A growing controversy over wine

On November 17, 1991, a segment aired on the popular television show 60 Minutes that changed the world—or at least the world as wine fanciers and wine producers know it. The show examined the diets, lifestyles, and health of people living in southwestern France, where saturated fat intake (primarily from butter, cream, and cheese) was high. The surprising finding was the low heart attack rate among the French—one of the lowest in the world! This discovery flew in the face of everything the American public had been told about how to lower the risk of coronary heart disease. What were the French doing to keep their heart attack rates so low? The study concluded that they were drinking wine.

Hallelujah! the world responded. We can eat whatever we want, follow it with a glass of wine, and everyone will be fine! Within a few weeks of the airing of the notorious 60 Minutes episode, red wine sales rose 40 percent in the United States.

Of course, as with any purported panacea, the picture is far more complicated than it seems at first glance. While wine does appear to have many benefits, from a high flavonoid content to antibacterial effects, the French study subjects didn’t overindulge. Red wine consumption in France is, on average, daily but moderate—about 8 ounces per day for men, half that amount at most for women.

A recent study published in the January 2003 issue of the New England Journal of Medicine showed that men who drank alcohol reduced their risk of heart attack by one-third, but consumption was moderate. The men in the study drank no more than two (roughly 4-ounce) glasses of alcohol. In this study, the alcohol consumption was in the form of wine, beer, or hard liquor, no more than seven times a week, which averages to no more than two glasses of alcohol a day. This is right in line with the amount of wine (alcohol) consump­tion seen in the traditional Mediterranean diet, but note that the study did not include women.

One study out of Denmark suggests that wine drinkers tend to have better eating habits. Wine drinkers, according to the study, tended to eat more fruits and vegetables, fish, salads, and olive oil, making the health benefits of wine a lit­tle less clear. Research in the United States additionally sug­gests that wine drinkers are, in general, more moderate drinkers who smoke less and are better educated than non­drinkers of wine.

Alcohol consumption of any kind has been linked to in-creased risk of breast cancer in women, so women may think twice about a daily glass of wine. One study suggests that two to five drinks a day can increase a woman’s risk of developing breast cancer by 40 percent. While the recommended single 4-ounce daily serving of wine (red or white) may be small enough to make little difference in cancer risk, those otherwise at risk for breast cancer (and anyone else, for that matter) needn’t feel compelled to drink any.

Anyone at risk for alcohol-related problems should also forgo wine in favor of more fruits and vegetables. Alcohol intake has been associated with an increased risk of accidents, cirrhosis (liver failure), stroke, and all causes of death, and alcohol is certainly not a necessary component in any healthy diet. While many researchers suspect flavonoids are the key to the protection wine may offer against heart disease, plenty of other fruits and vegetables have more flavonoids than a glass of wine.

For those who already enjoy wine in moderation, how-ever, the research investigating the link between wine consumption and health is intriguing. Research has shown a U-shaped curve linking alcohol consumption with longevity. People who drink alcohol in moderation seem to enjoy a longer life than people who don’t drink at all or people who drink heavily. “Moderation” generally refers to two or fewer 8-ounce glasses of wine per day for men, and less than one 8-ounce glass of wine for women.

Although some research suggests a longer life for moder-ate alcohol drinkers, alcohol consumption certainly has its risks, and other studies dispute the claim that moderate drinkers live any longer than nondrinkers.

The link between wine consumption and a reduced risk of heart disease is even more compelling. Many studies have associated moderate alcohol intake with improved cardiovascular health, especially a reduced risk of suffering a heart attack, and much research has been conducted in an attempt to determine what particular aspects of alcohol and/or wine consumption are responsible for this protective effect. One theory is that alcohol has a protective tendency to raise HDL (“good”) cholesterol and lower LDL (“bad”) cholesterol; an­other centers on alcohol’s tendency to inhibit blood clotting.

Other researchers are investigating wine’s particular antiox­idant phytochemicals, specifically phenolic compounds like flavonoids and the phenolic fungicide resveratrol. Again, however, most of these studies included male subjects only. Keep in mind, also, that most plant foods contain phenolic compounds, many in concentrations higher than in wine. Grapes and peanuts are also good sources of resveratrol, and flavonoids are present in many plant foods, especially red grapes, green leafy vegetables, and fruity vegetables like tomatoes. If these antioxidant compounds are the “magic in­gredient” in wine, then consumption of grapes and other foods with high levels of phenolic compounds should offer similar protection. The following chart demonstrates the rel­ative flavonoid content of various fruits and vegetables.

Flavonoid Beverage Fruit Vegetable Content

High flavonoid             None                   Cranberries Broccoli

content                                                                           Celery

(>50mg/kg or mg/L)                                                       Endive

French beans Kale

Onions

Table adapted from “Alternative Approaches to Lowering Choles-terol,” Patient Care 29, no. 18 (November 15, 1995): 110 (21).

The problem with wine consumption involves the Ameri-can tendency to do everything in a big way, and also to choose only those aspects of a healthy program for eating or living that are most desirable. The traditional Mediterranean diet is most effective and beneficial for health if followed completely—not just red wine, olive oil, and extra bread, but all these as part of a low-saturated-fat, plant-based diet combined with a high level of physical activity. If you enjoy wine, maximize its health benefits by consuming it in the Mediterranean way:

·~Only with meals, never recreationally.·~Only in small amounts—8 ounces daily for men, 4 ounces daily for women, at most.·~As one part of an overall low-saturated-fat, plant-based diet and active lifestyle.

Don’t forget that while small amounts of daily alcohol have indeed been associated with lower risk of heart disease and other chronic health problems in men, as well as lower rate of death from all causes and greater longevity, consumption of larger amounts of alcohol have been linked to a higher risk of accidents, including car accidents; heart dis­ease; certain cancers; stroke; birth defects; and an increase in death rate from all causes, not to mention alcohol depend­ence and a tendency toward obesity. So, to sum up, drink if you like to, but if you can’t do so in moderation, abstain. The health risks from overconsumption of alcohol far out­weigh any possible lack of benefits from abstinence.