a blood vessel-relaxing molecule called NO (nitric oxide). This in turn helps lower blood pressure and prevent cardiovascular disease.
56. Resveratrol helps burn fat. We will get into the specifics of this later, but one of the more important findings about resveratrol is that it triggers the activation of prolongevity genes called sirtuins. These are normally turned on by caloric restriction, or near-starvation. One of the effects is release of fat from fat cells, which can also be acheived with resveratrol.

Monday, June 29, 2009

patriotic reasons to drink wine

In the spirit of Independence Day, we resume the countdown of 101 reasons to drink wine with an homage to the founding fathers.

50. Thomas Jefferson, who died at age 83 on July 4, 1826 (the 50th anniversary of the Declaration of Independence) likely owed his longevity in part to his lifelong habit of moderate wine consumption. The average life was about half of Jefferson's long and productive span in those times. And there was no greater fan of wine in America.
"Good wine is a necessity of life for me."
--Thomas Jefferson

51. Benjamin Franklin was another lover of wine and the good life. Among his many useful observations he noted "Wine makes daily living easier, less hurried, with fewer tensions and more tolerance." I say a penny saved is a penny you can spend on wine. But reflecting on the miracle of turning water into wine, Franklin says it best:
"But this conversion is, through the goodness of God, made every day before our eyes. Behold the rain which descends from heaven upon our vineyards, and which incorporates itself with the grapes, to be changed into wine; a constant proof that God loves us, and loves to see us happy."

52. Count John Adams among the founding enophiles. During a sea blockade that reulted in wine imports being curtailed, Adams wrote to his beloved Abigail from Philadephia:

"I would give three guineas for a barrel of your cyder. Not one drop of it to be had here for gold, and wine is not to be had under sixty-eight dollars per gallon, and that very bad ... In short, I am getting nothing that I can drink, and I believe I shall be sick from this cause alone. Rum is forty shillings a gallon, and bad water will never do in this hot climate in summer where acid liquors are necessary against infection." Adams died the same day as Jefferson, at age 90.

53. And not to be left out is George Washington. While not the enthusiast Jefferson was, he appreciated the importance of wine in daily living and health, and kept a well-stocked cellar. So this holiday raise a toast to the founding fathers.

Monday, June 22, 2009

Tax wine to pay for health care? Bad idea.

We are just about halfway through the countdown of 101 healthy reasons to drink wine, leading up to the publication of the second edition of Age Gets Better with Wine from the Wine Appreciation Guild August 17. So we pause to consider a topic of current importance, the debate in congress about health care reform and how to pay for it. One of the proposals being floated is the recurring theme of “sin taxes” which are erroneously interpreted as including wine along with all alcoholic beverages. The logic is that since alcohol contributes to health problems and is a discretionary expense, it should make a contribution to health care costs. This is exactly backwards.
Here’s why: Moderate drinkers (and that is most people), especially wine drinkers, actually have lower health care costs because they are healthier. You have seen a partial list of the many health benefits with this countdown, but the government’s own studies confirm it. A 2006 study of drinking habits in Medicare patients revealed that over a 5-year period, moderate wine drinkers (defined as those consuming 6-13 glasses of wine per week) had medical costs averaging about $2000 less than nondrinkers. (Reference available on request.) So by implication, health care expenditures across the board could be decreased substantially by a program of promoting wine drinking, not taxing it. How about a tax on high-fructose corn syrup instead?
"I think it is a great error to consider a heavy tax on wines as a tax on luxury. On the contrary, it is a tax on the health of our citizens."
-Thomas Jefferson

Tuesday, June 16, 2009

Age Gets Better with Wine: 5 more reasons

45. A study in rats, who were given either red wine or alcohol in the same percentage to drink over 6 weeks, found several changes in their fat cells compared to those drinking only water. Both the red wine and alcohol groups gained less weight than the nondrinkers despite equivalent overall calorie consumption. The wine drinkers had smaller fat cells, which is a good thing.
46. A wine-derived compound called quercetin improved liver and pancreas function in diabetic rats. Although resveratrol has received a lot of attention as an anti-diabetes therapy, this study showed how other wine polyphenols help too.
47. A form of quercetin called Q3 was tested for anti-flu viral activity and found to be more potent that oseltamivir (Tamiflu) according to a recent study from Korea. This provides further support to findings that wine drinkers have fewer colds and flu.
48. A study from Brazil evaluated the effect of wine polyphenols on a type of brain cancer called glioma. They found that resveratrol and quercetin together had a synergistic effect on inhibiting cancer cell growth.
49. And to further the idea that resveratrol isn't the only good thing in wine, another study looked at the effects of quercetin on the inflammatory effects of exercise on muscle. This is an important study because it is one of the few clinical studies reported. They found that quercetin supplementation reduced inflammatory markers after 3 days of intense exercise in trained cyclists.

Wednesday, June 10, 2009

4 more reasons: counting to 101

41. Researchers at McGill University in Montreal have found that moderate drinking releases endorphins, those molecules in the brain that make you feel good. Marathon runners get this sort of natural high by running "through the wall" but I'd prefer moderation in both my exercise routine and drinking. Heavy drinking cancels the effect.
42. Bone density. A number of studies point to a positive correlation between moderate drinking and preservation of bone density with aging. Although this seems to hold for all categories of drinking (beer vs. wine vs. spirits) to some degreee, the association is most positive for wine. This is especially true for postmenopausal women, who are at greater risk for osteoporosis.
43. A study from UCLA (my alma mater) found that moderate drinkers are at lower risk for disabilities of any type as they age, as compared to nondrinkers or heavy drinkers. This is another example of the J-shaped curve.
44. Why you should have red wine with meat: I love a good steak as much as the next guy, but there is the downside of not only saturated fats but harmful oxidants (free radicals). Recent research has shown that when red wine is consumed along with the red meat, the formation of these harmful substances is thwarted. Not that you would hoist a glass of chardonnay with your prime rib anyway.

Monday, June 8, 2009

alcohol helps prevent gallstones.

40. This one gets a post by itself because it is hot off the press: Alcohol helps prevent gallstones. This is another reason why the benefits of drinking, especially red wine, can't be put into a pill "with all the benefits of wine without the alcohol." Gallstones can lead to abdominal pain, surgery, even pancreatitis, which believe me you don't want. Just remember moderation is the key as always.

Monday, June 1, 2009

More healthy reasons to drink red wine ; counting to 101

Arthritis is an category that has some particularly interesting responses to wine drinking. As we continue to count up to 101 reasons to drink red wine, we start with:
37. Gout. This one surprised even me, since it has long been standard advice for gout victims to avoid rich foods and drinks. But a review from the School of Medicine at the University of California, San Diego found that wine drinkers actually have a lower incidence of gouty arthritis.
38. The inflammatory actions of arthritis are largely mediated through a chemical called Tumor Necrosis Factor. Resveratrol from wine is a potent neutralizer of TNF.
39. In two large Scandinavian studies, alcohol consumption coorelated with a decreasing risk for rheumatiod arthritis, as much as 40% lower in the heaviest drinkers.

Friday, May 29, 2009

four more smart reasons to drink wine

33. Wine polyphenols appear to have some benefit in treating and possible preventing the onset of Parkinson's disease, a progressive neurological disorder. although resveratrol has been extensively studied in this regard, the most recent paper found benefits from a combination of resveratrol and quercetin.
34. Another neurological disorder call Huntington's chorea may also respond to resveratrol according to some laboratory studies.
35. Cells in the memory center of the brain, called the hippocampus, are sensitive to the detrimental effects of alcohol. However, wine polyphenols are protective, canceling out the bad effects. All the more reason to choose wine if you drink.
36. Enzymes called "AMP kinases" which are active in the memory and leaqrning centers of the brain are stimulated by resveratrol.

Friday, May 22, 2009

A sigh of relief: Wine and lung health

The next three items in the list of 101 healthy reasons to drink wine involve the lungs.
30. Several studies have found specific activity of red wine polyphenols against lung cancers of different types. Of course there are other important things such as not smoking that you can do to reduce risk.
31. Chronic Obstructive Pulmonary Disease (COPD) is marked by inflammation of the lungs in addition to other problems. Wine's potent polyphenol antioxidants are being investigated as therapeutic agants for COPD and indications are that it could be very helpful. One specific way they work is by preventing the release of the chemical mediators of inflammation called cytokines.
32. Cytomegalovirus (CMV) is a common cause of respiratory infections. Wine polyphenols have been shown to interrupt the process by which the virus enters lung cells, and so could thereby help prevent CMV infections.

Thursday, May 21, 2009

Two more healthy reasons to drink wine

These next two items deal with kidney health, an unglamorous but important topic. If your kidneys aren't happy, you won't be either.
28. Several studies have analyzed the relationship of drinking to risk of kidney (renal) cancer. A pooled analysis indicates that wine drinking offers a measurable benefit in reducing the risk.
29. Diabetes causes a disease of the kidneys called diabetic nephropathy. Wine drinking and diets high in polyphenols (the antioxidants from wine and berries) are associated with a slowing of disease progression in diabetics.

Tuesday, May 19, 2009

The eyes have it: 3 more reasons

For this next section, I was reviewing the effects of wine on the eye. One of the groups working on these issues is from the “Department of Wine, Food and Molecular Biosciences” at Lincoln University in New Zealand. The fact that such a department exists seems reason enough to celebrate! Here are my insights on wine and vision:
25. A group from Tufts University evaluated the relationship of drinking patterns to development of cataracts. They found that the risk of cataracts was increased with alcohol consumption generally, but decreased by 12% for every two glasses of wine consumed per week.
26. Early experimental evidence points to a possible role of wine polyphenols and other antioxidants in the treatment and prevention of glaucoma.

27. A 2006 study found a possible protective effect of wine consumption and age-related macular degeneration, one of the most onerous causes of visual impairment. The study found increased risk with alcohol consumption in the form of beer or spirits, but a protective effect with wine consumption. A separate study identified resveratrol as a likely mediator of this benefit by reducing oxidative stress in the retina.

Friday, May 8, 2009

13-24 of the 101 reasons to drink wine: Anti-cancer properties

13. In order to understand how wine helps prevent cancer, we look at what happens inside of a cell as it takes the first steps toward becoming a cancer and converts from a healthy, productive cell to one out of control. Cancer researchers define three steps in this process, the first of which is called initiation. This includes the mutations in DNA that disrupt the cell's programming. Wine polyphenols protect against these mutations.
14. Carcinogens do their damage by causing mutations. Most of them need to be activated, that is they are converted from a less harmful state by enzymes that normally serve more noble purposes. Wine compounds help prevent carcinogen activation.
15. The second phase of a cell's journey to the dark side is called promotion. These are all of the things that encourage the cell to follow its baser instincts. One of these factors is the enzyme COX-2, which is inhibited by wine-derived compounds.
16. Another aspect of promotion is the ability to bypass a cell's auto-distruct mechanism. Cells typically know when they are to shut down, a process called apoptosis. (For example, the dead skin cells that form a surface barrier have undergone apoptosis, while new ones are continually being made underneath.) Wine compounds have been shown to activate apoptosis pathways in cancer cells.
17. One of the ways that cells know whether or not their time is up is by the presence of anti-apoptotic proteins. Wine helps ramp down levels of these molecules, so that cancer cells lack the necessary encouragement to keep going.
18. A similar process is what are called "activation pathways" which are molecular signals that spur a cell to keep growing and reproducing. Cancer cells have turned up these activation pathways, while wine polyphenols have been shown to counter the effect.
19. After promotion comes progression. This is where things really start getting out of control and the cancer becomes invasive. Growth factor molecules within and between the cells encourage this sort of behavior. Wine polyphenols appear to have the opposite effect.
20. Cancer cells have to develop specific skills in order to invade adjacent tissues. Wine polyphenols have been found to have their own skill set to protect against this.
21. Cancer cells of course have to grow in addition to all of their other misbehaviors. Wine polyphenols have been found in laboratory studies to directly suppress cancer cell growth. Clinical trials are underway to evaluate their role in cancer treatment.
22. As the tumor enlarges, it needs a growing blood supply which in turn requires that new blood vessels form. Certain specific signals facilitate this process (called angiogenesis). Wine polyphenols inhibit the growth of new blood vessels in tumors.
23. Wine polyphenols have some interesting possibilities in treating established cancers. Certain chemotherapy drugs appear to be more effective and with fewer side effects when given with wine polyphenols. This is another area of clinical research.
24. Radiation therapy is another mixed blesssing for cancer patients. The effects on the normal tissues around a tumor can be problematic. Resveratrol, from wine, may have the ability to both enhace the effectiveness of radiation treatments while ameliorating the side-effects.

Thursday, April 30, 2009

reaons 10-12 to drink wine

10. According to a new study from the University of Wageningen in the Netherlands, drinking wine adds 5 years to your life. You gain about half that by drinking beer in moderation.
11. Drinking with friends lowers your risk of stroke, according to a study from Japan. Wine tends to encourage social drinking, so now you have even more reason to share.
12.Wine polyphenols are effective anti-viral agents. One study showed that mice given a fatal innoculum of the influenza virus all survived if they were given resveratrol.

Monday, April 27, 2009

7-9 of 101 healthy reasons to drink wine

7. Wine polyphenols discourage the formation of a hormone-like substance called endothelin-1, which is associated with the develoment of cholesterol plaques in arteries. One of the many ways in which wine is heart-healthy.
8. Wine substances encourage the development of molecules called "heat shock" proteins which protect the heart and other muscles from the deleterious effects of oxygen starvation.
9. Wine -derived molecules bind LDL, the bad cholesterol.

Thursday, April 23, 2009

reasons 4-6

(continuing the series 101 healthy reasons to drink wine)
4. You are less likely to have a heart attack with regular moderate drinking. Studies reviewing hospital admissions for heart attack reveal that it is less likely if you have had a drink within the previous 24 hours.
5. You are less likely to have a second heart attack if you adopt a habit of moderate wine drinking.
6. Heart attacks when they do occur are less severe in wine drinkers.

Tuesday, April 21, 2009

101 healthy reasons to drink wine

It's official, the second edition of Age Gets Better With Wine is in production and is scheduled for release in July, under the Wine Appreciation Guild label. So I am counting down with 101 healthy reasons to drink wine, in no particular order.
1. In the right amounts, alcohol lowers LDL ("bad" cholesterol) and raises HDL ("good" cholesterol). This effect does not require that the alcohol come from wine, though it is more likely that the drinking pattern will be a healthy one if it is.
2. Alcohol raises levels of heart-healthy omega-3 fatty acids. This is a relatively recent discovery but potentially very important. Have some wild (not farmed) salmon with a glass or two of pinot noir and you are on your way.
3. Wine drinkers have lower health care costs. This may seem obvious to those who have an interest in the science of healthy drinking, but it has been documented in a study by Medicare. In a review of health care costs related to drinking, they found that those drinking 6-13 glasses of wine per week had annual expenses about $2000 less than nondrinkers.

Tuesday, April 7, 2009

Whole wine polyphenols better than resveratrol against cancer

With all the hype about resveratrol (for which I am at least partly responsible, I admit) you would think the anti-cancer properties have been pretty well spelled out. There is in fact a long list of resveratrol's anti-cancer activities, at least based on lab studies. But when we look for clinical studies on resveratrol to support the increasingly widespread use of supplements, evidence is lacking. The evidence that red wine drinkers enjoy lower cancer rates, on the other hand, seems reasonably clear at least for some types of cancer. How can it be that drinking wine is better than taking supplements of its miracle molecule resveratrol?

A couple of studies from the medical school at the University of San Juan, Puerto Rico, shed some light on this. They decided to test the anti-cancer capabilities of a combination of the polyphenols from red wine, in concentrations equivalent to what is achieved by healthy drinking, against higher concentrations of resveratrol. The study used breast cancer cells in culture, along with a variant of the type that metastasizes to bone. Incredibly, the combination was far more effective, suggesting that the natural wine compounds working together, that is the key.

Ther are a number of explanations for this. One would be that there is a natural synergy between the chemicals that is not completely understood but seems to amplify the effect. Another is that these antioxidant molecules, for all their potency, may break down when they are extracted out of their natural context in wine. If you ask me, it is the theory that supplements are somehow better than whole foods (this includes wine) that breaks down under scrutiny. So while resveratrol as a pharmacologically stabilized compound administered under standardized conditions may well prove to be the next breakthrough in cancer prevention and treatment, that is not the same as popping pills from the health food store.

Tuesday, March 31, 2009

Should wine labels make health claims?

Winemakers have been in a debate for some years now with the U.S. Department of Treasury's Alcohol, Tax and Trade Bureau (formerly the ATF, for Alcohol, Tobacco, and Firearms--yeah, that made a lot of sense) about ingredient listing for wines, particularly since the healthful properties of wine polyphenols such as resveratrol have been widely publicised. A couple of years back, an Oregon pinot noir producer gained approval for a fairly benign claim: "Pinot noir develops a natural defense against botrytis (mold) in our moist, cool climate - the antioxidant resveratrol." Since resveratrol is indeed produced in the skins of grapes subjected to certain environmental stresses such as mold, and Oregon's climate is certifiably moist, it seems a fairly harmless claim. However, the feds simultaneously disallowed placing the same wording on another vintage from the same producer, citing concern about making therapeutic claims on labels or creating "misleading" associations between the consumption of alcohol and health.
With more than 2500 scientific publications on the healthful effects of resveratrol, it may seem that the ATTB has some catching up to do. Wine is demostrably a health food when consumed in the right amounts and in the right pattern. But the problem that I have with expanded labeling is that it gives too much credit to the individual ingredients and not enough emphasis on healthy drinking and associated lifestyle choices. For all of resveratrol's impressive properties, clinical data about its effects in people is still lacking. We know that it does wonderful things in a petri dish or a lab rat, but frankly not much else.
So rather than making claims about how magical the components of wine are, the debate really should be about whether or not wine itself is good for you. How about this on the label: "When consumed in moderation, with meals, wine can be an important part of a healthy lifestyle."

Monday, March 23, 2009

drink with a friend

When I was growing up in California, there were periodic droughts that resulted in mandates to cut down on water use, and one of my favorite pieces of advice was to shower with one or more friends. Now it turns out that drinking with friends has measurable health benefits. It seems obvious that drinking alone is not necessarily a good thing, but a new study from Japan provides actual data that social drinking--in moderation--is healthful. (Whether it also leads to communal bathing remains a personal choice.)
The data comes from a large prospective public health study in Japan involving more than 19,000 subjects evaluated for the incidence of stroke and heart disease relative to drinking habits. As one would expect, light-to-moderate drinkers had fewer episodes (this has been reported in studies too numerous to list) and heavy drinkers had more. In epidemiology this is known as a J-shaped curve, about which more in my book. What was unique about this study was the use of a measure called the "social support score" which looks at patterns of social behavior. When this was applied as a filter (a tool known as stratification) the risk of stroke was significantly lower among social drinkers.
There are a number of ways this can be interpreted. The most likely one is that it is simply a "marker" for healthy behaviors and a healthful drinking habit. But from an anti-aging point of view, it is an important finding, as it reinforces the well-known phenomenon of people living longer when they are connected and engaged in their communities. This study provides a link between the two.
I say cheers to that. Join me for a glass of wine?

Tuesday, March 10, 2009

red, white, and breast cancer

The red vs white debate is enough to make me blue. Red wine, with very few exceptions, has much higher levels of the polyphenols to which many but not all of wine's benefits are attributed. In recent weeks, reports came out that it didn't matter whether it was even wine or any other alcoholic drink, breast cancer risk was apparently raised by as little as a glass a day. As I have pointed out in previous posts, there are too many problems with the way the data for these studies is gathered to say anything that definitive, but now a study from the Fred Hutchinson Cancer Research Center here in Seattle weighs in with the red vs white wine question. They were particularly interested because earlier studies from the Hutch (as we call it here) found that red wine drinking correlated to lowered odds of prostate cancer in men, and a large body of research suggests that wine polyphenols are effective at countering breast cancer.

The study, funded by the National Cancer Institute, was looking for reduced risk of breast cancer with red wine. What they found was that more than 14 drinks per week correlated to an increase of 24% in breast cancer incidence, regardless of type. The authors were careful it appears to not make the mistake that many others do in interpreting the data, however, which is to extrapolate backwards from 2 drinks per day equalling 24% risk to 1 drink implying a 10-12% risk. The reason it is a mistake is that there is no way of measuring self-reported behavioral data that accurately so the effects of a drink a day are essentially unknowable. This is especially true because there are so many other studies showing that moderate drinking is beneficial, in terms of cancer risk and many other health factors. And of course there are few people who really only drink one type of alcoholic beverage and in the same amounts every day.

The authors did recommend that women should limit drinking to one per day, which is probably sensible especially if you are in a higher than average cancer risk category. I'm still in the red wine camp, at least where healthy drinking is concerned.

Friday, March 6, 2009

Wine lowers risk of esophageal cancer

Last week the news was that wine is supposedly equal to any other type of alcoholic beverage in encouraging the development of cancer, particularly of the digestive tract, even when consumed in moderate amounts. This week it is the opposite, at least in terms of one especially nasty type of cancer involving the esophagus. Wine drinkers, it turns out, have a lower risk because they tend not to get as much reflux of stomach acid up into the lower esophagus, which causes inflammation. This condition is called Barrett's esophagus and is not only miserable but potentially deadly because it predisposes to cancer.
It reminds me of my days as a general surgery resident, when one of the most common conditions leading to surgery was stomach ulcers. (They are prone to bleeding and numerous other unfortunate consequences.) Standard advice regarding ulcers was to avoid spicy foods and alcohol, in the belief that these encouraged the stomach to produce more acid. It was some years later that we learned that the culprit in most cases was a type of bacteria, which as luck would have it is inactivated by wine polyphenols. So ironically we should have been encouraging these patients to have wine with dinner, contrary to all prevailing logic.
The real point here is that studies of this type, called population studies, require a healthy degree of skepticism in order to derive anything useful. For one thing, they rely on self-reporting of drinking habits, which is notoriously unreliable; for another, there are few populations with consistent drinking patterns anymore. The best information actually comes from studies done years ago when such populations did exist, for example in rural France. These studies consistently find health benefits to regular moderate consumption of wine. The final lesson here is that regular moderate wine drinking is linked to other healthy behaviors, so that it can't be reduced to a chemical formula and put into a pill. So when you see the ads for the newest supplement touting "all the benfits of wine without the alcohol" you know it just ain't so.

Tuesday, February 24, 2009

French study says wine causes cancer

Just when we thought the issue was settled, a new large scale study from France's National Cancer Institute finds that even small amounts of regular drinking can increase the risk of cancer. In fact, even as little as one glass of wine per day supposedly ups the odds of cancers of the throat all the way through to the colon and rectum. Problem is, this study is so out of phase with everything we have been hearing about wine and health that it ends up confusing the issue rather than helping. Here's what I think:
The first key to putting this in context is to remember that cancer isn't the whole story with wine and health. Benefits in lowered cardiovascular disease risk, Alzheimer's, diabetes, osteoporosis, and many others would vastly outweight the increased cancer risk even if it did exist. Secondly, no single study provides the definitive answer; in order for it to be meaningful, it has to be independently confirmed by other studies. This one is inconsistent with nearly every previous study of its type, notably statistics from the American National Cancer Institute. Cancers of the type referenced in the French study are known to have a high association with smoking, and a very large percentage of French drinkers also smoke, so it is impossible to tease out the statistical risk attributable to wine drinking alone with any accuracy.
There was a similar hubbub about a year ago when a large study from Kaiser-Permanente found that even modest consumption of wine increased breast cancer risk. Less noticed was a study from Japan published the same month finding exactly the opposite. I cover the reasons behind this in the next edition of Age Gets Better with Wine.

Monday, February 16, 2009

Are vitamins bad for you?

One of the hardest notions to shake is that taking antioxidant vitamins (A, C, and E) will reduce the chances of developing what we call "degenerative" diseases: things like cancer, heart disease, and Alzheimer's. We all know that antioxidants are good for us, because the oxidation theory of aging--free radical molecules wreaking havoc on our DNA--is so well accepted. But studies keep throwing cold water on the idea that vitamins are the key. The latest is a study from the Fred Hutchinson cancer center here in Seattle, out this past weekend. This study, called VITAL (VITamins And Lifestyle) looked at not just the traditional vitamin supplements but also lutein and lycopene. Across most categories, cancer risk was actually higher in those using supplements. This is consistent with many previous studies but somehow vitamin sales seem to be unaffected.
So what does this have to do with wine? Recall the whole wine and health story started with the identification of what we now know as the Mediterranean Diet, which includes healthy servings of fruits and vegetables. Initially it was believed that the antioxidant vitamins in the diet were the key to its relationship to lower risk of degenerative diseases, but the studies conducted to confirm this found no benefit to vitamin supplements. Only then did attention turn to the role of daily, moderate wine consumption. When this variable was independently studied, the health benefits of wine began to be appreciated. We now know that the antioxidants in wine (such as resveratrol) are much more potent, but we also know that they aren't the whole story. So spend your money on a bottle of good red wine instead of a bottle of vitamins.

Friday, January 30, 2009

resveratrol and breast cancer

Researchers have been wrestling with the question of the relationship between drinking and breast cancer for years, and the issue remains far from settled. It is a huge topic and so I plan to post on it from time to time, but today I am interested in the role of resveratrol and cancer. Several recent studies have identified unique ways that resveratrol might be important in both prevention and treatment of breast and other types of cancer. One study in particular, from the University of Nebraska this past summer, helped shed some light on the subject.

It is known that estrogen increases the risk of breast cancer, which is one of the reasons why post-menopausal hormone replacement therapy (HRT) is so problematic. What makes it more complicated still is that it isn't the estrogen itself, but one of the compounds formed when it is metabolized (broken down) that is responsible for initiating the cancerous changes in breast cells. Estrogen is metabolized by certain enzymes, of which there are two types; one converts estrogen into harmful carcinogens, while the other pathway leads to harmless compounds. These researchers found that resveratrol actually interacts with the cells' DNA to direct the processing of estrogen down the right path by producing the "good" enzymes. Of course this oversimplifies it a bit, but the importance of the study is explaining this capability of resveratrol to actually direct the function of cells by interacting with the "operating system" to keep them on the straight and narrow. There are at least a dozen other anti-cancer properties of resveratrol, and several clinical trials are underway.
So while the question of healthy drinking andbreast cancer remains a source of consternation for many, I would suggest that red wine should at least be the beverage of choice for women who are concerned about breast cancer risk.

Monday, January 26, 2009

60 Minutes and Resveratrol

We have to give credit to CBS TV's "60 Minutes" for breaking open the wine and health story 17 years ago with their segment on the French paradox. On January 25 2009 (last night as I write this) they aired a long overdue update on resveratrol, the polyphenol extract from red wine to which so many of the health properties are attributed. Of course, I covered all this in some detail in the first edition of Age Gets Better with Wine, and in the second edition which will be coming out this year there is a chapter devoted to resveratrol. But my readers will also appreciate that the resveratrol story is a bit more nuanced than you might assume from a short television segment. True, it seems to improve exercise tolerance, improve cholesterol levels, prevent and treat diabetes and cancer, prevent the brain changes associated with Alzheimer's, and trigger the genes that extend lifespan, at least in mice. But what of the effects in humans? Largely unknown. Let me repeat that: the effects of resveratrol supplementation in humans are still largely unknown. The biotech company Sirtris, which was acquired by GlaxoSmith Kline last year for more than $700 million, is developing synthetic molecules based on resveratrol, but hundreds of times more potent.

Thursday, January 22, 2009

the days of wine and chocolate

It's no secret that dark chocolate is good for you. What many people don't realize is that the healthy compounds are the same things (polyphenols) that are in red wine. That is why they naturally complement each other. But many of these molecules have a somewhat bitter flavor, so cocoa processing actually removes them, especially for milk chocolate products. And going dark isn't necessarily the answer, it has to be chocolate specially processed to preserve the good parts without sacrificing taste. Check out Theo Chocolates from Seattle. And if you really care about your valentine, get the good stuff!

Thursday, January 15, 2009

Is resveratrol the answer?

It is hard to aviod hearing the hype about resveratrol, the polyphenol from wine to which so many of its healthful properties attribute. The body of research is indeed truly impressive: anti-cancer, anti-diabetes, a whole range of anti-aging activities have been identified in laboratory studies. One company, Sirtris, derived compounds from reseveratrol that had such interesting capabilities that they were acquired by GlaxoSmith Kline in 2008 for more than $700 million. Resveratrol supplements are available widely over the internet and most grocery stores, and now we hear about a genetically engineered beer with resveratrol!
There are two problems with the assumption that resveratrol is the key to wine's health benefits. First, there are a number of other compounds in wine, such as quercetin, that also have interesting data to support theri potential importance, and it may be that it is the interactions of all of the various things in wine that really makes it work. Secondly and most important though is that to date there are no published studies of resveratrol supplementation in human subjects! From a strictly scientific point of view, the effects are unkown. It is all still extrapolation from mice and cell cultures in petri dishes, at least so far. What we do know is that wine drinkers (not grape juice drinkers) are healthier and live longer, and resveratrol may be only a small part of the story.