WINE AND HEAL TH - IS IT THE ALCOHOL OR IS IT THE WINE?
By Dr. Philip Norrie, MBBS,MA,MSc,MSocSc(Hons),PhD,MD
"Beer is made by man - wine is made by God" Martin Luther (1483-1546 Scholar and Religious Reformer)
Man has been consuming wine for about 9,500 years, beer for about 6,000 years and spirits for about 3,000 years. Wine is man's oldest medicine, having been used as such by the medical profession for over 5,000 years.
The cultivation of grapes and the making of wine may have also contributed to the beginnings of civilization. Nine to ten thousand years ago, the domestication of animals and the cultivation of cereals took place in the Fertile Crescent, which stretched from Israel and Jordan in the west, to Iran's Zagros Mountains in the east. These are traditionally thought to be the precipitants of the formation of the first food producing communities (instead of being nomadic communities), which led to the creation of settlements and towns. The cultivation of the vine, and the need to stay in one place for long periods of time to make wine, could also be argued as another influence or cause for the establishment of the earliest static communities; because the first wine making was occurring at the same time just to the north, in nearby Georgia. Wine was also being made at this time from indigenous grapes, hawthorn fruit and rice in Jiahu, a Yellow River valley settlement in northern China. This wine may even predate the earliest Middle Eastern wines.
Wine should be regarded as a food. Historically it has been regarded as such and has been an integral part of the healthful Mediterranean diet for thousands of years. Wine also has important religious connections, being used to represent the blood of Christ in holy communion.
Dr. Maynard Amerine, Professor Emeritus of Oenology and Viticulture at the University of California at Davis described wine as "a chemical symphony composed of ethylalcohol, several other alcohols, sugar, other carbohydrates, polyphenols, aldehydates, ketones and pigments, with half a dozen vitamins, fifteen to twenty minerals more than twenty-two organic acids and other things that have not yet been identified"(!)
A full table of wine's composition by Dr. Bryce Rankine, former Dean of the Faculty of Oenology at Roseworthy Agricultural College, follows at the end of this paper (2)
Professor Walter Willett, Chairman of Harvard University's Department of Nutrition has stated "Wine..... can't be forgotten as an important part of the Mediterranean diet"(3)
Professor Curtis Ellison, Head of Epidemiology at Boston University says "a Mediterranean diet, high in fruit, vegetables and grains, also typically includes one or two glasses of wine per day"(4)
Australia's Dr. William Lennox Cleland, Medical Superintendent at the Glenside (psychiatric) Hospital in Adelaide thought of wine as a food when he addressed the Royal Agricultural and Horticultural Society on 27/8/1880 with a paper titled "Some remarks upon wine as a food and its product ion"
" The centuries-old belief that wine used with meals is an aid to nutrition has been confirmed by research project at the University of California in Berkeley.
In the first such study ever made a liter of Zinfandel wine or a liter of an equivalent (11.5 percent) aqueous solution of ethanol were fed daily with a controlled isocaloric diet to six healthy young adult males while their feces, urine, and sweat were collected and analyzed.
The results showed that all of the subjects had absorbed from their diet significantly more of such nutrients as calcium, phosphorus, magnesium, iron and zinc after taking the wine than after taking the alcohol solution.
Equally significant was that when dealcoholized wine and deionized water were substituted for the wine and for the alcohol solution during part of the 75-day study, the results were similar. Significantly greater absorption of nutrients was found after the dealcoholized wine than after the water" .(5 )
Wine should also be regarded as separate from other alcohol containing beverages because wine is unique in that it is the only alcoholic beverage to not only contain alcohol but also nature ' s most potent antioxidants namely resveratrol, quercitin and eipcatechin and wine has the best mode of consumption because it is usually sipped slowly over a long period of time accompanying a meal, whereas beer and spirits do not contain these potent antioxidants and are usually consumed on an empty stomach thus greatly increasing their alcohol's absorption rate.
The main components that give wine its health benefits are alcohol and the polyphenol antioxidants. Alcohol is responsible for reduced clot formation (by increased fibrinolysis, reduced fibrinogen and reduced platelet aggregation), and raised good cholesterol (HDL) levels - all of which help reduce vascular disease. The antioxidants are responsible for the rest of the health benefits of wine such as lowering bad cholesterol (LDL) levels, preventing bad cholesterol ' s incorporation in the vessel wall to form plaque (because LDL has to be oxidised to perform this function), stabilising plaque because the antioxidants reduce plaque inflammation which makes the plaque rupture, aid blood vessel walls to be more mobile thus helping them expand during heart contractions or systole and reducing damage to DNA, which can trigger cancer formation.
As Louis Pastuer stated wine is also "the most healthful and hygienic of all beverages". This has been shown very clearly by the Copenhagen City Heart Study which was the first study ever to compare the death from all causes rates of beer, wine and spirits. It is a very robust study being large in size with 19,220 participants, long in duration having started in 1976 and involving both men and women. Dr. Marten Gronbaek the study's director summed up the findings thus: -
" Low to moderate intake of wine is associated with lower mortality- up to 50% - from cardiovascular and cerebrovascular disease and other causes. Similar intake of spirits implied an increased risk - up to 34% - while beer drinking did not affect mortality"(6) Later follow-ups and reviews of this study have reconfirmed and re-enforced wines significant health benefits and difference to beer and spirits from a health benefit point of view.
The Zutphen Study in the Netherlands is another study that shows wine is different to the other forms of alcohol. In this study , 1,373 men born between 1900 and 1920 were examined several times from 1960 to 2000. The study showed that long term alcohol consumption of 20 gms/day increased life expectancy compared to abstainers by 2 ½ years on average due to reduced cerebrovascular , cardiovascular and all cause mentality; while long term wine consumption increased life expectancy compared to abstainers by 5 years on average.
Another study has also shown wine is not only healthful but also different to others forms of alcohol. " In a study conducted by the Department of Family Medicine at the Medical University of South Carolina and published in the March 2008 issue of the American Journal of Medicine, researchers found that middle-aged non-drinkers who began consuming moderate amounts of alcohol saw an immediate benefit of lower cardiac disease morbidity with no change in mortality after four years.
Studying 7,697 people between 45 and 64 who were non-drinkers and who were participating in the Atherosclerosis risk in Communities (ARIC) study over a 10 year period, the authors found that 6% began moderate alcohol consumption (1 drink per day or fewer for women and 2 drinks per day or fewer for men) during the follow-up period. After 4 years of follow-up, new moderate drinkers had a 38% lower chance of developing cardiovascular disease than did their non-drinking counterparts. Even after adjusting for physical activity, Body Mass Index, demographic and cardiac risk factors, this difference persisted.
The study also identified a subset of new drinkers who consumed only wine.
When comparing non-drinkers to wine-only drinkers, drinkers of other types of alcohol, and heavy drinkers , the wine-only drinkers had the most significant reduction in cardiovascular events. Drinkers of other types of alcohol also had an advantage over non-drinkers, but the difference did not reach statistical significance".(8)
So the Copenhagen City Heart Study, the Zutphen Study and the ARIC Study are robust long term longitudinal studies that prove wine is different and better than the other forms of alcohol, from a health point of view.
Why is this so? A 34 year long follow-up study of 1,462 women in Goteborg , Sweden comparing the effect of beer, wine and spirits on the incidence of dementia in these women, showed women who consumed wine only had the lowest rate of dementia. " Results show that wine and spirits displayed opposing associations with dementia.
Because a protective effect was not seen for the other beverages, at least part of the association for wine may be explained by components other than ethanol". (9) The antioxidants (polyphenals) which are only in wine are five times more potent than the standard benchmark antioxidants VitC and Vit E, plateauing at 100% antioxidant activity after a few glasses and these antioxidants reduce insulin resistance thus help to significantly reduce diabetes, block damage being done to DNA in our cell nuclei thus reduce cancer and increase the activity of MAP kinase in the brain and reduce cerebral vascular disease thus help reduce dementia by up to 80% (an incredible figure) (10)
Antioxidants, especially resveratrol in wine, stimulate a nerve enzyme called Mitogen Activated Protein (MAP) kinase which stimulates nerve cells and helps them regenerate their dendrites or nerve interconnections . Thus Dr. Alberto Bertelli from University of Milan, the world authority on the subject states "By daily reinforcing these contacts we can prevent neurodegeneration" (Such as dementia and Parkinson' s disease).
The Copenhagen City Heart Study not only looked at vascular disease incidence and risk factors but it also revealed a lot of other medical information as well such the effect of the amount and type of alcohol on the risk of dementia. The researchers concluded " ... .. . ....... intake of wine is associated with a lower risk of dementia....... suggest that certain substances in wine may reduce the occurrence of dementia " .(11)
Free Radicals are the poisonous waste products from our metabolism which cause biological havoc to our bodies. The antioxidants from wine neutralize the effect of these Free Radicals, thus protecting our bodies from degeneration and aging i.e. cytoprotection or preventing cell death.
Macular Degeneration causes blindness in 30% of all people over the age of 65 (that is a lot of blindness). It cannot be treated once it is established, but it can be prevented and the only thing that helps prevent it is consuming wine in moderation which reduces the Macular Degeneration rate by up to 34% (12)
The biggest health benefit from consuming wine in moderation daily though comes from the up to 50% reduction in vascular disease. This is not only coronary heart disease but the whole vascular tree to include the brain (strokes), aorta (aneursyms), veins (DVT) and kidneys (50% of renal failure is due to vascular disease). Vascular disease is the biggest cause of death in our society accounting for about half of all deaths.
Again studies have shown a difference between wine and other alcoholic beverages. One good example is the meta-analysis of 26 studies on the relationship between wine and beer consumption and vascular disease carried out by an Italian research group in 2002. They concluded "These findings show evidence of a significant inverse association between light-to-moderate wine consumption and vascular risk. A similar, although smaller association was also apparent in beer consumption studies. The latter finding, however, is difficult to interpret because no meaningful relationship could be found between different amounts of beer intake and vascular risk".(13)
Latest medical research is showing that vascular disease is a chronic inflammatory disease , like rheumatoid arthritis , involving the internal lining of the vessel wall called the endothelium. Thus the new focus of research now is emphasizing the anti inflammatory effect on the endothelium to prevent rupture of atherosclerotic plaque and subsequent clotting that results in the obstruction of the blood vessel and death of the tissue supplied by that vessel. The antioxidants in wine significantly reduce this inflammation and clotting, thus reducing vascular disease deaths by up to 50%. This is a whole new exciting area of benefit and role for wine ' s antioxidants, not only involving complementary antioxidant mechanisms but also new alternative biological mechanisms for wine's polyphenols.
Normally bad cholesterol (LDL) is oxidised and then incorporated into the vessel wall to form atherosclerotic plaque which eventually swells up , then ruptures. This rupture is closed off by clot which is the final event that causes an occlusion of the vessel. Now the endothelial inflammation theory explains why someone can have a large stable, full of scar tissue binding it together, plaque for decades which does not rupture and someone else can have a small but unstable or inflamed plaque , which does rupture at an early age and kills them. As mentioned earlier the anti-oxidants in wine help reduce vascular disease by five different mechanisms .
One of these anti-oxidants has an extra vital role to play and is another point of difference between wine and other alcoholic beverages; and would help to explain the results of the Zutphen study which showed that wine drinkers lived the longest.
Professor David Sinclair; a fellow Australian also from Sydney's northern suburbs and a fellow graduate from the University of NSW (he gained his PhD there and I gained my medical degree) from the Anti-Aging Laboratory at Harvard' s School of Medicine has shown that resveratrol stimulates Sirt I, the Sirtuin gene that makes organisms live longer by increasing the activity of their mitochondria or the cell ' s powerhouse. The only other way to trigger Sirt I activity is by a 30% caloric restriction.
The new Resveratrol Enhanced Wine containing up to 100mg/1 of resveratrol, compared to 1-2mg/l in current white wines and 3-6mg/l in current red wines , developed and patented by Dr. Philip Norrie means that white wine drinkers no longer have to feel that they are drinking an inferior product compared to red wine drinkers.
The only downside to consuming wine is if it is abused , but if it is consumed in moderation daily then only health benefits will result. Hippocrates (460-370BCE , Greek
Physician and father of modem medicine) said we should let food be our medicine and that " wine is fit for man in a wonderful way provided it is taken with good sense by the sick as well as the healthy" . Wine needs to be consumed daily as the antioxidants (like vitamins) cannot be stored hence need to be ingested daily.
To paraphrase Abraham Lincoln " The problem of alcoholism is not the use of a bad thing, but the abuse of a very good one". The members of the wine industry are not purveyors of poison, as the anti-alcohol lobby groups would have us believe, but actually delayers of death and will help you to die young as late as possible, just like the medical profession.
In summary - wine is different to all other alcoholic beverages because it also contains nature's most potent antioxidants and it is consumed in the most healthful way.
SUMMARY OF BENEFITS
1. Reduced vascular disease which kills up to 50% of us resulting : -
(a) Reduced Coronary Heart Disease by up to 50%(14)
(b) Reduced Ischaemic Stroke (Ischaemic strokes account for 90-95% of all strokes)(l 5)
(c) Reduced Deep Vein Thrombosis by up to 50% (16)
(d) Reduced Ostoeporosis (17)
(e) Increased Intellect in the Elderly(9)
(f) Reduced Macular Degeneration (a common cause of blindness) by up to 34%(12)
(g) Reduced Renal Failure (up to 50% ofrenal failure due to Vascular disease)(l 8)
2. Tonic - wine contains many substances including most vit amins , minerals , trace elements , proteins and carbohydrates (1)
3. Fat and cholesterol free source of carbohydrate(l)
4. Reduced cancer because the Antioxidants in wine block free radicals causing damage to the cell's nucleus (19)
5. Reduced blood pressure (20)
6. Antiseptic due to alcohol and more importantly polyphenols (21)
7. Increases morale and appetite - nursing home and hospital patients (30) + (5)
8. Wine contains Quercetin, Resveratrol and Epicatechin, which are Nature' s most Potent antioxidants and also act as anti-carcinogens (22)
9. Reduction in colds/ URTI by up to 85% (23)
10. Diabetes reduced by up to 50% because the antioxidants reduce insulin resistance. Dry wine best alcoholic drink that is allowed with diabetes as all the sugar has been converted to alcohol.(24)
11. Reduced gallstones by up to 30% (25)
12. Reduced kidney stones by up to 39% (26)
13. Reduced Alzheimer' s disease and multinfarct (stroke) forms of dementia by up to 80%(9)
14. Reduced Parkinson ' s disease (27) 15 . Improved digestion (5)
16. Reduced H. Pylori infection of the stomach and duodenum leading to reduced Ulcers (28)
17. Improved physical and intellectual condition in the elderly (10)
18. Reduced Hepatitis A (29)
19. Reduced stress and depression (30)
20. Reduced essential tremor (3I)
21. Reduced tooth decay (32)
22. Reduced cancer of the prostate by up to 50% (33)
References
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(2) Rankine ,B. , Making Good Wine. A Manual of Winemaking Practice for Australia and New Zealand. Pan MacMillan Aust. P/L, 1993.
(3) Willett , W., Harvard ' s New Mediterranean Diet Guidelines Include Wine, Research News Bulletin, The Wine Institute , Vol.2, No. I , January 1993
(4) Ellison , R., Alcohol in the Mediterranean Diet , American Journal of Clinical Nutrition, (65) pp13785-12825, 1995
(5) Wine in Nutrition Study , Bulletin of the Society of Medical Friends of Wine, Vol. 17 No. l , February 1975
(6) Gronbaek , M., Mortality Associated with Moderate Intakes of Wine, Beer or Spirits. British Medical Journal, Vol.310,6th May 19 95, pp1165-1169
(7) Streppel, M..Tetal, Long -term wine consumption is related to cardiovascular mortality and life expectancy independently of moderate alcohol intake. Zutphen Study , Journal of Epidemiology and Community Health, 30 April , 2009, doi:1 O. l l 36/jech2008.082198, p. l
(8) Moderate alcohol consumption in middle age can lower cardiac risk www.bio-medicine-org/medicine-news-l / moderate alcohol consumption in middle age can lower cardiac risk, 3/7/2008,p l
(9) Mehlig, K. eta l; Alcoholic Beverages and Incidence of Dementia :3 4-year follow up of the Prospective Population Study of women in Goteborg , American Journal of Epidemiology 2008, Vol.167, Number 6 ,pp. 684-691, abstract
(10) Orgogozo, M., etal Wine Consumption and Dementia in the Elderly: A Prospective community study in the Bordeaux area, Revue Neurologique , Vol.153 No.2,1997
(11) Truelsen, T. ,eta l; Amount and type of alcohol and risk of dementia. The Copenhagen City Heart Study. Neurology 2002; Vol.59, pp.131 3-1319, Conclusion
(12) Obisesan, T.O. , eta) Moderate wine consumption is associated with decreased odds of developing age-related macular degeneration in National Health and Nutrition Examination Survey (1971-1975). Journal of the American Geriatrics Society 1998 ,46(I), pp1-7
(13) Castelnuovo. A., eta l; Meta-Analysis of Wine and Beer Consumption in Relation To Vascular Risk, Circulation, 2002; 105:2836 , Conclusion
(14) Renaud, S. Wine , Alcohol, platelets, and the French paradox for coronary heart disease. The Lancet Vol. 339, 20 June 1992, pp 1523-1526
(15) Rodgers H., Alcohol and Stroke: A case Control Study of Drinking Habits Past and Present. Stroke Vol. 24,1993, pp 1473-1477
(16) Maale j, N.., Antithrombotic Effect of Flavonoids in Red Win e, Wine Nutritional and Therapeutic Benefits, American Chemical Society, Washington D.C.1997
(17) Alcohol and Stronger Bones - The Newly Emerging Evidence , Wine Issues Monitor, The Wine Institute , San Francisco 1997
(18) Bertelli, A., eta!; Resveratrol, a component of Wine and Grapes, in the Prevention of Kidney Disease in Alcohol and Wine in Health and Disease , Annals of the New York Academy of Sciences, 2002 Vol. 957, pp230-238
(19) Renaud, S, Alcohol and Mortality in middle aged men from Eastern France, Epidemiology, 1998, Vol.9,No.2
(20) Jackson, R, Alcohol consumption and blood pressure. American Journal of Epidemiology, Vol.122,NO.6 ,4th April , l985, pp1037- l 044
(21) Weisse, M., eta!, Wine as a digestive aid comparative antimicrobial effects of bismuth salicylate and red and white wine , British Medical Journal, 1995 Vol.311, pp1657-1660
(22) California Wines and their antioxidant activity in inhibiting oxidation of Human Low-Density Lipoproteins, Journal of Agricultural Food Chemistry,1995 Vol43 pp890-894
(23) Takkouche , B. , eta !., Intake of Wine , Beer and Spirits and the Risk of Clinical Common Cold, American Journal of Epidemiology 2002 , Vol.155, No.9, pp853- 858
(24) Rimm , E., eta!. , Prospective study of cigarette smoking, alcohol use and the risk of diabetes in men , British Medical Journal, 1995 , Vol310 , pp555-559 and Lazarus,R. , etal, Alcohol intake and insulin levels : the Normative Aging Study, American Journal of Epidemiology, 1997, Vol 145, pp909-916
(25) Maclure , K. eta!., Weight Diet and the Risk of Symptomatic Gallstones, New England Journal of Medicine , August 19
(26) Curham , G., eta l., Prospective study of beverage use and the risk of kidney stones, America! Journal of Epidemiology, I 996 , Vol.143 .,No.3, pp240-247
(27) Bertelli, A., etal, Resveratrol, Map kinases and neuronal cells: might wine be a neuroprotectant? Drugs under Experimental and Clinical Research, 1999, Vol .XXV (2/3)pp99- l 03
(28) Brenner, H., etal. Alcohol consumption and Helicobacter Pylori infection: Results from the German National Health and Nutrition Survey, Epidemiology, 1999, Vol.IO pp214-218
(29) Alcohol in Moderation Gateway website
(30) Lipton, R., The effect of moderate alcohol use on the relationship between stress and depress ion, American Journal of Public Health, 1994, V0184, pp1913-1917
(31) Ford.G., The Science of Healthy Drinking, Wine Appreciation Guild 2003 Chapter 26 Essential Tremors pp261-266
(32) Daglia, M. et al, Antibacterial Activity of Red Wine and White Wine against Oral Streptococci, J.Agric. Food Chem., 2007,55,5038-5042
(33) Stanford,J.L., Alcohol Consumption and Risk of Prostate Cancer in Middle Aged Men, Int.I . Cancer, 2004 Aug 25