Allied Domecq: Wine and Coronary Heart Disease
For centuries wine has been regarded as a superior beverage. Plato remarked, "Wine is the most healthful and hygienic of beverages, nothing more valuable than wine has ever been granted by the Gods to man." For many of us who enjoy the varieties and tastes wine offers, we can now also appreciate the health benefits of wine. Modern scientific research indicates that moderate wine and alcohol consumption have beneficial effects against the most common health hazards of today, including heart disease, stroke, dementia, and perhaps even certain forms of cancer. One of the largest studies, reported by the American Cancer Society, involving 500,000 individuals between the ages of 35 and 69 with a nine year follow-up period, found that the risk of dying from any cause was greatest among abstainers and people reporting six or more drinks per day. The lowest risk for total mortality was seen among individuals who reported consuming between one-half and two drinks per day. Medical research also supports that moderate consumption of wine and other alcoholic beverages can be a vital element of a healthy lifestyle. A healthy lifestyle is comprised of many building blocks, a topic which is of great interest to everyone today. Several large prospective studies, led by Harvard University, such as the Nurses Health Study and the Health Professionals Study, have been tracking lifestyle and health issues of groups as large as 100,000 participants over a time period of several decades. The investigators of these studies have found common lifestyle traits or habits which appear to be key for better health. Individuals who met these criteria had 80 percent fewer heart attacks and more than 90 percent fewer cases of diabetes than the other subjects in these studies. These five factors are listed below.
Building Blocks of a Healthy Lifestyle
Wine Spectator, October 2004Nurses Health Study, Health Professionals Study
- Avoid obesity
- Consume a healthy diet
- Engage in moderate to vigorous physical activity
- Avoid smoking
- Consume one-half to two drinks of an alcoholic beverage per day
Coronary Heart Disease
Much of the interest for wine and health was first brought to public attention when the French Paradox received nationwide attention. Scientific studies revealed that in areas of France where the diet is high in fat, particularly saturated fat, wine consumption provided protection against heart disease. Subsequently, Michael Criqui and Brenda Ringel at the University of California, San Diego, investigated comparable data and came to a similar conclusion. Wine was one of the few dietary factors that correlated with reduced coronary heart mortality. The traditional Mediterranean cuisine is also another healthy phenomenon which included plant-based foods, healthy meals, lifestyle, and moderate consumption of wine as part of the meals. Today, there is no dispute that moderate wine and alcohol (beer and spirits) consumption on a daily basis is associated with lower coronary heart disease mortality. Moderate consumption being defined as one to three drinks per day. In most studies, one drink equals a five-ounce serving of wine, 12 ounces of beer, or a one-half ounce of spirits such as vodka or whiskey. Because many of the beneficial health effects of alcohol are transient, lasting 24 hours or so, the best pattern is to drink moderately every day. Recent studies suggest that when the drinks are consumed with food there are favorable effects on the body's absorption of antioxidants in the food and the metabolism of dietary fats in the body.
Despite the issues surrounding total mortality, it is clear that moderate alcohol consumption itself reduces coronary heart disease mortality. Several mechanisms for this are now recognized, the best known being alcohol's ability to increase levels of HDL "good" cholesterol.
But does wine confer any special benefit and if so, is there an explanation for this effect that is unrelated to alcohol? Several scientific studies have concluded that wine consumption is much more strongly correlated with reduced coronary heart disease mortality than total alcohol consumption. Wine contains compounds, such as polyphenols and other chemical elements, which may offer additional health benefits beyond alcohol. Wine is a rich source of phenolics, particularly resveratrol and the flavonoids. The flavonoids include four major classes: flavonols, anthocyanins, catechins, oligomers, and polymers, commonly referred to as tannins. The total amount of these compounds present is one to three grams per liter in red wine and 0.2 grams per liter in white wine. The flavonoid content is much higher in red wine due to its higher concentrations in the skin and seeds of red grapes. In white wine production, the skins and seeds are separated from the juice immediately after crushing the grapes, thus the flavonoid levels are much lower. The number of individual phenolic compounds in a particular wine can vary, but scientific analysis of red wine has revealed at least 50 different constituents to be present in the wine.
Phenolics have always been studied by wine makers for their contribution to the sensory properties of wine. These substances act as antioxidants and give wine its bitterness and astringency, and are the foundation of long-term aging. The variety of these different compounds also exert protective health benefits via many different modes. One of the most important health benefits of these compounds is their role as antioxidants. These antioxidants are particularly effective against the progressions of atherolsclerosis (plaque buildup in the arterial walls). Atherosclerosis leads to coronary heart disease and to the most common type of stroke, ischemic stroke. A key study by Frankel and colleagues at the University of California at Davis showed that wine antioxidants inhibit oxidation of low density lipoproteins, and may thereby have the ability to slow down the development of atherosclerosis. These authors also suggest that the major contributor to what is known as the French Paradox is related to the intake of these phenolics from red wine. Scientists have also identified additional ways or mechanisms in which alcohol itself and/or substances such as phenolics in wine decrease risk factors of coronary heart disease. These mechanisms include positive effects on clotting factors in the artery, hormonal factors which stimulate the lining of the artery to prevent the formation of plaque which lead to obstruction, and even genetic influences which may lead to less obstruction within the artery. Wine appears to offer the health benefits of alcohol with the added benefits of protective substances such as polyphenols.
Diabetes
Numerous worldwide studies have shown that diabetes occurs less commonly among moderate drinkers than individuals who do not drink at all. In a recent review of the scientific literature, Howard and colleagues reported that with the moderate intake of alcohol, the risk of developing diabetes was reduced by 22 to 56 percent and among individuals who have diabetes, the risk of coronary heart disease was reduced by 34 to 55 percent.
Alzheimer's Disease and Dementia
Studies from Holland, France, Australia, Demark, and the United States suggest that elderly people who are moderate drinkers tend to perform better on memory and cognitive function tests when compared to non-drinkers. However, there are also studies which show that dementia develops less in individuals who consume wine. The exact mechanisms, whether from wine or alcohol, is not certain; however, it may be related to a prevention of atherosclerosis in blood vessels which supply the brain.
Summary
The following is an excerpt from the 2005 USDA dietary guidelines: "Drinking in moderation may lower risk for coronary heart disease, mainly among men over age 45 and women over age 55. However, there are other factors that reduce the risk of heart disease, including a healthy diet, physical activity, avoidance of smoking, and maintenance of a healthy weight." The guidelines also define moderate as no more than one drink per day for women and no more than two drinks per day for men. This limit is based on differences between the sexes in both weight and metabolism. While the dietary guidelines do not distinguish between wine and alcohol consumption from spirits, the scientific research does and relates the effects in relation to specific parts of the body.
There are many different ways to achieve a healthy lifestyle and, of course, there are individuals who should not consume alcohol depending on age, health, and medical conditions. As the scientific research continues, more ways are revealed which help explain these intricate components of wine and health, thus providing us with insight to longevity, health, and well being.
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