Saturday, February 27, 2010

Is wine a health food?

I often joke that wine is a health food, but it actually is when looked at objectively. Of course in order to be a health food, it must be a food, which would in turn require that there be some nutritional value. The calories in dry wines are from alcohol, which is processed by the body in a different way than other carbohydrates, such that it tends not to cause a spike in blood sugar levels. So right away it has benefits over other calorie sources, since these blood sugar variations are believed to contribute to weight gain. Wine drinkers tend to have less of an issue with being overweight, so perhaps this is one of the reasons.

We all know, or have been told often enough to believe, that alcohol is detrimental and that such adverse effects more than counteract any potential benefits. But interestingly, our bodies come equipped with an enzyme called alcohol dehydrogenase, which does nothing but metabolize alcohol. The ability to consume alcohol is programmed in our DNA, so if we aren’t meant to then it is quite a mystery.

So what of the other elements in wine? One thing that recurs in research on wine’s health benefits is the importance of consuming it with meals. There are several explanations for this, such as the fact that the antioxidants in red wine blunt the effects of oxidizers in food, especially such offenders as red meat. Wine actually makes the other foods in the meal healthier. Another reason is that wine with food slows the absorption of alcohol, thereby reinforcing the whole concept of wine as food rather than alcohol consumption as a drug. People who drink in this way have a range of other healthy habits that all mutually reinforce their respective benefits. For this reason, the healthy Mediterranean diet, so prominently featuring daily wine consumption, is best viewed as a lifestyle, a way of living, rather than a menu of prescribed foods.

One could almost make a case for red wine as a vitamin.

Thursday, February 18, 2010

Should your doctor prescribe wine? Answer to NY Times piece

The New York Times online has a Q&A feature which today addressed the question of "prescribing" wine. Dr. Mark Willenbring of the National Institute on Alcohol Abuse and Alcoholism addresses the question. (His answer and my comments here: The good doctor does allow that it might be helpful in very limited amounts for some people, but dismisses the data as "correlational." In other words, finding a correlation between moderate drinking and health is insufficient to draw conclusions. I agree, but there is so much more than correlational data to draw on. In my book Age Gets Better with Wine I use what I call the skeptic's checklist for that very reason; we need plausible cause-and-effect explanations and evidence to support those explanations. I will leave you to read about it in the book, which is extensively referenced with peer-reviewed scientific and medical literature. Wine is not only safe in moderation for those without susceptibility for alcohol abuse, it is a powerful health food.

Monday, February 15, 2010

A modern view of moderation

We hear so much about wine being healthy in moderation. Then there is the popular (and cynical) saying, “all things in moderation, including moderation.” If you are drinking wine for your health, and who doesn’t, it is actually quite important to define the term “moderation” if we are to get the maximum benefit. If you drink for purely aesthetic reasons, or anesthetic reasons for that matter, then you have other considerations to deal with. But here’s the deal on moderation:
Studies on wine drinking and health in populations often use weekly alcohol consumption as a convenient measure. From data like that we get the familiar J-shaped curve, showing that maximum health benefits are associated with about 2-3 glasses of wine a day for men and half that for women, and disease risk about equal to that of nondrinkers at about double that level of consumption (the bottom loop of the “J”.) But we also know that binge drinking is particularly bad, so the pattern of daily drinking is critical. You can’t do all your drinking on the weekend and expect any health benefit, despite the inconveniences that can occur during a busy workweek.
Integrating your wine consumption with meals seems to be important as well. This slows the absorption of alcohol, but also provides antioxidant capacity to counteract many of the harmful compounds that are found in the modern diet. There have been some interesting clinical studies on this point and it seems to have scientific validity. Perhaps just as important is that drinking with meals sets an example of wine as food rather than alcohol as a drug, reinforcing the concept of healthy drinking.
So how big are these glasses of wine? I know what you are thinking, if I have to limit myself to only 2 glasses, I’ll just get bigger glasses. But for purposes of research, a drink has to be defined so for wine it is a 5-oz. pour. Unfortunately, that makes a standard 750 ml bottle a bit much for a man and a woman to split. On the other hand, the half-bottles (375) don’t really fill the bill either; any winemakers out there want to do a 500 ml bottle?

Monday, February 8, 2010

Wine and Chocolate: a not-so-silly Valentine

Silly me, I thought I could write up a simple blog post about the health effects of wine and chocolate, just in time for Valentine’s Day. So I go online to search the recent medical literature on the health effects on cocoa, and find that there are now more than 2000 articles on the subject. Needless to say, my comments here are based on a selected list. (You should know by now that wine and chocolate contain many of the same antioxidant molecules that have proven to be so beneficial, and that it has to be in the form of dark chocolate. There are a lot of studies now on how cocoa polyphenols lower blood pressure and help keep arteries clean, and the latest ones provide confirmation of the earlier reports.)

One article out just last month caught my eye. It turns out that simply smelling dark chocolate can provide a sense of satisfaction. The researchers proved this by comparing blood levels of insulin and the satiety hormone ghrelin in volunteers who either ate or just smelled dark chocolate, and both had a similar response. It reminds me of how enticing the “bouquet” of a great wine can be; sometimes I just want to enjoy that for a while before drinking it. Of course we already knew that wine and chocolate make for a sensory experience but it’s good to know that science is on the job here.

We also know that chocolate helps put one in the mood, so to speak, but now we have confirmation from a different study that cocoa not only makes us smarter but improves mood in scientifically verifiable ways. Using standardized assessments and cognitive performance testing, researchers documented significant improvements following ingestion of dark chocolate, along with measures of mood. Similar results have been found for red wine polyphenols, so it makes sense.

This last item is a bit more obscure, but I had to include it because I love the terminology used to describe the category of things like chocolate: “hedonic foods.” I’m not sure having a glass of wine or a piece of chocolate fully qualifies as hedonism, but they definitely give pleasure so we’ll accept the term. Researchers from the Department of Neurobiology at the University of Chicago observed that animals experiencing pain react often by eating rather than avoidance, a phenomenon called “ingestion analgesia.” Through a series of experiments on rats they were able to show that the behavior is controlled at the level of the brain stem, meaning that it is a primitive reflex not subject to motivation, and powerful enough to overcome strong incentives to not eat. Major implications for obesity and eating disorders here.

All I know is that wine and chocolate are health foods of the first order, regardless of whatever part of my brain is telling me so, and I am not about to try and get by with a sniff  instead of a sip.

Monday, February 1, 2010

No Sir thing with wine-derived drugs

Pharmaceutical giant Glaxo made headlines two years ago with their purchase of biomedical startup Sirtris for $720 million, following reports that Sirtris was making progress with resveratrol-based compounds that might extend lifespan. But doubts are now being cast on the question of whether wine-derived molecules even work for anti-aging the way that scientists at Sirtris believe. It’s an important story for consumers as well as investors, given that use of resveratrol supplements continues to rise. (Consumer Lab reports that resveratrol use by consumers surged some 66% last year.)

If you have been following the wine and health story, you know why resveratrol is such an exciting compound. It has impressive anti-cancer properties (in lab studies), fights heart disease (again, not clinically proven), diabetes (if you happen to be a lab rat), and the list goes on. What is really interesting is that it appears to activate enzymes called sirtuins (the corresponding genes are called Sir1-7), which trigger a metabolic change that prolongs the lifespan of laboratory organisms such as yeast and fruitflies. If the effect could be replicated in humans, we could perhaps expect to live well into our 150’s.

The problem is, it might not work that way, either in humans or primitive organisms. Concerns about an artifact of the testing method that leads to false-positive results have been expressed by skeptics such as Matt Kaeberlein here in Seattle (at the University of Washington), and now studies from Glaxo’s rivals cast further doubts. Amgen published a report this past fall provocatively titled “Resveratrol is not a direct activator of SIRT1 activity.” Pfizer has weighed in with a similar sentiment. So given the lack of clinical data supporting the use of resveratrol supplements, it is fair to say that a lot of work remains to be done.

It’s pretty complicated stuff, but there are some simple truths in which we can take comfort. One is that wine drinkers outlive teetotalers, enjoy better health, and have a higher quality of life according to published studies. The sentiment was aptly expressed in one of the iconic wine & health studies published in 1979. In considering the possibility that wine’s benefits might be attributable to some as-yet unidentified compound, the authors observed that “The medicine is already in a highly palatable form.” (St. Leger, Cochrane, and Moore)