Wine and Health
Cancer prevention and Red Wine
Red wine is a rich source of biologically active phytochemicals, chemicals found in plants. Particular compounds called polyphenols found in red wine, such as catechins and resveratrol, are thought to have anti oxidant or anti cancer properties.
What are polyphenols and how do they prevent cancer? Polyphenols are antioxidant compounds found in the skin and seeds of grapes. When wine is made from these grapes, the alcohol produced by the fermentation process dissolves the polyphenols contained in the skin and seeds. Red wine contains more polyphenols than white wine because the making of white wine requires the removal of the skins after the grapes are crushed. The phenols in red wine include catechin, gallic acid, and epicatechin.
Polyphenols have been found to have antioxidant properties. Antioxidants are substances that protect cells from oxidative damage caused by molecules called free radicals. These chemicals can damage important parts of cells, including proteins , membranes, and DNA . Cellular damage caused by free radicals has been implicated in the development of cancer. Research on the antioxidants found in red wine has shown that they may help inhibit the development of certain cancers.
What is resveratrol and how does it prevent cancer? Resveratrol is a type of polyphenol called a phytoalexin, a class of compounds produced as part of a plant's defense system against disease. It is produced in the plant in response to an invading fungus , stress , injury, infection, or ultraviolet irradiation. Red wine contains high levels of, resveratrol as do grapes, raspberries, peanuts, and other plants.
Resveratrol has been shown to reduce tumor incidence in animals by affecting one or more stages of cancer development. It has been shown to inhibit growth of many types of cancer cells in culture . Evidence also exists that it can reduce inflammation . It also reduces activation of NF kappa B, a protein produced by the body's immune system when it is under attack. This protein affects cancer cell growth and metastasis . Resveratrol is also an antioxidant.
What have red wine studies found? The cell and animal studies of red wine have examined effects in several cancers including leukemia , skin , breast and prostate cancers . Scientists are studying resveratrol to learn more about its cancer preventive activities. Recent evidence from animal studies suggests this anti-inflammatory compound may be an effective chemopreventive agent in three stages of the cancer process: initiation, promotion, and progression.
However, studies of the association between red wine consumption and cancer in humans are in their initial stages. Although consumption of large amounts of alcoholic beverages may increase the risk of some cancers, there is growing evidence that the health benefits of red wine are related to its nonalcoholic components .
Wine's antioxidant assets
Of late, there has been a spate of reports emanating from the medical community citing wine's effects upon health based on the presence of those components other than alcohol, - says Dr. Harvey Finkel, clinical professor of medicine at Boston University Medical Center and chairman of the Committee on Health of the Society of Wine Educators.
Much of the new data supports the basic premise discussed in my past commentaries: Moderate consumption of wine and other alcoholic beverages is associated with a longer and healthier life than that of abstainers (an observation supported by a great mass of published evidence). While at least half of the benefits associated with wine consumption appear to be derived from the alcohol itself (conversely, alcohol, when abused, is the only component of wine that adversely affects health), there are other components of wine that contribute to the same benefits, but they are more complex and variable, and less precisely defined.
Alcohol's health benefits chiefly favor the cardiovascular system, and are dramatically reflected in reduced risks of atherosclerotic heart attacks, ischemic strokes and limb amputations due to compromised blood supply. Scientific views on the healthful effects of wine's other compounds are not as unanimous, however, but are under increased scrutiny. We are just beginning to peel back the layers of understanding.
Most intriguing are the poly-phenolic flavonoids, which can be referred to as antioxidants, according to their most attractive function. Found in grapes, chiefly the skins, their concentrations tend to be higher in red wines (when skins are included in fermentation) than white (when skins are culled). Their functions in the vine are only partially known, antifungal for one.
These antioxidants are less available in other alcoholic beverages. Among the best known, and most biologically active, are resveratrol, quercetin and the catechins.
The antioxidants with which we are concerned are a class of phytochemicals, compounds of vegetable origin. They are not exclusive to grapes, although grapes are richly endowed with them. They are also found in allium vegetables (onions, leeks, garlic, shallots), broccoli, spinach, blueberries, strawberries, tea and chocolate.
For some time, there was doubt about whether antioxidants could be absorbed when ingested as foods and whether they were biologically potent. The most current research has erased any doubt that the antioxidants remain vital when consumed this way. They appear to be even more active than the more renowned antioxidant vitamins A, C and E.
At or near the top of the list of causes of death and disability (some the product of human instigation, others not) are diseases of the heart and blood vessels, cancer and degenerative disorders. While the cause and aggravation of these ills may be multiple and varied, free radicals and the process of oxidation also figure heavily into the formula.
Free radicals (not a political term!) are highly reactive compounds produced normally as the body uses oxygen. Factors such as smoking, radiation and certain chemicals enhance their production, thus straining, and sometimes over-whelming, the body's natural, enzyme-mediated antioxidant defense system. For this reason, there is much interest in supplementing the anti-oxidants derived from food and drink.
Some of mankind's most insidious diseases are suspected of being able to be relieved to some degree by antioxidants, among them heart attack, stroke, other complications of blood-vessel disease, cancer, Alzheimer's disease and other dementias and degenerative disorders, immune dysfunction, cataract and macular degeneration. Aging itself may be retarded by antioxidants. Precise formulas for the relief of these conditions are not yet known. There is reason to believe that antioxidants may not always be entirely benign.
Recent studies of the cardio-vascular system report reduction of the risk of heart attack in the elderly by a diet high in vitamin A (but not vitamins C or E), reduction in the risk of ischemic stroke associated with the antioxidants found in fruits and vegetables (but no benefit from vitamins A, C or E), and improved coronary artery function apparently due to vitamin C.
The antioxidants in wine and grape juice favorably modulate the blood clotting that climaxes heart attacks and strokes; they help further by relaxing blood vessels and inhibiting the oxidation of LDL (the "bad") cholesterol to its dangerous form. Similar, but less-established, benefits may result from the antioxidant flavonoids found in tea and chocolate, virtually identical to those of wine.
Second in importance to their cardiovascular benefits are wine's antioxidant actions against cancer. As a consequence of its antibacterial effects and the scavenging of destructive superoxides to reduce tissue injury, these compounds may prevent cancers of the stomach and other organs.
The antioxidant quercetin has been noted to inhibit the growth of cancer and leukemia cells, and to potentiate anti-cancer chemotherapy. One report has resveratrol initiating a process one might term cancer-cell suicide, but another suggests that antioxidant vitamins may do the opposite, resulting in larger brain tumors in mice. (No harm comes to cancer-free mice of this strain.)
While the above mentioned data is solid, the demonstrated or suspected benefits of the antioxidants discussed below are still preliminary.
- Improved brain and muscle function also has been associated with moderate wine consumption and with inclusion of blueberries, strawberries and spinach in one's diet. One of the most compelling studies compared sets of aging twins. The co-twin of each pair who consumed an average of one to two drinks a day scored higher intellectually than their counterparts who drank significantly more or less.
- A number of very nasty bacteria and viruses are inactivated by wine and by grapes (but, surprisingly, in some cases not by alcohol).
- One report suggests that antioxidants may help prevent toxemia in pregnancy.
- Long noted, but unexplained, has been a disparity between the number of alcohol calories ingested and weight gain. A peek into the mystery may be offered by the recent observation that catechin polyphenols (flavonoid antioxidants, as found in wine and green tea), stimulate the "burning" of body fat.
An ascetic teetotaler might be inclined to ask, why not eat just fruits and veggies, and shun alcohol?
Fear not, there are reasons enough to quaff. Alcohol, in moderation, contributes at least half of wine's cardiovascular benefits, and likely provides numerous other health benefits, and little, if any, risk. In fact, it may even enhance the desired actions of the antioxidants in the enriching form of wine, which is a package that can't be beat.
Jefferson study shows Red Wine more heart-healthy than Gin
When the choice is red wine or gin, choose red wine – at least when considering your heart's health.
That's according to a recent study by researchers at Jefferson Medical College (JMC) of Thomas Jefferson University in Philadelphia , who compared the effects of drinking either red wine or gin on several biochemical markers in the blood. Red wine contains many complex compounds including polyphenols, which are absent from gin. The researchers found that drinking red wine had a much greater effect in lowering levels in the bloodstream of so-called “anti-inflammatory” substances that are risk factors in the development of heart disease and stroke.
The results, which appeared recently in the journal Atherosclerosis , didn't surprise co-author Emanuel Rubin , MD , who led the study.
“It's clear from these results that while drinking some form of alcohol lowers inflammatory markers, red wine has a much greater effect than gin,” says Dr. Rubin, Distinguished Professor of Pathology at JMC.
Determining alcohol's effect in reducing heart attack and stroke
While there are well-known associations between alcohol and a lowered risk of heart attack and stroke – the so-called “French paradox,” for example – Dr. Rubin says that “breaking down the data epidemiologically” has been difficult.
To find evidence related to alcohol's effect in reducing heart attack and stroke, he and his colleagues at the University of Barcelona turned to “surrogate” or substitute markers of disease. Inflammation, he notes, has long been implicated in the development of atherosclerosis and coronary artery disease. “High levels of c-reactive proteins and other markers of inflammation in the blood are risk factors that have been implicated in coronary artery disease and ischemic stroke,” he says.
The Jefferson-led team compared the effects of red wine and gin on the levels of inflammatory biomarkers in the blood, including adhesion molecules, chemokines and white blood cells that are related to atherosclerosis. According to Dr. Rubin, no clinical trials have been done comparing the effect of red wine to that of alcoholic beverages with low levels of non-alcoholic substances, such as polyphenols.
In the first part of the study, the researcher gave 20 subjects in two groups two drinks a day of either wine or gin for 28 days. That was followed by a “washout period” of 15 days with no alcohol. In the second part of the trial, those who received red wine the first time then were given gin. Those who had gin first then received red wine. The researchers measured levels of biomarkers before and after each half of the trial. They attempted to rigorously control subjects diets.
Both wine and gin showed anti-inflammatory effects. Both groups had reduced levels of fibrinogen, which clots blood but is not an inflammatory marker, and IL-1, which is. Raised levels of fibrinogen are a risk factor for heart attack.
But red wine also dramatically lowered the levels of inflammatory molecules such as adhesion molecules, and proteins in monocytes and lymphocytes.
Longer-Term Studies Needed to Prove Benefit. Dr. Rubin argues that one or two glasses of red wine a day may be beneficial, and that there is some degree of protection from heart disease and stroke by alcoholic beverages in general. Still, the results are only indirect evidence and can't prove a protective effect against the development of atherosclerosis. The study is far too brief to analyze a process that takes years to develop. “It's tough to root out just what is going on,”- says Dr. Rubin .- “There will have to be long-term epidemiological studies done.”
Weighing the health benefits of wine
A growing number of studies show that wine has surprising health benefits. But it's well known that consuming alcohol can carry real risks, too.
Medical Editor Mary Ann Childers reports what you need to know before saying "bottom's up." They call it the French paradox: the fact that the French, despite having a similar high-fat diet and higher rates of smoking, have lower rates of cardiovascular disease than Americans. Could it be because they drink more red wine?
"I'd love to give you a real definite yes or no, but we don't know yet," said Dr. Richard Stein, M.D. with the American Heart Association.
But we do know wine is full of powerful anti-oxidants, called flavonoids, and resveritrol. Studies show these grape compounds can slow Alzheimer's disease, and cut the risk of ulcers, some cancers, macular degeneration, type-2 diabetes, and hypertension.
"One to two glasses of wine a day either has your blood pressure come down, or stay the same," said Dr. Stein .
There's also evidence that wine raises good cholesterol and prevents blood clots. Light to moderate drinking has been linked to lower rates of heart disease and stroke.
"Here we have now evidence gathering that, yes, it's definitely got a lot of health benefits," explained Dr. Ara Ter-Marderosian, Ph.D. at the University of the Sciences.
But experts caution those health benefits can turn quickly to health risks.
"Once you get up to 4 or more glasses, or the equivalent of that, you start to notice an increase in blood pressure with an increase in heart risk that outweighs the benefit of wine," said Dr. Stein .
And there's the very real problem of alcohol addiction.
"Then you have the physicians on this side saying, 'Well, there are a lot of people who are alcoholics, what about that?'," said Dr. Ter-Marderosian .
Dr. Ter-Marderosian , who's an expert in medicinal chemistry, says think of drinking one 5-ounce glass of red wine the same way you would taking a once-a-day multi-vitamin. "It has to be consistent, long-term and more or less like eating certain foods which have a lot of phytochemicals in them, then you derive the benefit," she said.
The American Heart Association stops short of recommending red wine as a way to prevent heart disease. "I would much rather you start walking 30 minutes a day, cut some really high-fat foods out of your diet, give up smoking," said Dr. Stein .
But if you're going to indulge, think moderation. The American Heart Association says that is one to two glasses a day for men; one glass for women. "If wine will make you sit down for a little longer and relax with your meal, it could be very much a part of a healthy lifestyle," said Dr. Stein .
Why red wine is healthier
Scientists may have discovered the reason why red wine appears to protect the heart. Numerous studies have suggested that moderate alcohol drinking helps to reduce the likelihood of heart disease. The so-called "Mediterranean diet", which includes a larger intake of wine, has been credited with lower rates of heart disease in those countries, despite a higher intake of saturated fats. However, there is no clear evidence that red wine is any better than any other alcoholic drink.
But a team of scientists from Barts and the London School of Medicine , and the Queen Mary University in London , may have found a mechanism which points to the benefits of red wine. They say it appears to interfere with the production of a body chemical which is vital to the process which clogs up arteries and increases the risk of a heart attack.
Researchers link red wine to “good cholesterol”
Researchers in France have found differences in red wine drinkers' “good cholesterol,” which could account for the drink's beneficial effects against cardiovascular disease.
Researchers analyzed the high-density lipoprotein composition of teetotalers, regular drinkers and heavy drinkers (most of whom generally drank red wine). They found that HDL cholesterol increased as alcohol consumption increased, and that HDL particles from wine consumers were richer in certain components that can play a protective role in cardiovascular disease.
The well-documented relationship between moderate consumption of alcohol — particularly red wine — and reduced risk for heart attack may be partly explained by alcohol's relationship to increased levels of HDL. The new research provides an in-depth look at that connection.
“This study provides, for the first time, a detailed characterization of HDL composition in regular drinkers,” writes lead author Bertrand Perret of the French medical research institute Inserm. The study appears in the August-2005 issue of
Alcoholism: Clinical and Experimental Research
Forty-six men between ages 35 and 65 participated in the study. Their dietary patterns, including alcohol intake, were examined through a process in which a dietitian helped participants recall their food consumption over the previous three days. The men also completed an extensive questionnaire on their drinking habits. They were categorized into three groups on the basis of their self-reported alcohol consumption: teetotalers, regular drinkers (who drank less than 35 grams of alcohol each day), and heavy drinkers (who drank 35 to 60 grams of alcohol each day).
After participants fasted overnight, their blood samples were analyzed for HDL and other components related to cardiovascular disease. Researchers analyzed the nutrition data and collected information on smoking and medical history, including current blood pressure and physical activity, to mitigate the possibility that other factors caused the HDL differences in the three groups.
“Our study shows that the increase in HDL levels observed in regular drinkers is associated with an enrichment of HDL particles in polyunsaturated phospholipids, and particularly in those containing omega-3 fatty acids, an effect that might be, in itself, beneficial against cardiovascular diseases,” says Perret. He calls for further research to test the possible mechanisms underlying the differences in HDL fatty acid composition observed in this study.
This study was supported by INSERM ( Institut National de la Sante et de la Recherche Medicale , France ) and by ONIVINS ( Office National Inter-professionnel des Vins , France ).
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