In Vino Veritas: A Drink to Your Health
Hemingway called it “the most civilized thing in the world,” Ambrose Bierce said it was, “God’s next best gift to man,” and the Scot scholar John Stuart Blackie went even further, declaring it “the drink of the gods.”
As for whether a god would drink wine, there are as many opinions as there are gods and religions. Greek mythology’s Dionysius and his Roman incarnation (Bacchus) did not shrink from celebrating the excesses of intoxication in the most shocking ways. In contrast the Qur’an warns of the dangers of wine and forbids it for mortals but promises that in paradise the faithful will be given “rivers of wine of joyous taste.” Jews are not forbidden alcohol, but many follow the traditional laws and drink only Kosher wines. Christian religions vary in practice according to their interpretation of scriptures about wine. The Bible certainly stresses the pitfalls of over-indulgence but contains examples of those who enjoyed it in moderation. Within its pages one young man is even advised, “drink no longer water, but use a little wine for the stomach’s sake and for your often infirmities.”
These last words illustrate that, whether or not it can rightfully be called “the drink of the gods,” wine has long been considered to have health-enhancing properties. Indeed, the Romans believed it maintained youth and restored vigor and it now seems they may have been on to something.
Zipping ahead a couple of millennia, we find this encouraging November 2006 press release from Harvard scientists: “Researchers have used a single compound to increase the lifespan of obese mice . . . The research, led by investigators at Harvard Medical School and the National Institute on Aging, is the first time that the small molecule resveratrol has been shown to offer survival benefits in a mammal . . . resveratrol is found in red wines.” Researchers considered their findings “positive clinical indicators” that similar results would occur in humans.
Anti-aging properties are not the only health benefits of wine being studied by researchers, however. Michael Downey points out another in the January 2003 issue of Better Nutrition: “More than 100 scientific reports since 1991 provide strong evidence that wine consumption prevents heart disease,” he writes. Downey then asks rhetorically, “But didn’t some studies point to red wine over white? And wasn’t there some suggestion that grape juice is just as beneficial?” His conclusion after fully fermenting the fruit of his research is that, yes—red wine is more protective than white, and no—grape juice isn’t quite as effective as wine. Almost—but not quite. In fact, he says, the alcohol plays a role in intensifying the beneficial effects. “Every glass of wine contains about 200 different polyphenols, and many are antioxidants, which slow the damaging cell oxidation process,” says Downey, and while purple grape juice can confer many of the same health benefits as wine, he insists “it takes three times as much grape juice to produce the same effect; wine’s alcohol acts as a solvent, extracting greater amounts of flavonoids.”
While it’s relatively old news that moderate consumption of almost any kind of alcohol decreases the risk of heart disease, Downey points out that many other benefits specific to wine have lately been added to the list. A glass of red wine with dinner at night [and yes, there is a connection to having it alongside an evening meal] reduces the risk of cancer, peptic ulcers, respiratory infections, impotence, gall stones and kidney stones, while increasing cognitive function and memory.
Great news, if it’s true—and Downey has certainly done an admirable job of sifting through the research and presenting it to his readers. However, those who prefer to see the studies for themselves can usually do so, as many of them are accessible through Internet libraries.
The trail begins in London, in December of 1998, when S. Goya Wannamethee and A Gerald Shaper, researchers from the Royal Free Hospital School of Medicine, found reason to believe that drinking moderate amounts of alcohol reduced risks of coronary heart disease and “all-cause mortality.” Their most interesting finding was that non-drinkers had the highest risk of mortality, moderate drinkers had the lowest risk, and that moderate wine drinkers in particular had a lower risk of heart disease and all-cause mortality than those who drank alcohol in other forms.
The researchers, whose findings were published in the May 1999 issue of the American Journal of Public Health, speculated at the time that the lower mortality risk enjoyed by wine drinkers might simply be attributable to the fact that wine drinkers tend to have other beneficial habits as well. For instance, people who drink wine are not as likely to drink to excess as those who drink beer or spirits. They are also more likely to be well-educated in health issues, from higher socio-economic backgrounds, and to have “more favorable lifestyles” than those who primarily drink beer or other spirits.
Though it may be true that wine drinkers tend to have more healthful lifestyles and find it easier to drink moderately, later research has added to our store of knowledge about the benefits inherent specifically in the fruit of the vine. And apparently, the redder, the better.
In a study published in the April 1999 Issue of the Journal of the American College of Nutrition, researchers compared the effects of red wine, white wine and ethanol on the oxidation of LDL and HDL cholesterol. Since it’s the oxidation of cholesterol that is the problem in heart disease rather than simple cholesterol levels themselves, researchers wanted to see which substance was most effective at inhibiting oxidation. Their findings? Red wine “almost completely” inhibited LDL and HDL oxidation. White wine was much less effective and ethanol had no effect at all. While admitting that their experiments did not reveal the actual mechanism that produced the results, the researchers noted that “The antioxidant components of red wine include the polyphenol flavonoids catechin and quercetin and the phytoalexin resveratrol,” components already known as inhibitors of LDL oxidation. But then, red wine has long been associated with the “French Paradox”—a phenomenon first noted by Samuel Black in 1819. The Irish physician was the first to note in a study that, despite their higher fat intake, the French had a lower incidence of heart disease than other Western nations. He concluded the connection must be to their climate and their “moral affections.” While we won’t take issue with French morals for fear of succumbing to the “black pot” paradox, we must point out that science has finally been able to isolate the benefits of red wine to the point that antioxidants, rather than “moral affections” can begin to take some of the credit.
But what about that other serial killer—cancer? Some studies have indicated that drinking alcohol of any kind, including wine, increases the risk of certain cancers. How does one reconcile this? One factor is that early studies lumped all alcohol together, failing to consider the effects of spirits, red wines and white wines separately. A hint to another factor may have been uncovered by a February 2007 study among women in a broad range of age groups. Research Triangle Park scientists found that peri- and post-menopausal women who used estrogen HT (hormone therapy) and drank wine increased their risk for ovarian cancer. Women who did not use HT, or used a combined estrogen-progestin HT had no increase in risk when they drank wine.
In recent years, the connection between hormone replacement therapy and estrogen-related cancers has been strengthening. In fact, the concern has been spreading to the point that the popularity of this therapy has dropped sharply . . . only to be followed by a corresponding drop in breast cancer rates. While some scientists hesitate to associate these factors directly, there is good reason to wonder whether conclusions can be drawn about alcohol consumption without controlling for hormone therapy use.
Another interesting thread in the tapestry can be pulled from a 2004 study conducted by researchers including Elizabeth Eng of the Beckman Research Institute at City of Hope in California. She and her colleagues were interested in previous research showing that estrogens in breast cancer tissue promote tumor progression. They also noted that “approximately 75 percent of postmenopausal patients have estrogen-dependent cancers,” and that substances that inhibit aromatase are “a viable means for preventing and treating breast cancer in postmenopausal women.” Further, “Previous research from this and other laboratories has shown that extracts from red wine inhibit aromatase activity.” What is aromatase activity and why is it important in estrogen-dependent cancers? Aromatase activity is anything that encourages the conversion of androgens to estrogens. In estrogen-dependent cancers, for obvious reasons, one does not want androgens converted to estrogens. Wine can, apparently, prevent this from happening in ordinary circumstances. When the body’s hormones are artificially supplemented, however, wine may inhibit further androgens from being converted, but there is still going to be sufficient estrogen to aid cancer progression. Could this be why wine-drinking is not effective protection for women who use hormone replacement therapy? There is much to learn. But all indications are that red wine is inclined to be our ally against the most common form of cancer for Western women.
For men, of course, cancer most commonly turns up in the prostate—but here too is good news. It comes from a 2004 study by researchers at Seattle’s Fred Hutchinson Cancer Research Center who found that men who drink red wine significantly decrease their risk of developing prostate cancer. In comparison, white wine, beer and other spirits had no effect. Janet L. Stanford, the researcher who led the study, commented that “Among men who consumed four or more 4-ounce glasses of red wine per week, we saw about a 60 percent lower incidence of the more aggressive types of prostate cancer. The more clinically aggressive prostate cancer is where the strongest reduction in risk was observed.” The polyphenol resveratrol was specifically given the credit for these benefits, though as other researchers have realized, there are many powerful flavonoids (a subgroup of polyphenols) in wine that contribute as much or more than resveratrol to protection from cancer. The common denominator among all these polyphenolic substances is that their levels are much higher in red wine than in white.
For Western men and women lung cancer is the second most prevalent cancer, though worldwide it is first. This too has been the subject of a study about wine. Spanish researchers in 2004 found that, once again, red wine was linked to a reduced risk, while white wine was linked to a “very slight but significant” increase in risk. Published in the British medical journal, Thorax, this was one more indication that the specific nutrients linked to the skin and seeds of grapes—which give red wine its color—are fundamental to its benefits.
According to the World Health Organization, over 900,000 new cases of colorectal cancer occur annually, making it the third most common cancer on the planet. In 2006, researchers at Stony Brook University in New York found that red wine reduced the risk of colorectal neoplasia (pre-cancerous lesions) by 68 percent. White wine had no effect. Those who drank beer or other spirits elevated their risk to the same level as those who had a family history of colon cancer. While alcohol in general has long been known to have a detrimental effect on the colon in particular, this study found that the alcohol in red wine did not.
Despite what is quickly becoming insurmountable evidence, skeptics continue to raise questions about whether there were other health habits of wine-drinkers that could be responsible for such results. Some argue that those who drink red wine are less likely to be smokers than those who drink white. Maybe red wine drinkers exercise more, or eat more green vegetables. How could it ever be justifiable to conclude that something like wine, which carries the potential for abuse, could be healthful? As much as it may go against the grain, there is no longer reason to deny that two types of polyphenols: resveratrol and flavonoids, play key roles in red wine’s beneficial track record.
As far as resveratrol is concerned, there is no shortage of information. In one example among many, researchers from Goethe University in Frankfurt published a paper in the December 2004 issue of The Journal of Nutrition, summarizing the role of resveratrol in colorectal cancers. They note, “Recently, it was demonstrated that resveratrol can function as a cancer chemopreventive agent, and there has been a great deal of experimental effort directed toward defining this effect. . . . The inhibitory potency of resveratrol in various stages of tumor development has attracted much attention. . . .In grapes, especially when infected with botrytis cinerea, resveratrol is exclusively synthesized in the grape skins, which contain 50-100 mg resveratrol when they are fresh. Because the grape skins are not fermented in the production process of white wines, only red wines contain considerable amounts of resveratrol.”
In contrast flavonoids have not garnered as much attention, but they may be even more important than resveratrol in explaining the healthful benefits of wine. There are thousands of flavonoids, plant pigments that act as antioxidants in the human body, and red wine is rich in many of them. Dry reds contain the highest concentrations, since flavonoids, like resveratrol, are contained in the seeds and skins of grapes. But whereas resveratrol exhibits preventive properties against cancer, flavonoids may actually have curative ones. Researchers at the University of Guelph in Ontario studied the effects of flavonoids on breast cancer and found that three different flavonoids in wine attack and kill cancer cells while leaving healthy cells intact. The flavonoids seemed to help regulate cell division, and calm down the uncontrolled growth of cancer cells, bringing the overactive systems down to normal levels.
All this good news begets another question. Since so many of the benefits of wine can be traced to grape skins and seeds, can’t you get the same effects from grape juice or whole grapes?
Common sense and countless studies do say that grapes and grape juice can confer many of the same benefits as wine. But there are some caveats.
An important one is that the alcohol in wine enhances the beneficial effects of grape polyphenols. In return for this favor, the polyphenols seem to provide protection from harmful “rebound” effects related to sudden death and stroke that can occur after the withdrawal of other forms of alcohol. This synergy created by the relationship between alcohol and polyphenols gives wine a significant boost over grape juice, as demonstrated in a study published in January 1995 by the American Heart Association. In this study, scientists examined the effects of red wine, white wine, and ethanol on “platelet aggregation” (sticky platelets) in rats. Why are sticky platelets a problem? In the case of wounds, they aren’t. Platelet aggregation is what causes blood to clot and injuries to heal. But sticky platelets in arterial walls can cause the kinds of clots that lead to heart disease and stroke. Researchers know that alcohol, in general, reduces the stickiness of platelets, at least temporarily. But with most forms of alcohol, some hours after the drinks have worn off there is a “rebound” in stickiness. In other words, the platelets become even stickier than before, increasing the risk of an arterial blood clot. In the 1995 study, however, 18 hours after alcohol was withdrawn, an interesting phenomenon was noted. There was a significant rebound effect with all forms of alcohol except red wine. In fact, red wine showed a continued decrease of “platelet stickiness.” The researchers experimented further to see whether this effect held true for grape seeds or non-alcoholic “wine.” Their findings? They could reproduce the effects by combining grape seeds with alcohol, but the benefits did not hold true at the same levels when the alcohol was absent. However, the researchers note that when the amount of grape juice is increased to 2.5 times that of wine, similar results can be achieved. Unfortunately, that also means double the calories, for those who may be watching their weight.
Calories aside, it can’t be denied that grape juice is one of the best alternatives to wine for those who object to alcohol on religious grounds. For those without religious objections, however, it’s comforting to know that science has come a long way from the days when the 16th century author William Turner claimed that “small white wines scour and drive out the uncleanliness of the body as much as it is possible to be done by them, and red and Claret wine . . . fill the body full of ill humors.” In the last half-century this wisdom has been turned on its head. As researchers continue to uncover the health benefits to be gained by pouring a glass of red wine with dinner, Alec Waugh emerges as the more trustworthy critic. In his 1959 book, In Praise of Wine and Certain Noble Spirits, he summarizes his philosophy with this oft-misquoted and mis-attributed gem: “At the age of twenty,” he says, “I believed that the first duty of a wine was to be red . . . during forty years I have lost faith in much, but not in that."