Thursday, February 9, 2017

Lost in translation: Why most reports on health and wine are erroneous

In an era of fake news, alternative facts, and conflicting advice on healthy drinking from even the most reliable sources, it is important to understand where reporting on clinical science can go awry. Does a glass of wine before bed help you to lose weight? A widely reported study last year seemed to suggest just that, at least if you only looked at the headlines. How about a glass of wine a day is as good as an hour at the gym? Both of these might be true - if you are a mouse - and substituting resveratrol for wine.

Of mice and men - and medicine

The journey from the research lab to the clinic is known as translational medicine, and the process can be long and unpredictable. Take for example the hypothesis that resveratrol alters metabolism in a way that mimics exercise (and ignore for the moment the separate idea that resveratrol supplementation is the same as drinking wine.)  There are limits on what sort of interventional studies you can do to test this idea on humans, before you determine if the doses needed are toxic or have other unexpected effects. Lab rats make a convenient model for these types of studies, and for trying out new therapeutic approaches, but they are not people. More than 9 in 10 cancer treatments that appear promising in animal studies on do not even make it to clinical trials in humans. Resveratrol supplementation in mice might keep them lean and fit, but it's a huge leap to conclude that wine does the same thing in you and me.

Studies on wine have to pass the sniff test

What we do know from human studies is that people who drink wine regularly and in moderation outlive (on average) nondrinkers and heavy drinkers – the J curve. Studies on wine, resveratrol and alcohol number in the thousands, but the majority of them are based on lab rodents or cell cultures. Clinical studies on wine can be problematic to conduct, so there are comparatively fewer of them. The ones that have been published tend to reinforce the concept of healthy drinking, with the jury still out on many aspects of resveratrol. So here’s my advice: The more attention-grabbing the headline, the less likely it is to translate into a meaningful aspect of healthy drinking. Like a freshly uncorked bottle of wine, it has to pass the sniff test; a glass of wine equating to an hour of exercise doesn’t, at least not until confirmed by actual clinical studies.