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Is it all lifestyle or is wine the key to health? New studies considered.

Much has been made of the recent report from a 20-year study from Harvard that apparently found that it is the lifestyle choices made by wine drinkers, not the wine itself, that is responsible for longer and healthier lives. Following more than 800 people over the age of 55, the researchers found that it was the pattern of moderate drinking and associated lifestyle factors that most closely correlated to health and longevity. Taken at face value, this study would appear to turn the French paradox on its head. But wasn’t the French paradox defined by heart health despite the unhealthy habits of the French? If that is so, then the findings from the Harvard researchers need to be reconsidered in a new light. On the one hand, it is widely known that aside from the French with their Galoises and penchant for fois gras, wine drinkers do tend to have healthier habits; we are better educated, we exercise more, and eat better. On the other hand, the French paradox – which is supported by sub

The biggest myths about wine and health

Just when it seems that people are starting to catch on about the wine and health story, along come the naysayers to muddy the waters with out of date and disproven assumptions. True, a lot of what I am about to cover here is counterintuitive and goes against longstanding beliefs, but it’s a matter of science. Like Lt. Joe Friday used to say in the 50’s TV series Dragnet, it’s “just the facts, ma’am.” Myth #1.   Alcohol abuse is the biggest cause of liver disease. We all know that alcohol leads to cirrhosis of the liver right? It turns out that by far the largest cause of liver failure in developed countries is Non-Alcoholic Fatty Liver Disease, or NAFLD . What’s more – and here’s the interesting part – wine seems to have a protective effect against NAFLD. The key here if course is amount, so as with all things wine and health, we are talking about a glass or two of red wine with dinner. Myth #2. Alcohol destroys brain cells. While technically it may be true that alcohol is toxic to

Wine and friendship in Spain - a healthy experience

Is there anything more beautiful in life than the joys of breaking bread and sharing wine and food around the table with friends? As I have written here before, there is some scientific evidence of the health benefits of wine with food and companionship, and it helps to explain why wine’s anti-aging properties can’t be reduced to biochemistry and put into a pill. So with that in mind, let me express thanks to some new friends in Spain from my visit to Madrid and the Ribera del Duero. Rebeca Colina Giralda gave us a wonderful tour of the Abadia Retuerta vineyards and a tasting of their magnificent wines. The juxtaposition of modern winemaking in a thoughtfully restored centuries-old abbey was an inspiring experience, and the wines are wonderful. Running into Rebeca at a tapas bar in Valladolid the next day was like seeing an old friend! But few have done more to advance winemaking in the Ribera than Alejandro Fernandez, founder of the Tinto Pesquera group. We had the great pleasure

Why the new study on alcohol and breast cancer got it wrong - again

Big news! The latest study on the association between alcohol and breast cancer found what all the numerous prior studies using the same methods found: even small amounts of consumption increase the risk, regardless of the type of alcoholic beverage, even red wine. But as I point out in my book Age Gets Better with Wine , they are simply repeating the same mistakes and failing to see the big picture. Here’s why: Self-reporting bias . Studies such as this, which seem to derive power from their large numbers, only magnify the errors if the data isn’t reliable. The nurses in this study were asked to fill out questionnaires on their drinking habits and other lifestyle factors every 6 months. It is widely acknowledged that this retrospective self-reporting is highly unreliable. So having a hundred thousand or even a million participants doesn’t yield stronger data, it just magnifies the error. Statisticians are of course aware of this and attempt to make adjustments according to known beh

New information on resveratrol’s breast cancer fighting properties

There is hardly a stickier subject than alcohol consumption and breast cancer, except perhaps the wildly exaggerated claims for resveratrol supplements. A new study helps to clarify the picture by looking at resveratrol’s interaction with estrogen receptors on breast cancer cells, though we still have a ways to go before resveratrol can be recommended for duty in the breast cancer battle. Some historical context will help put things into perspective. Most studies have concluded that breast cancer risk is increased by alcohol consumption, though the effect at moderate drinking levels is a very difficult thing to measure. On the other hand, it is well-documented that moderate regular consumption of wine is associated with longer life and lower rates of diseases such as cancer, diabetes, atherosclerosis, and Alzheimer’s. Though red wine contains a number of antioxidant molecules, resveratrol has emerged as one of the more interesting ones despite that fact that wine doesn’t actually h

Australian policy group statment on alcohol misses the mark

Anti-alcohol activists fired another salvo last week in Australia with the release of a paper by the Alcohol Policy Coalition challenging the view that regular consumption of red wine is good for the heart. They even went so far as to proclaim wine’s health benefits a busted myth. The paper authoritatively bases its interpretation on a review of “all the scientific evidence” and asserts that red wine has “no special, protective qualities when it relates to cardiovascular disease.” I too have reviewed a lot of data on this subject for my book “Age Gets Better with Wine” and came to the exact opposite conclusion. So again I am left to wonder how such this well-meaning group of knowledgeable people can still get it so wrong? It may be that the Australians are just a bit behind the times on this one, so let’s back it up a few years. Nearly all of what is now gospel about lifestyle factors and heart health comes from the Framingham study , now in its fourth generation. Back in the 1970

Resveratrol derivative helps obese lab mice live longer – so what?

Do the new findings about the resveratrol derivative SRT-1720 extending the normally shortened lifespan of obese mice tell us anything new? It’s been a long and ultimately disappointing road with the red wine derivative resveratrol, once touted as the basis for miracle anti-aging drugs and now a fading star. As I have described here before, resveratrol was purported to activate an enzyme system known as sirtuins, which in turn activate anti-aging genes that trigger a unique lifespan extension phenomenon normally associated with severe caloric restriction. Take a pill and skip the starvation diet was the promise, and live up to 40% longer. The idea was so compelling that the biotech company Sirtris was founded to exploit more potent (and patentable) resveratrol derivatives such as SRT-1720. This latest report showed that giving mice resveratrol after rendering them morbidly obese through an unhealthy diet helped them live longer than they normally would have, by improving insulin s

Is organic wine a healthier choice?

Many people accept as gospel that organic food (and wine is a food) is healthier. No chemicals, harmful pesticides, or hormones must mean more nutritional value, right? Maybe, but there is a surprising lack of evidence in the form of dietary intervention studies –that is, actual measures of health parameters comparing organic and regular diets. That isn’t to say that there aren’t any, and recent studies are helping to shed some light on the subject. Beyond the questions of environmental stewardship and moral/ethical reasons to eat organic, it is important to identify what sorts of nutrients that organic foods might contain in greater abundance and how this translates into better health. Vitamins aren’t the answer; simple enough to take a multivitamin pill and get what you need. A more promising possibility is antioxidants, nutrients such as the polyphenols that make red wine red and in general seem to be more prevalent in brightly colored foods. Antioxidants come in a variety of ty

Red wine may protect against breast cancer for some women at increased risk

As we have discussed here before, the question of alcohol consumption and breast cancer is a volatile one, but a new study helps to shed some light on the subject. It becomes especially difficult for a subset of women with a genetic trait that places them at increased risk. Two genes, called BRCA1 and BRCA2, are mutations of genes that normally code for tumor suppression. When one of these mutations is present, the chances of developing breast cancer are substantially increased, and it is now routine to test for them when there is a family history of breast cancer. And given the consensus that alcohol consumption further increases the odds of developing breast cancer, it might make sense that the BRCA gene and drinking would be an especially dangerous mix. But when it comes to red wine, the story takes a different turn. This new study, from the University of Ottawa in Montreal, looked at a large population of women with breast cancer, and tested them for BRCA. Additionally, drink

How wine helps diabetes

If current trends continue, an epidemic of diabetes is looming over the country. Are wine drinkers exempt? There is good evidence that wine drinkers are less likely to develop type 2 (non insulin-dependent) diabetes, and recent research may help explain why: wine derived compounds work in much the same way as popular diabetes medications. To begin with, type 2 diabetes is typically associated with obesity, a main reason for the upward trend in developed countries. Wine drinkers tend to have healthier lifestyles overall so a certain amount of the benefit relates to healthier eating and exercising regularly. However, there seems to be more to it than that, and now we have biochemical evidence to back us up. One way that diabetes drugs work is to make cells more sensitive to insulin, which in turn helps them take in sugar. (Type 2 diabetics have a problem with insulin sensitivity, not a lack of insulin as in type 1.) Fat cells in particular become resistant to insulin. Diabetes drug

Let them drink wine: A Bastille Day toast to healthy drinking

Marie Antoinette may be popularly credited with spurring the French revolution (and losing her head) with her response to the shortage of bread, but a closer look at the events leading up the storming of the Bastille on July 14, 1789 reveals that access to affordable wine was perhaps an even more important factor. In May a national assembly was convened to air grievances of the common people and demand formation of a constitution. A series of poor harvests and widespread food shortages contributed to general unrest, but the Bastille became a target both because “political” prisoners were housed there on arbitrary orders from the king, and also because it was an armory. But it was not the storming of the Bastille that was the first act of civil unrest in the French revolution, it was attacks on the customs houses where duties on wine were collected. Wine, however, was not in particularly short supply in the 1780’s. The issue was a tax that was collected on wine as it was brought into

Space: The next frontier for wine and health?

Spaceflight has a number of deleterious effects on health, but recent evidence suggests that resveratrol – a polyphenol antioxidant from red wine – might help to offset some of these effects. If you ask me, not having access to wine with dinner is bad enough, but there is a long list of physical deteriorations that occur with prolonged zero gravity. These include muscle wasting and decrease in bone density, but there are also physiologic alterations such as insulin resistance and a shift from fat metabolism to carbohydrate utilization. These are issues with a months-long stay in the international space station, but extrapolating to the time required for planetary exploration they become serious problems. A study on rats suggests how resveratrol may help protect against these changes. While the animals were not launched into space, there is an experimental model that mimics the effects to some degree by “unloading” the hind leg. This results in loss of muscle mass, decrease in bone

Why wine makes food healthier

In my book Age Gets Better with Wine I have a chapter called “Wine is a Food” in which I emphasize the importance of wine as a part of a healthy meal. There is good scientific evidence for why this is the case, and a new study adds to the picture. Wine with food changes the way the fatty components of the meal are handled by the body. We all know that saturated fats are bad news nutritionally speaking. High cholesterol levels contribute to increases risk of heart disease and other problems, but it isn’t purely a matter of the fat content in the food. When the fats are absorbed and oxidized, they are converted into a particularly malicious form know as cholesterol oxides and lipid peroxides. This recent study, conducted by INRAN, the Italian Institute for Research on food and Nutrition, (a division of the Ministry of Agriculture, Food and Forestry), recruited 12 volunteers who were given a meal with known cholesterol-laden meal consisting of a double cheeseburger. The 6 men and 6 w

Cholesterol drug Niaspan disappoints; better to just have a glass of wine?

This week it was announced that a clinical trial on the use of Niaspan (a sustained release formulation of the vitamin niacin) to raise levels of HDL or “good” cholesterol, was suspended because of disappointing results. While it is well-established that higher levels of HDL (high-density lipoprotein) relative to LDL (its low-density counterpart) are associated with reduced risk of heart attack and stroke, the addition of Niaspan to the cholesterol-lowering statin drugs (for example Lipitor) has failed to deliver the same benefit seen in people who naturally have a high HDL/LDL ratio. In this recent trial, there was even a trend to an increased stroke incidence. Sales of Abbott’s Niaspan totaled nearly $1 billion last year, but development of several cholesterol drugs has been suspended recently due to lack of efficacy in preclinical trials. It seems appropriate then to take a few steps back and see what we know about what does work. Not smoking, along with exercise and a healthy

The French Paradox at 20

This year will mark twenty years since the CBS television show 60 Minutes christened the term “French paradox” and ushered in the modern era of research on wine and health. It was a provocative idea at the time, attributing the French custom of regular imbibing to health and well-being, and it still has its naysayers; at the other extreme, there are those who reduce the idea to a simple question of nutritional biochemistry and proclaim that all of wine’s health benefits can be put into a pill, conveniently and properly skipping the alcohol. Is there still a useful truth underlying the paradox? As with many questions in the realm of lifestyle and health, the answers are often nuanced and conditional. Though challenged by government authorities in both America and Europe, the authors of the idea – Serge Renaud in Bordeaux and Curt Ellison in Boston – provided a rigorous defense of the notion. The French paradox is invoked regularly as an excuse for having a few, to the point that it h

New Heart Association Survey on wine: Why are Americans confused about healthy drinking?

The American Heart Association recently released the results of a survey of Americans on their knowledge of healthy drinking and consumption of sea salt. No surprise, they concluded that we have it all wrong. On the plus side, two thirds agreed with the statement that wine is good for the heart, but less than one third know the AHA’s recommended limits of a daily glass or two for men and no more than one for women. The survey showed that “we need to do a better job of educating people about the heart-health risks of overconsumption of wine” according to a spokesperson. I say bless their hearts but their paternalistic message only adds to the confusion. For starters, they don’t even have their definitions right, which is a 5-ounce pour as the standard on which research and policymakers have long agreed, but the AHA cuts it back to 4. Granted, they have come a long way since the mid 1990’s when the official policy grudgingly acknowledged that a glass or two a day “might be considered

Should diabetics drink wine?

An epidemic of type 2 diabetes looms over the western world, with some estimates predicting that as many as a third of all Americans will have the condition within a decade or two. Obesity is the culprit, a complicated issue to be sure but the role of wine in the diet of diabetics is even more so. A recent study finding that low-dose supplements of the wine-derived polyphenol resveratrol improve glucose tolerance and other parameters in humans provides some guidance in sorting it all out. It has long been known that wine drinkers, especially those who consume red wine in moderation with dinner on a daily basis, are less likely to gain weight and hence less prone to type 2 diabetes. There are a number of potential explanations, including the fact that wine drinking is linked to a range of healthy lifestyle factors including diet and exercise, but the science of wine polyphenols – including the antioxidant resveratrol – provides some intriguing evidence of a biochemical mechanism at

A charitable view of wine and health

As most of you know I am on the board for the Washington Wines Festival , which raises awareness of Washington’s wonderful wines and funds for worthy charities such as Camp Korey . The wine business has a long and laudable history of charity, dating at least as far back as the famous Hospices de Beaune in Burgundy. Dating to 1443, the hospice was a hospital for the poor and needy, supported by funds raised from the local wine producers. To this day an important wine auction is held every November at the Hospice, maintaining a centuries-long tradition. Health care continues to be a popular beneficiary of charity wine auctions, and there are some interesting parallels to the circumstances that prevail today with the conditions at the time of the founding of the Hospices de Beaune. The Hundred Years War had just ended, but the long conflict had been financially ruinous. Marauders roamed the countryside, pillaging and plundering, and much of the population was destitute. The Hospice bec

German study confirms benefits of drinking in elderly

One of the hardest ideas to wrap one’s head around is the idea that alcohol consumption (in moderation) actually improves mental function and lowers the risk of developing Alzheimer’s disease as we age. But a recent study from Germany adds to the already considerable evidence, and to the ongoing controversy. The study enrolled more than 3200 subjects aged 75 or more from primary care practices, and gathered detailed information about drinking and lifestyle patterns. Additionally, they were tested comprehensively for signs of declining mental function, and specifically Alzheimer’s dementia. The average age in the group was more than 80 years, and after 1.5 and 3 years of follow-up a clear benefit to the moderate drinking cohort was found. Drinkers were 30% less likely to experience mental decline, and 40% less likely to have Alzheimer’s. The controversy relates to the question of moderate drinking as a lifestyle “marker” for a range of healthy behaviors. In other words, people in thi

Healthy wine drinking is a family value

There are few more controversial subjects than the topic of underage drinking, so let me just say at the outset that I am not encouraging it. But with many such questions, things aren’t always so black and white, as a recent study on teenage drinking demonstrated. In a nutshell, the study evaluated beverage preferences among high school students who display risky drinking patterns, concluding that hard liquor and beer are preferred over wine. The study, called the Youth Risk Behavior Survey, questioned nearly 8000 adolescent drinkers, and the correlation between preference for liquor and/or beer was strongest among those who exhibited the riskiest behaviors (binge drinking, drinking and driving.) No surprises there you say, we all know that liquor is quicker where the beverage is merely a vehicle for alcohol consumption as a drug. We don’t expect teenagers to be wine connoisseurs, even if it were legal. But there is the well-known European tradition of starting children on watered-

Which types of wine are the healthiest?

I am often asked after lecturing on the healthful properties of wine which type is best to drink. Since much of the discussion has to do with the polyphenol antioxidants from the skins and seeds of the grape, red wine is the first criterion since it is fermented with the whole grape rather than the pressed juice. This allows for extraction and concentration of these compounds, familiar ones being resveratrol and tannins. But beyond that, which varietals have the highest concentrations? According to the Roman philosopher Pliny the Elder, “The best kind of wine is that which is pleasant to him that drinks it” but modern science expects more specifics. (The point of course is that if you have a wine that you enjoy you are more likely to drink regularly and therefore reap the benefits.) But there are several difficulties in singling out certain wines for their healthful properties. Which compounds to measure? Are we talking about heart health or the whole gamut? Is it the varietal of th

Is any amount of alcohol good? Resolving the conflict

Sometimes it happens that opposing views on a controversial subject juxtapose. Such is the case this week, with a new large study published on the role of alcohol and health, another outlining the reasons for it, and an opinion piece questioning whether any amount at all is beneficial. In brief, the argument goes something like this: Anti-tobacco activists point out that any amount of tobacco is harmful, and since alcohol in excess has many hazards it must be bad in small doses too, if less so. On the other hand, if moderate wine consumption is a good thing for health, as I affirm in my book Age Gets Better with Wine , then we must account for a positive role of alcohol in the health equation. The case against alcohol is made by one Professor David Nutt, professor of neuropsychopharmacology at Imperial College in London. Professor Nutt outlines his reasons why he belives that it is a myth that small amounts of alcohol are not harmful: First, alcohol is a toxin, and amounts only

Red wine compound resveratrol supports anti-cancer therapy

Resveratrol, for all appearances the miracle molecule from red wine, has disappointed on several research fronts but don’t count it out just yet. In the right amounts it may be an important part of an anti-cancer diet, but the story now is synergy: compounds working together in ways that enhance their effectiveness. Evidence has been slowly coming to light in recent years that the compounds in red wine amplify each other’s health benefits, explaining why studies continue to support the benefits of moderate drinking but supplements often fail in clinical tests. New research demonstrating how resveratrol supports the anti-cancer drug rapamycin provides another example of synergy. Rapamycin , derived from a bacterium first found in the soil on Easter Island (hence the name, from Rapa Nui, the original name of the island), is clinically used as an anti-immune drug for organ transplantation. Its anti-cancer capabilities are being explored, in particular for breast cancer. But as with o

An end to wine headaches at last

Thank food biotechnologist Hennie van Vuuren at the University of British Columbia for finding the solution to one of the most vexing problems for would-be wine lovers: the headache that so often accompanies wine drinking for up to 30% of the population. These unfortunate folks are sensitive to compounds known as biogenic amines such as histamine, which can also impart off-putting flavors to wines. (It isn't the sulfites.) I have long thought that there was a huge opportunity for someone to crack this particularly hard nut and figure out how to make low-amine wines. van Vuuren apparently had the same idea, and over the past several years he has been developing a strain of yeast for wine fermentation that produces low levels of amines. The yeast, known as Malolactic ML101, has already been approved by Health Canada and the US Food and Drug Administration. According to the developers of the new yeast, Lesaffre Yeast Corporation, there is a good chance you have had wine produced

Notch up a victory for alcohol and heart health

OK, we all know that wine is good for the heart; French paradox, old news. And if you are at all interested in anti-aging, you will have heard that wine’s benefits are attributed to the polyphenol antioxidants from the skins, including resveratrol, quercetin, and a menagerie of other exotic molecules. But the role of alcohol has long been questioned. Even though the epidemiologic evidence points to a contributory part for alcohol, the exact mechanisms by which it might accomplish this have not been well understood, other than favorably shifting the high density/low density cholesterol ratio. New findings implicate a signaling molecule called Notch, another one of those exotic breeds that seem to be involved in a lot of things once we get to know them.      Vessel thickening is reduced in the carotid arteries of mice fed the equivalent of two drinks, compared to no-alcohol controls. (Credit: Image courtesy of University of Rochester Medical Center) Notch does seem to be a multita

Aging in oak barrels may improve wine’s healthful properties

No one knows for sure when the oak barrel was invented, but it probably dates to the 13th century. Wine and oak have had a long and happy marriage, despite occasional excesses and changes of taste, and it is as hard to imagine a big red without oak as it is beer without hops. Vanillins and other compounds improve the wine if managed carefully, but the question of how these molecules may affect the health benefits of wine has just recently begun to be explored. Collectively these compounds are called lignin-derived polyphenols, which bear a relationship to polyphenols from grape skin and seeds. These molecules are often aromatic, vanilla being a good example. And the prolonged time that red wines often spend in barrels can result in a high degree of extraction into the wine, though levels may still be small in comparison. Nevertheless, their contribution to wine’s effects on health may be as important as their input to flavor and structure, according to recent research. A study fro